Environmental Business Council of New England

1
Emerging Regulatory Trends and Management Issues
for New England Hospitals and Healthcare
Facilities
Robert Castaldo Director, EHS Massachusetts
General Hospital Boston, MA
Environmental Business Council of New
England July 27, 2005
2

• Partners HealthCare Network
• Founding Members
• Massachusetts General Hospital
• Brigham Womens Hospital
• Other Members
• Faulkner Hospital
• McLean Hospital
• Newton Wellesley Hospital
• North Shore Medical Center
• MGH Institute of Health Professions
• Partners Community HealthCare
• Partners Continuing Care
• Harvard Teaching Affiliate

3

• Third Oldest Hospital in US Largest in New
  England
• 19,500 employees (includes 2,900 nurses)
• 3,600 member medical staff
• In- Patient Services
• Available Beds 893
• Average Occupancy Rate 80.47
• Admissions 44,518
• Average Length of Stay 5.83 days
• Admissions to Observe 5,285

4

• Ambulatory Services
• MGPO Visits 694,268
• Clinics Visits 417,203
• Health Centers Visits 299,232
• Emergency Visits 74,905
• Total Ambulatory Emergency 1,485,608
• Surgical Services
• In-Patient 17,957
• Ambulatory 15,013
• Total Surgical Cases 32,970
• Births 3,604

5
MGH Mission Clinical Care, Teaching and Research

• Almost all staff physicians are on
• the Harvard Medical School faculty
• Largest hospital-based research
• program in the US

6
Downtown Campus clinical research Charlestown
Navy Yard - research Community Centers -
clinical
7

• Current Operational Drivers of EHS Programming
• Hospital Growth and Renewal
• New Construction and Renovation
• New Emergency Management Demands
• HAZMAT Response Readiness
• Biosafety
• JCAHO
• Periodic Performance Review Process
• Patient Safety
• Specific Continual Regulatory Oversights
• EPA
• MWRA

8

• Hospital Growth and Renewal
• Major additions on the main campus
• Extensive backfill renovations
• Preparations for next major rebuilding project
• Impact on EHS
• Keeps facilities-related safety issues as an
  everyday
• priority
• Construction Impacts internal and external
• Fire Safety Management
• Life Safety Management
• Environmental Impacts asbestos, molds, ICRA

9

• Emergency Preparedness and Homeland Security
• HAZMAT Response Capabilities Greater
• expectations for hospitals
• Chemical Radiological Biological Incidents
  Mass
• Casualty Management
• Biosafety and Select Agent Rules Public Health
  Security
• and Bioterrorism Preparedness and Response Act
  
• Impact on EHS
• HAZMAT Incident Response heightened and
• continual readiness mass casualty focus
• More systematic oversight and control of
  biological
• research increased security re personnel
  and
• facilities

10
Chemical HAZMAT Response Teams
Risk Assessment Recruitment Training Drills
11
Location Visibility and Accessibility
Fleet Center Government Center Transportation
Hubs MGH
12

• Protect our patients
• Protect our staff
• Protect our facility
• Preserve the ability of MGH to serve the
  community in a large-scale disaster involving
  hazardous materials

13
(No Transcript)
14
(No Transcript)
15

• JCAHO Periodic Performance Review Process
• Changes JCAHO 3-year auditing process
• Now requires mid-cycle self-review
• Performance Improvement Plan submission
• Improvement Tracking
• Engineering surveyors now on the JCAHO team
• 2006 Patient Safety Goals
• Impact on EHS
• From a once every 3 year exercise to more
  continual
• quality management process in all areas
• Engineer surveyors up the ante with
  facilities-related
• management issues
• Align safety functions with current patient
  safety goals

16

• 2006 Patient Safety Goals
• Improve Accuracy of Patient Identification
• Improve Caregiver Communication
• Improve the Safety of Medications Usage
• Reduce Care-Associated Infections
• Reconcile Medications Across a Patients Care
• Continuum
• Reduce Harm from Patient Falls

17

• Specific Continual Regulatory Oversights
• EPA
• RCRA
• Contingency Planning and SPCCs
• Air Emissions
• Real Estate Assessment
• MWRA
• Mercury