Regulations, Requirements, and Standards Paper

HCS/529

November 3, 2014

Regulations, Requirements, and Standards

A health facility should be safe for staff and patients in the facility. When planning the setup of the health facility the management should provide key safety measure that will make the facility safe to both the staff and the patients thus enabling a peaceful environment (Guenther & Vittori, 2008). The setup should include exit route in case of fire, fire extinguishers, adequate spacing of pathways to enable people to escape from the venue without causing a stampede. With high level safety measures the facility will be secure and safe for effective performance of tasks by medical staff. It will also be conducive for the patients and clients of the institution who come on daily basis for checkup. A safe environment for a health care facility is favorable as it enhances the safety standards of the institution. The facility should be on secure location for the sake of both the client and all staff working in it, as the institution is highly labor based the security of all people to use the facility should be put on consideration (Guenther & Vittori, 2008). In January of last year, the emergency room of Doctors’ Hospital of Michigan (DHM) closed and was later converted it into a 24-hour Urgent Care. This paper will discuss regulations, requirements, and standards that will affect facility design and renovation of DHM’s urgent care department. A health care should incorporate operational functions and sustainability design models. Detailed operational function and space programming begins the moment the project has been defined, approved, and funds have been allocated. The operational and space programming provides the green light for the architect to begin design. Operational function and space allocation provides a description of the nature of services and operational concepts. In addition the operational function addresses the facility layout, necessary equipment, staff accommodations, and potential for future growth. Many lives are dependent on how it manages its resources, especially water storage and supply and energy management.

The health care facility should be easily accessible to many people. Accessibility is a primary objective of both federal and local state government. Therefore with this kind of objective the health care facility should look for a strategic location which can be easily accessed from multiple locations by the target client base (Great Britain, 2006). The location should also be easily accessible for patients using public transportation and those with disabilities.

There are million of Americans with disabilities. The American with Disability Act (ADA) must be contemplated whether a new office is being constructed, renovations of an existing one, or moving directly into a facility that does not require any architectural design is flexible to fit each need. An important aspect of the planning process is reviewing and addressing any legal considerations for construction of the facility. The American with Disabilities Act places legal obligations on the facility managers to remove barriers and or provide auxiliary aids on the landlord and the tenant. The facility planning must include handicap parking, curbs and ramps, signage, doorway and adequate hallway width, and a door opening force.

All health care facilities must follow mandates from the Federal government, the state and the local institutions, which set the standards and guidelines to be followed when setting up a health care facility (US National Research Council & US National Research Council, 2011). Some of the necessary standards/certifications needed in accordance with renovation of the Ambulatory Care include: Certification of Need (CON), Health Insurance Portability and Accountability Act (HIPPA), Occupational Safety and Health Act (OHSA), Health and Safety Executive (HSE), and The Advisory Committee on Dangerous Pathogens (ACDP).

Certificate of Need programs in Michigan approve new facilities, renovations and/or new equipment that are based on a genuine need of the community. This program was originally put in place to regulate the number of beds in a medical facility in order to prevent the overbuying of expensive equipment. Obligatory rules through treatment development organizations decide the majority vital medical management needs, give to answer for the requirements, and effort to supervise the critical medical treatment needs, supply to solutions for essential care, and try to rising and falling in the cost often cause problems in the market (National Conference of State Legislatures, 2014). After the decision to store medical records electronically, there seemed to be apprehension concerning privacy and security issues of patient information. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) plays a vital part in the privacy and security of all patient information. HIPPA was formed as a way to protect patients and workers from having their personal health information shared among others outside their organization without verbal/written agreement from the person in question. With the evolution of electronic medical records, health care facilities must take extra precautions to make sure they stay within HIPAA standards.

Occupational Safety and Health Act of 1970 (OSHA) is part of the U.S. Department of Labor. OHSA was designed to inform individuals from injuries, illnesses, or deaths resulting from of anything job related, yet it still holds all employers accountable for safety of a workplace. It also offers job preparation, outreach, schooling, and support that the facility may need. Section 18 of OSHA allows every health care facility to develop their own safety and health care plans. OSHA places a severe set of federal protection criterion in which all companies must hold to. These standards deal with discarding of dangerous substances, employee protective gear such as goggles and ear plugs. OSHA inspects all health care facilities to make sure they are following all rules and decrease employees’ chances of mistakes or harm (Rouse, 2014). Health and Safety Executive (HSE) is the public self-governing for labor associate health, protection, and disease. HSE was created through the Health and Safety at Work Act 1974. The main objectives of this regulation, is to establish preparation, support, investigate, publicize, educate and inform the facility of its efforts. It also initiates protection for government divisions, managers, workers, their individual delegate companies, and other individuals that are given data and optional service and are maintain knowledgeable of, and effectively counseled on such situations (Health and Safety Executive, 2014). The Advisory Committee on Dangerous Pathogens (ACDP) is serviced by a link committee of Health and Safety Executive, the Department for Environment, Department for Food & Rural Affairs, and the Health Protection Agency since 2011. These committees inform all health care facilities and their employees on characteristics that are of danger and/or threat from coming in contact with bacteria or viruses. The group creates lists of common and foreign hazardous bacteria and viruses, the alert all health care facility about break outs, maintenance, and how to keep staff or others for contracting it. The group is also responsible for guiding workers how to handle biohazard materials in laboratories and how to dispose of the waste safety (Davis, 1995). In order for renovations the Ambulatory Care department of Doctors’ Hospital to be effective, it must begin with planning a foundation and end with a health risk assessment (HRA).
After the completion of design for the project the health care facility is responsible for conducting a HRA. This assessment determines any health risk, safety issues, infection control, air quality control, emergency management, noise and vibrations, and other issues that have the potential to be harmful. Planning and renovations must consider all Michigan requirements, regulations, standards and community needs of the patients being treated. A “textbook” urgent care facility design would be planned so that all essentials, needs, and requirements for medical staff would always be at their fingertips to easily service their patients. Architectural design and planning can help promote, inspire, and model human health and well-being (Guenther, 2008).

References

Davis, C., Categorization of Biological Agents According to Hazard and Categories of Containment. (1995). Crown, 2(4), 21-42.
Great Britain. (2006). Policies and principles: Best practice guidance for healthcare engineering. London: TSO (The Stationery Office).

Guenther, R., & Vittori, G. (2008). Sustainable healthcare architecture. Hoboken, N.J: John Wiley & Sons.

Health and Safety Executive. (2014). How HSE enforces health and safety. Retrieved from http://www.hse.gov.uk/enforce/enforce.htm
National Conference of State Legislatures. (2014, July 20). Certificate of Need: State Health Laws and Programs. Retrieved from http://www.ncsl.org/research/health/con-certificate-of-need-state-laws.aspx
National Research Council (U.S.)., & National Research Council (U.S.). (2011). Achieving high-performance federal facilities: Strategies and approaches for transformational change. Washington, D.C: National Academies Press.

Rouse, M. (2014). Occupational Safety and Health Administration (OSHA). Retrieved from http://www.searchcompliance.techtarget.com/definition/Occupational-Safety-and-Health-Administration-OSHA
United Stated Department of Justice. (2010). ADA standards for accessible design. Retrieved

from http://www.ada.gov/2010ADAstandards_index.htm