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JCI ‘Facility Management and Safety

(FMS)’ standards are crafting safest
hospital buildings’ equipment and
.(!)systems, with disaster readiness
Follow DR M Zakirul KARIM
3 3 54 … nternational Hospital, Vietnam

Most hospitals were built over many years with different systems added and varying levels of
maintenance performed. This has created complex healthcare facilities that risk instability because each
system typically operates disparately yet is critical to the infrastructure. The hospital infrastructure has
thousands of pieces of equipment and system parts, ranging from massive boilers, switch-gear, and
uninterruptible power supplies (UPS), to sensors that go virtually unnoticed. So how can ensure the
hospital building is safe and has the ability to offer uninterrupted care for the long term? Creating the
safest hospital is as much about having full visibility into the building’s overall status as it is about
actual resources to fix problems. Today, the safest, most profitable hospitals are run by those who have
their finger on the pulse of their buildings’ equipment and systems, identifying problems before they
negatively affect their hospital. Besides, A Health Buildings Risk Assessment allows prioritizing and /
 creating a performance improvement plan that optimizes capital and operational expenditures. Critical
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equipment failure brings unexpected costs and the possible loss of revenue-generating services. It can
significantly impact patient care/satisfaction and employee safety, while increasing exposure to
litigation and negative public relations. Environment of Care standards require hospitals to maintain
their buildings and understand the health of their utility systems. Another concern is during times of
climatic disasters, people often make it a point to head to local hospitals in the hopes of finding safety
from the storm. After an investigation by Consumer Reports, it has become apparent that flocking to
nearby hospitals may not be the safest option, especially when so many people do it. Studies found that
most hospitals have out of date generators, which are often placed in poor locations, and many other
factors that could lead to complications within the building. These problems are made worse if the
natural disaster shuts down the electricity in the region and issues with generators have raised some
questions in regards to hospital safety problems during times of natural disaster. Another safety
challenges during disaster for hospitals are the loss of services. Natural disasters can cut off the
electricity, water and supply chain in many locations. In most hospitals, generators are more than fifty
years old and are found in the basement, where they are not protected from flooding. Another issue is
the lack of regulation for installing backup generators, and there is no transparency for the public when
dealing with hospitals that fail generator tests. Other issues include the loss of infrastructure, such as
electronic records, a shortage of workforce due to transportation loss, or injury, or illness, as well as a
drastic increase in the number of patients with severe illnesses or injuries. Even a relocation of care to
an alternate location is not enough to help, as it will not be well equipped enough for the influx of
patients. Therefore, the JCI (Joint Commission International) accreditation standards for hospital in 5th
edition is discussing about Facility Management and Safety (FMS). This FMS is the fourth chapter
belongs to Section-III which contains another two chapters. The JCI hospital accreditation standards
manual of 5th edition covers 304 standards and 1218 Measurable elements (MEs) which are compatible
with local needs of the patient. However, this FMS chapter contains twenty three (23) standards and
eighty nine (89) measurable elements. The chapter also addresses nine topics for examples (1)
Leadership and Planning, (2) Safety and Security, (3) Hazardous Materials, (4) Disaster Preparedness,
(5) Fire Safety, (6) Medical Technology, (7) Utility Systems, (8) Facility Management Program
.Monitoring, and (9) Staff Education

