Presentation on theme: "2014 The Healthcare Environment"— Presentation transcript:
12014 The Healthcare Environment John Maurer, SASHE, CHFM, CHSPEngineering DepartmentThe Joint Commission1
22013/2014 Challenging standards The top 20 Issues
32014 Non Compliance, First 6 months Standard/NPSG2014 Non Compliance, First 6 months2013 Non ComplianceEC53%47%LS52%EC51%39%EC50%45%IC46%LS49%48%RCLSLS44%36%EC34%
42014 Non Compliance, First 6 months Standard/NPSG2014 Non Compliance, First 6 months2013 Non ComplianceMM32%35%PC29%27%EC21%PC18%MM24%22%PC20%LD23%19%LD14%ECMM16%
5Top 10 Cited Standards: 2011 – 2014 (YTD) 201320122011EC : Utility Systems Risks#1#4#10#13LS : Means of Egress#2EC : Built Environment#3#8#7#11EC : Fire Safety Systems#5LS : General Bldg Req’s#6LS : ProtectionLS : Extinguishment#9EC : HazMat & Waste#15
6#18 LDThe hospital effectively manages its programs, services, sites, or departmentsProblematic EP:EP 4: Staff are held accountable for their responsibilitiesUsed when leadership has allowed non compliance to exist without correctionSometimes used when situation is serious but does not warrant a “decision rule”
7What is your approach to ESC? Do you have a team approach or is one person responsible?Do you do what you need to do to “make it go away” or are the issues analyzed to determine why the non compliance is present?Do you use this standard ESC response: “We have re-educated the “Fill In The Blank”?”Have you looked at patient safety events and near misses/close calls in relation to non compliance identified during your survey?Have you considered what the short term and long term impact will be if you are unsuccessful in correcting the RFIs?
8What is your approach to ESC? Do you develop generic ESC or are your ESC specific to the root causes of the RFIs?Does the safety culture in your organization encourage staff and medical staff to identify system and process problems so they can be addressed quickly or do you wait until something happens or a surveyor finds it?When you develop your ESC do you find a way to incorporate it into daily activities and processes or do you lay it on top of everything else staff have to do?Is the culture in your organization one that allows the importance of the ESC to fade after a few months or is patient safety and compliance embedded in your mission/vision?
9Bottom Line! If you don’t address the issues the first time you will be continually be doing rework and patient safety and quality suffer!
10Some things to consider… Do you have the right people at the table to address the issues identified?Are you focusing on systems and processes and how to improve them?Have you had an issue with this requirement on previous surveys?What kind of follow up monitoring have you planned to determine whether or not the ESC has been effective over the long term?If you find that your ESC hasn’t worked how do you go about fixing that?
112014 The Healthcare Environment Standards Update 11
12Risk Icon Integrated into the Manuals, E-dition, AMP, & FSA Tool Proximity to patientProbability of harmSeverity of harmNumber of patients at riskRisk IconIntegrated into the Manuals, E-dition, AMP, & FSA ToolAll products will display a single icon at the EP levelfor three risk-focused categories:National Patient Safety GoalsAccreditation program-specific risk area standardsSelected direct/indirect impact standardsIn addition, the FSA Tool will use the R icon to identify the fourth risk category:RFI standards from current cycle survey events.
13Time RE-Defined The Joint Commission EC chapter defines time as: Daily, weekly, monthly are calendar referencesQuarterly is once every three months +/- 10 days effective January 1, 2014Semi-annual is 6 months from the last scheduled event month +/- 20 daysAnnual is 12 months from the last scheduled event month +/- 30 days3 years is 36 months from the last scheduled event month +/- 45 daysNOTE 1: The above does not apply to required frequenciesNOTE 2: An alternative of developing either a unique, written policy or adopting NFPA definitions when available is acceptable
14Quarterly: +/- 10 days Semiannual: +/- 20 days Annual: +/- 30 days Due Date+Due Date+10101010Scheduled MonthScheduled Month2020202030303030QuarterlyJanFebruaryMarchAprSemiannualJuneJulyAugSeptOctNovDecAnnualJanFMAMJJASONDJanFrequencies required by Code may not be modified(e.g. EC EP 4 & 7)
15Changes to Elements of Performance Effective 7/1/2014 EC , EP 3When quarterly fire drills are required, at least 50% are unannounced. Fire drills are held at unexpected times and under varying conditions.Added: “Fire drills are held at unexpected times and under varying conditions.”
