Mitigate Long-term Care Infection and Other Risks: Train and Credential Healthcare Construction Personnel

Photo courtesy of the Green House Project, thegreenhouseproject.org

On March 17th of this year, my beloved mom passed away. Just nine days short of her 100th birthday, she had become quite challenged, and like many other Americans, required 24/7 care. She was fortunate to have escaped the ravages of COVID-19 and other healthcare-associated infections (HAIs). Tragically, even prior to this pandemic, about two million healthcare patients in the US acquire HAIs. HAIs delay recovery, significantly increase the cost of healthcare, and in tens of thousands of cases, result in death. HAIs can be decreased by learning about them and how to design and construct healthcare facilities with HAIs in mind.

Out of necessity, the COVID-19 pandemic has diverted attention and resources from more traditional HAIs in order to cope with the impacts of this new HAI. Older adults are particularly vulnerable. Infections and deaths are concentrated among those who reside and work in long-term care facilities, such as nursing homes, assisted living and memory care facilities. 10% of COVID-19 infections have been linked to these facilities, while COVID-19-related deaths associated with these facilities represent more than 40% of US pandemic fatalities.

As a result, many healthcare organizations face weakened occupancy rates, devalued assets, and increased capital costs. While some level of risk is inevitable, there are important recommendations from The Joint Commission, the organization that accredits 80% of US healthcare organizations, to improve the care environment, mitigate risk and protect business balance sheets as they engage in retrofitting existing facilities or building new ones.

A Pre-Construction Risk Assessment (PCRA) for planned and unplanned healthcare construction proactively addresses capital project construction risk. PCRA is the umbrella for Infection Control Risk Assessment (ICRA), as well as other healthcare-related construction risks that include noise; vibration, odor; security, maintenance; life safety; ventilation; utility systems; medical equipment; storing, transporting and delivering supplies and materials; and waste management.

Even prior to the COVID-19 pandemic, efforts were underway to raise the bar to protect the public through more advanced PCRA/ICRA. In a December 2019 publication of The Joint Commission, five expert healthcare authors urged all pre-construction, construction and maintenance workers to possess an ANSI/ASTM-accredited Pre-construction Risk Assessment/Infection Control Risk Assessment (PCRA/ICRA) Certificate as a prerequisite to work on healthcare construction projects. They cited the emergence or reemergence of infectious diseases, antimicrobial resistance, pollution, disturbing healthcare DART rates (days away, restricted, or transferred due to work-related illnesses or injuries), climate change and natural disasters as compelling reasons to ensure workers are properly qualified.

Currently, Green Advantage, a non-profit organization, offers the only ANSI/ASTM-accredited PCRA/ICRA Certificate Program available. Those who complete 12 hours of webinar training and pass an exam earn this valuable credential.

Because of their prominence in the marketplace, long-term healthcare organizations have great influence over the condition of healthcare facilities and the quality of healthcare. The ANSI/ASTM-accredited PCRA/ICRA Certificate Program represents an excellent opportunity for these organizations to benefit all stakeholders engaged in the industry by prioritizing utilization of credentialed construction personnel.

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About the Author

Grady O’RearGrady O'Rear is President/CEO of Green Advantage, Inc., a non-profit credentialing organization that promotes high performance, healthy built environments in the U.S. and Canada. It offers three ANSI-accredited credentials: The Green Advantage Certified Practitioner® (GACP®) for construction supervisory personnel; the Green Advantage Certified Associate® (GACA®) for construction field personnel; and a Pre-construction Risk Assessment/Infection Control Risk Assessment (PCRA/ICRA) Certificate Program for healthcare pre-construction, construction and maintenance personnel.

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