Leadership and Planning: Local authorities’ laws, regulations, and inspections determine in large (1)
part how a facility is designed, used, and maintained. All hospitals, regardless of size and resources,
must comply with these requirements as part of their responsibilities to their patients, families, staff,
and visitors. Such requirements may differ depending on the facility’s age and location and other
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 factors. For example, many building construction codes and fire safety codes, such as for sprinkler
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systems, apply only to new construction. Hospitals begin by complying with laws and regulations.
Hospital leadership, including governance and senior management, are responsible for knowing what
national and local laws, regulations, and other requirements apply to the hospital’s facilities;
implementing the applicable requirements or approved alternative requirements; and planning and
budgeting for the necessary upgrading or replacement as identified by monitoring data or to meet
applicable requirements and providing evidence of progress toward implementing the improvements.
When the hospital has been cited for not meeting requirements, hospital leadership takes responsibility
for planning for and meeting the requirements in the prescribed time frame. To manage the risks within
the environment in which patients are treated and staff work requires planning. The hospital develops
one master program or individual programs that include; a) Safety and Security Safety—the degree to
which the hospital’s buildings, grounds, and equipment do not pose a hazard or risk to patients, staff,
and visitors Security—Protection from loss, destruction, tampering, or unauthorized access or use; b)
Hazardous materials—Handling, storage, and use of radioactive and other materials are controlled, and
hazardous waste is safely disposed; c) Emergencies—Response to epidemics, disasters, and
emergencies is planned and effective; d) Fire safety—Property and occupants are protected from fire
and smoke; e) Medical technology—Technology is selected, maintained, and used in a manner to
reduce risks; f) Utility systems—Electrical, water, and other utility systems are maintained to minimize
the risks of operating failures. Such programs are written and are up to date in that they reflect present
or recent conditions within the hospital’s environment. There is a process for their review and updating.
When the hospital has non-hospital entities within the patient care facilities to be surveyed (such as an
independently owned coffee shop or gift shop), the hospital has an obligation to ensure that these
independent entities comply with the facility management and safety programs. Hospitals work to
provide safe, functional, and supportive facilities for patients, families, staff, and visitors. To reach this
goal, the physical facility, equipment, medical technology, and people must be effectively managed. In
particular, management must strive to reduce and control hazards and risks; prevent accidents and
injuries; and maintain safe conditions. Effective management includes multidisciplinary planning,
education, and monitoring as follows: Hospital leadership plans the space, technology, and resources
needed to safely and effectively support the clinical services provided; All staff are educated about the
facility, how to reduce risks, and how to monitor and to report situations that pose risk; Performance
criteria are used to evaluate important systems and to identify needed improvements. Hospitals need to
develop a facility/environment risk management program that addresses managing environmental risk
through the development of facility management plans and the provision of space, technology, and
resources. One or more individuals provide oversight to the program. In a small hospital, one individual
may be assigned part-time. In a larger hospital, several engineers or other specially trained individuals
may be assigned. Whatever the assignment, all aspects of the program must be managed effectively and
in a consistent and continuous manner. Program oversight includes: a) planning all aspects of the
program, such as development of plans and providing recommendations for space, technology, and
resources; b) implementing the program; c) educating staff; d) testing and monitoring the program; e)
periodically reviewing and revising the program; and f) providing annual reports to the governing body
on the effectiveness of the program. Depending on the hospital’s size and complexity, a
facility/environment risk committee may be formed and given responsibility for overseeing the
program and program continuity. The topic of FMS contains three (03) standards, and ten (10)
:measurable elements, and the standards are
Standard FMS. 1: The hospital complies with relevant laws, regulations, and facility inspection .1
.requirements
Standard FMS. 2: The hospital develops and maintains a written program(s) describing the .2
.processes to manage risks to patients, families, visitors, and staff
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 Standard FMS. 3: One or more qualified individuals oversee the planning and implementation of .3
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.the facility management program to reduce and control risks in the care environment

Safety and Security: The terms safety and security are often used synonymously in many (2)
countries; however, here they are defined differently. Safety refers to ensuring that the building,
property, medical and information technology, equipment, and systems do not pose a physical risk to
patients, families, staff, and visitors. Security, on the other hand, refers to protecting the organization’s
property and the patients, families, visitors, and staff from harm. Prevention and planning are essential
to creating a safe and supportive patient care facility. Effective planning requires the hospital to be
aware of all the risks present in the facility. The goal is to prevent accidents and injuries; to maintain
safe and secure conditions for patients, families, staff, and visitors; and to reduce and to control hazards
and risks. This is also important during periods of construction or renovation. As part of the safety
program, the hospital develops and implements a comprehensive, proactive risk assessment to identify
areas in which the potential for injury exist. Examples of safety risks that pose a potential for injury or
harm include sharp and broken furniture, linen chutes that do not close properly, broken windows,
water leaks in the ceiling, and locations where there is no escape from fire. This periodic inspection is
documented and helps the hospital design and carry out improvements and budget for longer-term
facility upgrading or replacement. Construction and renovation pose additional risks to the safety of
patients, families, visitors, and staff, and include risk related to infection control, ventilation, traffic
flow, garbage/refuse, and other risks. A pre-construction risk assessment is helpful in identifying these
potential risks, as well as the impact of the construction project on services provided. The risk
assessment should be performed during all phases of construction. In addition to the safety program, the
hospital must have a security program to ensure that everyone in the hospital is protected from personal
harm and from loss or damage to property. Staff, vendors, and others identified by the hospital, such as
volunteers or contract workers, are identified by badges (temporary or permanent) or other form of
identification. Others, such as families or visitors in the hospital, may be identified depending on
hospital policy and laws and regulations. Restricted areas such as the newborn nursery and the
operating theatre must be secure and monitored. Children, elderly adults, and other vulnerable patients
unable to protect themselves or signal for help must be protected from harm. In addition, remote or
isolated areas of the facility and grounds may require the use of security cameras. This part consists of
:three (03) standards, and nine (09) measurable elements, and the standards are

