Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Indoor Air Quality Requirements

For over a decade now the JCAHO has taken an increasing interest in indoor air quality (IAQ) issues. In the early 1990’s JCAHO recommended that hospitals develop an IAQ plan as part of the facilities “Safe Environment of Care Inspection Process”. In 1997 a handbook on IAQ termed “A Guide to Managing IAQ in Health Care Organizations” was published by JCAHO. This handbook included sections on:

* Risk factors for occupational exposures

* Recognizing these risks and implementing an IAQ program

* Economic considerations and the benefits of IAQ programs

* Appendices included: IAQ sampling checklists, inspection logs and complaint forms.

Beginning in 1999, JCAHO announced that they were modifying their Utility Management Standard to include checking, testing, and management of IAQ issues. Then in 2004, requirements were added to address the importance of monitoring IAQ during construction and renovation projects. Now in 2005, these requirements have evolved and expanded into several standards as follows:

* EC.1.10 Management of Safety Risks. Requires facilities to “conduct proactive risk assessments that evaluate the potential adverse impact of buildings, grounds, equipment, occupants, and internal physical systems on the safety and health of patients, staff, and other people coming to the facility”.

* EC.7.10 Utility Management Plan. Requires each facility to “reduce the potential for hospital-acquired illness to be transmitted through the utility systems”.

* EC.7.30 requires facilities to maintain, test, and inspect its utility systems. Requires documentation of inventory and maintenance of utility components, consistent with maintenance requirements identified in the utility management plan (EC.7.10 noted above).

* EC.8.10 requires facilities to establish and maintain an appropriate environment, including verification that current “ventilation provides for acceptable levels of temperature and humidity and eliminates odors”.

* EC.8.30 IAQ Management During Construction. Requires facilities to use “risk criteria that address the impact of demolition, construction, or renovation on air quality requirements, infection control and utility requirements”.

* EC.9.10 addresses Measuring and Improving Activities related to the conditions in the environment.

These JCAHO requirements have been the standard operating procedure of Healthy Buildings International Inc in commercial, industrial and health care facilities since our incorporation in 1980. Furthermore, the regular comprehensive inspection reports not only support JCAHO accreditation by way of documentation, but also, prove due diligence and build a valuable resource should the facility ever be the subject of speculative plaintiff litigation. In practice, regular Proactive Monitoring (biannual, nine-monthly, or annual) appears to strike the optimum balance between cost and usefulness and with such comprehensive testing. Healthcare facilities employing programs such as HBI’s Proactive IAQ Inspection and Monitoring Program and HBI’s IAQ Monitoring During Construction will meet JCAHO, local, state and all currently known national standards.

In the case of private hospitals, Veteran’s Affairs Medical Centers, outpatient health care facilities and nursing homes, all the newfound attention to the indoor environment, and its impact on the organization, has elevated the status of the facility manager. But along with that elevated status has come increased responsibility to ensure that the indoor environment is indeed a healthy one. In the case of the health care administrator, that responsibility has become magnified. In a setting whose primary reason for existence is the restoration and maintenance of human health, any outside force working to erode that principle tenet cannot be tolerated. Attainment of good Indoor Air Quality (IAQ) gives the health care administrator an almost moral imperative to act proactively.

Proactive Indoor Air Quality Inspection and Monitoring Program

HBI was the pioneer in designing and implementing proactive IAQ programs. Starting in 1980, HBI’s diverse professional staff has been applying extensive experience to address any IAQ related concern or problem an engineer, safety manager, or facility manager might face. Today, HBI remains the preeminent firm with experience embracing 3,500 buildings in no less than 45 countries. This unparalleled experience lends confidence that HBI’s findings are accurate, the recommendations are realistic, and the report and certificate of inspection received carry the weight of prominent credibility.