Health Care Facility Planning Part II - Outpatient Clinic - Essay Example

Read Me First Week Three Introduction Three people were at work on a construction site. All were doing the same job, but when each was asked what the job was, the answers varied. ''Breaking rocks,'' the first replied. ''Earning my living,'' the second said. ''Helping to build a cathedral,'' said the third. -- Peter Schultz Over the past 20 years, the building industry has had increasing regulatory requirements for health care facilities. Regulations are an important aspect in a facility planning and design phase.

There are many federal, state, and local regulations; as well as many infection control and health care specific regulatory requirements. These regulatory agencies are important so that our health care facilities are designed in the safest, securest, most functional design. It is important to recognize some of the leading regulatory agencies including: Federal 1. International Building Code 2. National Electrical Code 3. Americans with Disabilities Act (ADA) 4. National Fire Protection Association (NFPA) 101 Life Safety Code for Healthcare Occupancies. 5. OSHA 6.

CLIA governs clinical laboratories 7. Medicare and Medicaid Conditions of Participation State 1. State health planning; Certificate of Need (CON) laws still apply in some states 2. State licensing agency (Department of Health, Aging or Senior Services) 3. State fire codes enforced by the State Fire Marshall 4. State building codes Local 1. Planning and zoning laws 2. Local building codes 3. Local fire department and city-specific fire requirements 4. Architectural/detailed construction plans must be approved and a building permit issued before construction begins 5.

Will conduct periodic surveys of the construction in progress (Haywood, 2006). If the completed project will be accredited (by JCAHO, CARF/CCAC, other), architectural plans should be reviewed to assure compliance with applicable standards. It is also critical to understand that state and department of health regulations are changing, such as the hospice industry by expanding Medicaid to pay for freestanding hospices (Solnik, 2003). These regulatory changes impact the design of the healthcare facility; thus the designs for hospices are going to become less in the home and more in a healthcare building.

While planning them health care facility design you must consider that all licenses and permits required for operating the facility (must be in place before the facility opens). The waste management plan must be addressed for new healthcare facilities. As a facility design planner, you will need to focus on such things as sorting of waste, handling, interim storage (short term before final disposal), and final disposal of all types of waste. All this is important especially the consideration of record keeping of these waste exchanges.

Over the past 20 years, the building industry has become much regulated, and healthcare facilities are the most regulated of all facilities. Disaster planning or emergency management (guidelines defined by the Department of Homeland Security) are important regulatory considerations in today’s world. According to Rosenfeld (2005), every national disaster brings new regulations. An example would be the black out in 2003 which stimulated the need for regulations on emergency generators in hospitals.

Hospitals are forced to rely on regional and national preparedness as seen with Katrina. Licensing and certifying prior to opening the new facility is a big event. The state licensing agency will conduct a survey of the completed facility. If all requirements are met, the license to operate will be issued. After state operating license has been issued and the first patients have been admitted, Medicare/Medicaid surveyors will arrive to check for compliance with the Medicare and Medicaid Conditions of Participation.

If the facility is in substantial compliance, the facility will be certified to receive payment for Medicare and Medicaid patients. This week in relationship to the course and the program This workshop will focus on learning the many different regulatory agencies overseeing that healthcare is safe and quality focused. Legal and regulatory issues will be explored during this workshop and there will be a focus on how they impact the many different types of health care facilities. We will also examine the variations between local, state, and federal legal and regulatory requirements (OSHA, HIPAA, JCAHO, CMS).

This workshop will help you develop a plan for regulatory issues such as waste management, fire and safety, and disaster management (Home Land Security). Hints for a reading strategy of the assigned materials Part of the initial task is to become accustomed to the acronyms for many of the regulatory agencies. This workshop will also assist you in clearly understanding the regulatory acronyms such as: JCHAO, CMS, CLIO, OSHA, etc. This is important when discussing healthcare planning designs because many architects already have studied and know these regulations; but as the facility design project manager you may also need to point out where architect’s designs failed to comply.

 Failure to comply with any of the regulations will delay the opening of the project. Many times the project manager will be held responsible for the on time completion and successful opening of the facility. Your readings will assist you with this task. It is also important to focus your readings on the main regulatory agencies for the varying health care facilities such as long term care, hospice, radiology, behavioral health, hospitals, etc. There are many examples where the regulations change based on the healthcare facility.

Some questions to ask as you hone your critical thinking As you read the material, create “why” and “what” questions that will sharpen your ability to apply these concepts. Start asking you self some of the following critical thinking questions: How do regulations affect facility design decisions? How do accreditation standards affect design decisions? How does zoning change your options for healthcare facility designs? Are there similar regulations from one regulatory agency to another – which standard should you follow if they are similar?

Why does NFPA require that wall and floor coverings as well as certain fabrics used in the healthcare facility be fire rated? How does disaster or emergency response planning differ from on type of healthcare agency to another? These are just a few of the planning questions related to regulatory compliance that may be helpful to explore. Summary In summary, workshop three focuses on the regulatory agencies standards for the healthcare facility design. Your understanding of these regulations and why they exist is important for your planning for any facility designing project.

Whether it is fire codes, building codes, zoning, or safety codes, your knowledge of the regulatory agencies and their main objectives assists in planning for a safe healthcare facility. References Hayward, C. (2006). Healthcare facility planning: Thinking strategically. Health Administration Press, Chicago. Rosenfeld, N. (2005, October) Critique: Whose rules? Contract. 47(10), 1-11. Solnik, C. (2003) Hospice care moving from homes to facilities. Long Island Business News. 50(20), 4B.