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 Standard FMS. 4: The hospital plans and implements a program to provide a safe physical .1
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.facility through inspection and planning to reduce risks
Standard FMS. 4.1: The hospital plans and implements a program to provide a secure .2
environment for patients, families, staff, and visitors
Standard FMS. 4.2: The hospital plans and budgets for upgrading or replacing key systems, .3
buildings, or components based on the facility inspection and in keeping with laws and regulations

Hazardous Materials: A hazardous materials program is in place that includes identifying and (3)
safely controlling hazardous materials and waste throughout the facility. World Health Organization
(WHO) identifies hazardous materials and waste by the following categories: (a) Infectious waste; (b)
Pathological and anatomical waste; (c) Hazardous pharmaceutical waste; (d) Hazardous chemical
waste; (e) Waste with a high content of heavy metals; (f) Pressurized containers; (g) Sharps; (h) Highly
infectious waste; (i) Genotoxic/cytotoxic waste; and (j) Radioactive waste. The hospital considers these
categories identified by WHO when developing an inventory of hazardous materials and waste. The
hazardous waste program starts by doing a thorough search for all areas within the facility where
hazardous materials and waste may be located. Documentation of this search should include
information about the locations, types, and quantities of hazardous materials and waste being stored and
should be updated when the location, storage, type, and quantities of hazardous materials has changed.
The hazardous materials program includes processes for the inventory of hazardous materials and waste
that includes the material, the quantity, and the location; handling, storage, and use of hazardous
materials; proper protective equipment and procedures during use, spill, or exposure; proper labeling of
hazardous materials and waste; reporting and investigation of spills, exposures, and other incidents;
proper disposal of hazardous waste; and documentation, including any permits, licenses, or other
regulatory requirements. Information regarding procedures for handling or working with hazardous
materials in a safe manner must be immediately available at all times and includes information about
the physical data of the material (such as its boiling point, flash point, and the like), its toxicity, what
effects using the hazardous material may have on health, identification of proper storage and disposal
after use, the type of protective equipment required during use, and spill-handling procedures, which
include the required first aid for any type of exposure. Many manufacturers provide this information in
the form of Material Safety Data Sheets (MSDS). This part contains two (02) standards and nine (09)
:measurable elements; and the standards are
Standard FMS. 5: The hospital has a program for the inventory, handling, storage, and use of .1
.hazardous materials
Standard FMS. 5.1: The hospital has a program for the control and disposal of hazardous .2
.materials and waste

Disaster Preparedness: Community emergencies, epidemics, and disasters may directly involve the (4)
hospital, such as damage to patient care areas as a result of an earthquake, or a flu epidemic that keeps
staff from coming to work. The development of the program should begin by identifying the types of
disasters that are likely to occur in the hospital’s region and what the impact of these disasters would
have on the hospital. For example, a hurricane or tsunami is more likely to occur in areas where the
ocean is near but unlikely to occur in countries surrounded by land. Facility damage or mass casualties
on the other hand could potentially occur in any hospital. It is just as important to identify the effects of
a disaster as it is to identify the types of disasters. This helps in planning the strategies that are needed
in the event that a disaster occurs. For example, what is the likelihood that a natural disaster, such as an
earthquake, will affect water and power? Could an earthquake prevent staff from responding to the
disaster, either because roads are blocked or because they or their family members are also victims of
the event? In such situations, staff personal responsibilities may be in conflict with the hospital
requirements for responding to an emergency. In addition, hospitals need to identify their role within /
 the community. For example, what resources will the hospital be expected to provide to the community
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in the event that a disaster occurs, and what communication methods will be used within the
community? To respond effectively, the hospital develops a program to manage such emergencies. The
program provides processes for a) determining the type, likelihood, and consequences of hazards,
threats, and events; b) determining the hospital’s role in such events; c) communication strategies for
events; d) the managing of resources during events, including alternative sources; e) the managing of
clinical activities during an event, including alternative care sites; f) the identification and assignment
of staff roles and responsibilities during an event; and g) the process to manage emergencies when
personal responsibilities of staff conflict with the hospital’s responsibility for providing patient care.
The disaster preparedness program is tested by an annual test of the full program internally or as part of
a communitywide test; or testing of critical elements c) through g) of the program during the year. If the
hospital experiences an actual disaster, activates its program, and debriefs properly afterward, this
situation represents the equivalent to an annual test. This section describes one (01) standard and five
:(05) measurable elements; and standard is
Standard FMS. 6: The hospital develops, maintains, and tests an emergency management .1
program to respond to emergencies, epidemics, and natural or other disasters that have the potential of
.occurring within their community

Fire Safety: Fire is an ever-present risk in a hospital. Thus, every hospital needs to plan how it will (5)
keep its occupants safe in case of fire or smoke. In addition, non-fire emergencies, such as a toxic gas
leak, can pose a threat to occupants. A hospital establishes a program in particular for the prevention of
fires through the reduction of risks, such as safe storage and handling of potentially flammable
materials, including flammable medical gases such as oxygen; hazards related to any construction in or
adjacent to the patient-occupied buildings; safe and unobstructed means of exit in the event of a fire;
early warning, early detection systems, such as smoke detectors, fire alarms, and fire patrols; and
suppression mechanisms, such as water hoses, chemical suppressants, or sprinkler systems. These
actions, when combined, give patients, families, staff, and visitors’ adequate time to safely exit the
facility in the event of a fire or smoke. These actions are effective no matter what the age, size, or
construction of the facility. For example, a small, one-level brick facility will use different methods
than a large, multilevel wooden facility. The hospital’s fire safety program identifies the frequency of
inspecting, testing, and maintaining fire protection and safety systems, consistent with requirements;
the program for safely evacuating the facility in the event of a fire or smoke; the process for testing all
portions of the program during each 12-month period; the necessary education of staff to effectively
protect and to evacuate patients when an emergency occurs; and the participation of staff members in at
least one fire safety test per year. A test of the program can be accomplished in multiple ways. For
example, hospitals can assign a “fire marshal” for each unit and have him or her randomly quiz the staff
about what they would do if a fire occurred on their unit. The staff can be asked specific questions, such
as, “Where is the oxygen shutoff valve? If you have to shut off the oxygen valve, how do you take care
of patients who need oxygen? Where are the fire extinguishers on your unit located? How do you report
a fire? How do you protect the patients during a fire? If you need to evacuate patients, what is your
process?” Staff should be able to respond correctly to these questions. If they do not, this should be
documented and a strategy for reeducation developed. The fire marshal should keep a record of those
who participated. Hospitals may also develop a written test for staff to take relating to fire safety as part
of testing the program. All inspections, testing, and maintenance are documented. The fire safety
program that addresses limiting smoking applies to all patients, families, staff, and visitors; and
eliminates smoking in the hospital’s facilities or minimally limits smoking to designated non–patient
care areas that are ventilated to the outside. The fire safety program that addresses limiting smoking
identifies any exceptions related to patients, such as the medical or psychiatric reasons a patient may be
permitted to smoke, and those individuals permitted to grant such an exception. When an exception is /
 made, the patient smokes in a designated, non-treatment area, away from other patients. This part
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:consists of three (03) standards and twelve (12) measurable elements; standards are
Standard FMS. 7: The hospital establishes and implements a program for the prevention, early .1
detection, suppression, abatement, and safe exit from the facility in response to fires and non-fire
.emergencies
Standard FMS. 7.1: The hospital regularly tests its fire and smoke safety program, including any .2
.devices related to early detection and suppression, and documents the results
Standard GLD. 7.2: The fire safety program includes limiting smoking by staff and patients to .3
.designated non–patient care areas of the facility

Medical Technology: To ensure that medical technology is available for use and functioning (6)
properly, the hospital performs and documents an inventory of medical technology; regular inspections
of medical technology; testing of medical technology according to its use and manufacturers’
requirements; and performance of preventive maintenance. Qualified individuals provide these
services. Medical technology is inspected and tested when new and then on an ongoing basis, according
to the technology’s age, use, and manufacturers’ instructions. Inspections, testing results, and any
maintenance are documented. This helps ensure the continuity of the maintenance process and helps
when doing capital planning for replacements, upgrades, and other changes. The hospital has a system
in place for monitoring and acting on medical technology hazard notices, recalls, reportable incidents,
problems, and failures sent by the manufacturer, supplier, or regulatory agency. Some countries require
reporting of any medical technology that has been involved in a death, serious injury or illness.
Hospitals must identify and comply with the laws and regulations pertaining to reporting of medical
technology incidents. The medical technology management program addresses the use of any medical
technology with a reported problem or failure, or that is the subject of a hazard notice or is under recall.
:This section contains two (02) standards and eight (8) measurable elements; the standards are
Standard FMS. 8: The hospital establishes and implements a program for inspecting, testing, and .1
.maintaining medical technology and documenting the results
Standard FMS. 8.1: The hospital has a system in place for monitoring and acting on medical .2
.technology hazard notices, recalls, reportable incidents, problems, and failures

Utility Systems: Utilities can be defined as the systems and equipment that support essential (7)
services that provide for safe health care. Such systems include electrical distribution, water, ventilation
and airflow, medical gases, plumbing, heating, waste, and communication and data systems. Effective
utility function throughout the hospital creates the patient care environment. The safe, effective, and
efficient operation of utility and other key systems in the hospital is essential for patient, family, staff,
and visitor safety and for meeting patient care needs. Patient care, both routine and urgent, is provided
on a 24-hour basis, every day of the week in a hospital. Thus, an uninterrupted source of essential
utilities is critical to meeting patient care needs. A good utilities management program ensures the
reliability of the utility systems and minimizes the potential risks. For example, waste contamination in
food-preparation areas, inadequate ventilation in the clinical laboratory, oxygen cylinders that are not
secured when stored, leaking oxygen lines, and frayed electrical lines all pose hazards. To avoid these
and other hazards, the hospital has a process for regularly inspecting such systems and performing
preventive and other maintenance. During testing, attention is paid to the critical components (for
example, switches and relays) of systems. Hospitals should have a complete inventory of all utility
systems components and identify which components have the greatest impact on life support, infection
control, environmental support, and communication. The utility management program includes
strategies for utility maintenance that ensure that these key systems components, such as electric, water,
waste, ventilation, and medical gas, are regularly inspected, maintained, and, when necessary,
improved. Patient care, both routine and urgent, is provided on a 24-hour basis, every day of the week /
 in a hospital. Hospitals have different utility system needs based on their mission, patient needs, and
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resources. However, an uninterrupted source of clean water and electrical power is essential to meet
patient care needs. Regardless of the type of system and level of its resources, a hospital needs to
protect patients and staff in emergencies, such as system failure, interruption, or contamination. An
emergency power system is required for all hospitals that intend to provide continuous service under
emergency conditions. Such a system provides sufficient power to maintain essential functions during
power failures. It also reduces the risks associated with such failures. Emergency and backup power
sources are tested under planned circumstances that simulate actual load requirements. Improvements
are made when necessary, such as enhancing electrical service to areas with new medical technology or
other equipment. Water quality can change suddenly from many causes, some of which occur outside of
the hospital, such as a break in the supply line to the hospital. When there is a disruption in the usual
source of water supplied to the organization, emergency potable water supplies must be immediately
available. To prepare for such emergencies, the hospital identifies the equipment, systems, and
locations that pose the highest risk to patients and staff (for example, it identifies where there is a need
for illumination, refrigeration, life support, and clean water for cleaning and sterilization of supplies);
assesses and minimizes the risks of utility system failures in these areas; plans emergency power and
clean water sources for these areas and needs; tests the availability and reliability of emergency sources
of power and water; documents the results of tests; and ensures that the testing of alternative sources of
water and electricity occurs at least quarterly or more frequently if required by local laws, regulations,
manufacturers’ recommendations, or conditions of the sources for power and water. Conditions of the
sources of power and water that may increase the frequency of testing include repeated repair of the
water system; frequent contamination of the water source; unreliable electrical grids; and recurrent,
unpredictable power outages. When the emergency power system requires a fuel source, the amount of
on-site fuel stored should take into account past outages and any anticipated delivery problems caused
by shortages, weather, and geographic conditions and locations. The hospital may determine the
amount of fuel stored unless an authority having jurisdiction specifies the amount. This part contains
:five (05) standards and twenty one (21) measurable elements and standards are
Standard FMS. 9: The hospital establishes and implements a program to ensure that all utility .1
.systems operate effectively and efficiently
.Standard FMS. 9.1: Utility systems are inspected, maintained, and improved .2
Standard FMS. 9.2: The hospital utility systems program ensures that potable water and electrical .3
power are available at all times and establishes and implements alternative sources of water and power
.during system disruption, contamination, or failure
Standard FMS. 9.2.1: The hospital tests its emergency water and electrical systems and .4
.documents the results
.Standard FMS. 9.3: Designated individuals or authorities monitor water quality regularly .5

Facility Management Program Monitoring: Monitoring each of the facility management (8)
programs through data collection and analysis provides information that helps the hospital prevent
problems, reduce risks, make decisions on system improvements, and plan for upgrading or replacing
medical technology, equipment, and utility systems. The monitoring requirements for the facility
management programs are coordinated with the requirements. Monitoring data are documented and
quarterly reports are provided to hospital leadership. This part contains one (01) standard and three (03)
:measurable elements and standard is
Standard FMS. 10: The hospital collects and analyzes data from each of the facility management .1
programs to support planning for replacing or upgrading medical technology, equipment, and systems,
.and reducing risks in the environment

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 Staff Education: Staff are the hospital’s primary source of contact with patients, families, and (9)
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visitors. Thus, they need to be educated and trained to carry out their roles in identifying and reducing
risks, protecting others and themselves, and creating a safe and secure facility. Each hospital must
decide the type and level of training for staff and then carry out and document a program for this
training and education. The program can include group instruction, printed educational materials, a
component of new staff orientation, or some other mechanism that meets the hospital’s needs. The
program includes instruction on the processes for reporting potential risks, reporting incidents and
injuries, and handling hazardous and other materials that pose risks to themselves and others. Staff
responsible for operating or maintaining medical technology receive special training. The training can
be from the hospital, the manufacturer of the technology, or some other knowledgeable source. The
hospital plans a program designed to periodically test staff knowledge on emergency procedures,
including fire safety procedures; the response to hazards, such as the spill of a hazardous material; and
the use of medical technology that poses a risk to patients and staff. Knowledge can be tested through a
variety of means, such as individual or group demonstrations, the staging of mock events such as an
epidemic in the community, the use of written or computer tests, or other means suitable to the
knowledge being tested. The hospital documents who was tested and the results of the testing. This
:section contains three (03) standards and twelve (12) measurable elements and standards are
Standard FMS. 11: The hospital educates, trains, and tests all staff about their roles in providing a .1
.safe and effective patient care facility
Standard FMS. 11.1: Staff members are trained and knowledgeable about their roles in the .2
.hospital’s programs for fire safety, security, hazardous materials, and emergencies
Standard FMS. 11.2: Staff are trained to operate and to maintain medical technology and utility .3
systems

Overall Required Written Policies (Including Those Required in English) in FMS: The standards
listed in the tables identify a requirement for eleven (11) written documents for FMS of which first one
should be in English. In some cases, that document is in the form of a policy and procedure. In other
cases, the document is less formal but addresses the issue identified in the standard. In many cases, a
number of standards requirements or MEs can be combined into one policy and procedure. Hospitals
may find it useful to group all related policies and procedures. The surveyor(s) may not need to review
all these documents in detail. However, to facilitate the review, it is best to gather all of the documents
into one book or identify each document by the corresponding standard number(s) if they are part of a
larger document. Some of these documents need to be provided to JCI surveyors in English, and these
documents are indicated in the “In English?” column in the tables. Other documents do not need to be
translated. For non-English documents, the survey team will have one member able to read the
documents, or alternatively, the survey team may request that one or more individuals be available to
.describe the contents of the document and answer questions concerning the document

It may be possible for a patient to have a positive experience of hospital care in an environment that
does not meet their needs, but there is no doubt that well-planned, well-designed, well-constructed,
well-run facilities enhance the delivery of treatment and care. The needs of patients change. Models of
care change. Ways of working change. The benefits of technology change. Hospitals must change to
keep pace, to remain fit for purpose. Hospitals are not buildings; they are systems through which a wide
range of healthcare services are delivered. They are not constrained by sites or boundaries, whether
physical, organizational or geographic. And yet the built environment is fundamental to the concept of
the hospital and needs to be treated accordingly. Hospitals are assets; they should be planned, designed,
operated, utilized and maintained in a way that befits their importance as a vehicle for the delivery of
.safe patient care and as a key contributor to the quality of the patient experience
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 Barry Rabner, president and CEO, Princeton HealthCare System, says the design process for his
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organization’s new hospital, University Medical Center of Princeton at Plainsboro (N.J.), helped him to
understand the relationship between good design and quality care. “It was a really big discovery for me
that the building was more than just a container that would hold people and things, but that it could, in
fact, be designed in a way that could help us to achieve important goals,” says Rabner. The project’s
goals included reducing the number of errors, falls and infections at the facility and improving patient
outcomes, patient and family satisfaction and the hospital’s financial performance. Safety was
considered important to all of these. A safe environment “results in better clinical outcomes, reduced
cost and higher satisfaction,” Rabner says. “And if you design the building well, as we’ve now come to
learn, it really can deliver on those objectives.” The facility is a zero-threshold building, with every
transition between rooms flush so as not to impede shoes, wheelchairs, walkers or any other form of
hospital transport. A handrail with a built-in nightlight leads from the patient bed to the bathroom.
Patient lifts are installed in the bariatric and ICU rooms; all patient rooms include the necessary
infrastructure to add lifts in the future. Hand-washing sinks are distributed throughout the facility, in
places like corridors and caregiver team areas, in addition to patient rooms. A hand-wash monitoring
system that uses radio-frequency identification technology is in use at the hospital. The patient rooms
are equipped with nurse servers, as well as bedside charting and medication scanning technology. By
designing the facility to limit staff interruptions and allow nurses to remain close to patients, the project
team endeavored to return two hours a day to caregivers for direct patient care. Safety features of the
same-handed rooms include ventilation with 100 percent fresh air; a hands-free, hand-washing sink and
soap dispenser; a nurse server for storing patient supplies (with a locked area for medications); a
computer for bedside charting; and a family zone with overnight accommodations. The flooring,
curtains and upholstery have antibacterial properties. A handrail leads from the patient bed to the
bathroom, which is located three feet from the head of the bed; the bathroom door slides for ease of
operation and the handrail features a low, recessed, wall-mounted, night-light fixture. The patient beds
can be lowered to 16 inches off the floor to reduce the impact of possible falls and have built-in scales,
pressure-relieving mattresses and a system for contacting nurses directly if high-risk patients attempt to
get up without assistance. The new design, along with staff training and improved technology and
equipment, has resulted in lower rates of falls, health care-associated infections and medication errors
.at the hospital
It will be combination effort of FMS standards and facility leader to involve into the patient safety
.goals where the patient's SAFETY always comes FIRST

DR M Zakirul KARIM DR
Follow … nternational Hospital, Vietnam M
Zakirul
KARIM
comments 3

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‫ ﺳﻨﺔ‬1 .Mansour H Mansour

Senior Clinical Engineer at Aldara Hospital and Medical Center
.H
thanks
‫إﻋﺠﺎب رد‬

/
 ‫ ﺳﻨﺔ‬2
‫اﻧﻀﻢ اﻵن‬ ‫ﺗﺴﺠﯿﻞ اﻟﺪﺧﻮل‬ KASHIF KHAN KASHIF
KHAN
Hazardous Materials Specialist at King Salman Military Hospital Tabuk, Saudi Arabia

I like your but please share hazmat safety according NFPA. Thanks
‫إﻋﺠﺎب رد‬

‫ ﺳﻨﺔ‬2 Ahmad Yousef Ahmad

Deputy CNO at Saudi German Hospital Riyadh
Yousef
thanks for this but if i can ask what the most appropriate FMS organizational structure if you
please
‫إﻋﺠﺎب‬ ‫إﻋﺠﺎب رد‬

‫ ﻣﻘﺎل‬101 DR M Zakirul KARIM ‫اﻟﻤﺰﯾﺪ ﻣﻦ‬

Don’t lose your ‘Power of Most difficult part in life is to use There is always darkness under the
!Survival’; Be a self-starter others understandable words in lamp. Let there be light at corporate
communication! Healthcare is NO !healthcare governance system
Don’t lose your ‘Power of !exception
…Survival’; Be a There is always darkness
M10 6 2019 Most difficult part in life is …under the lamp. Let
…to use others M10 10 2019
M10 8 2019

‫ﻧﺒﺬة ﻋﻨﺎ‬ 2019 ©

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