16Changes to Elements of Performance Effective 7/1/2014 EC , EP 4Staff who work in buildings where patients are housed or treated participate in drills according to the hospital’s fire response plan.Note: When drills are conducted between 9:00 p.m. and 6:00 a.m., the hospital may use alternative methods to notify staff instead of activating audible alarms.Replaced: “…the buildings fire alarm system.”
17EC EP 18 Effective July 2, 2014For hospitals that use Joint Commission for deemed status purposes: Radiation workers are checked periodically, by use of exposure meters or badge tests, for the amount of radiation exposure
18EC EP 19 Effective July 2, 2014For hospitals that use Joint Commission for deemed status purposes: The hospital has procedures for the proper routine storage and prompt disposal of trash.
19EC EP 3When quarterly fire drills are required, at least 50% are unannounced. Fire drills are held at unexpected times and under varying conditions.Added: “Fire drills are held at unexpected times and under varying conditions.”
20EC EP 4Staff who work in buildings where patients are housed or treated participate in drills according to the hospital’s fire response plan.Note: When drills are conducted between 9:00 p.m. and 6:00 a.m., the hospital may use alternative methods to notify staff instead of activating audible alarms.Replaced “building’s fire alarm system.”See NFPA , “…a coded announcement shall be permitted to be used instead of audible alarms.”
22Clinical Alarms – Brief History In 2004 there was a NPSG on clinical alarmsGoal retired, survey the issue under Environment of CareECECCoP Physical EnvironmentClinical Alarm Device SummitHealthcare Technology Safety Institute (HTSI)Plan, Do, Check, Act: Using Action Research to Manage Alarms, Signals, and Responses
23Clinical Alarms – Brief History Number 1 on ECRI top 10 for 2013 and 2014Incidents of alarms being silenced or shut offDefault settingsIncidents of inadequate staffing to supportNo mechanisms for monitoring/respondingIncidents of “alarm fatigue”Overuse, too many types of alarms, etc.Patient deaths have occurred
24Clinical Alarms – Brief History PC : Resuscitation services are available throughout the hospitalPC : The hospital recognizes and responds to changes in the patient’s conditionLD EP3: Leaders provide for a sufficient number and mix of individuals to support safe, quality care, treatment and services. CoP (b) Nursing ServicesHR : Staff are competent to perform their responsibilities. CoP (b)(5) Nursing Services
25Clinical Alarms – Brief History EC : Equipment ManagementEP 2 InventoryEP 3 maintenance, inspection and testing activitiesEC : Equipment ReliabilityEP 2 Life support devicesEP 3 Non-life support devicesEC : Monitoring & ReportingContinually monitoring medical equipment problems or failures. CoP (c)(2) Patient Rights
26The Alarming Problem More and more devices and alarms More patients connected to alarms or alarm-based devicesalarms per patient per day in a typical critical care unitAlarm-based devices are not standardized in many organizationsInconsistent use of alarms due to flexible alarm setting features
30NPSG on Alarm Mgmt In Phase I (beginning January 2014) Hospitals will be required to:(by 7/14) establish alarms as an organization priority(during 2014) identify the most important alarms to manage based on their own internal situations.Input from medical staff and clinical deptsRisk to patients due to lack of response, malfunctionAre specific alarms needed or contributing to noise/fatiguePotential for patient harm based on internal incident historyPublished best practices/guidelines
31NPSG on Alarm Mgmt In Phase II (as of January 2016) Hospitals will be expected to:develop and implement specific components of policies and procedures that address at minimum:Clinically appropriate settingsWhen they can be disabledWhen parameters can be changedWho can set and who can change parameters and who can set to “off”Monitoring and response expectationsChecking individual alarm signals for accurate settings, proper operation and detectabilityeducate those in the organization about alarm system management for which they are responsible
32Questions to ConsiderHave you identified clinical alarm safety as a priority?Who is on the team addressing the NPSG?How far along are you in identifying the most important alarm signals to manage?What is your biggest challenge?Remember that the entire goal must be fully implemented by January of 2016!
33What’s in a Name?HTM: Healthcare Technology Management is the department name, which indicates that technology that impacts patient care is managed.CE: Clinical Engineer. 4 year Engineering degree with emphasis in Clinical Engineering.BME: BioMedical Engineer: 4 year degree, typically working in Research and Manufacturing for HealthcareBMET: BioMedical Equipment Technologist. Typically has a 2 or 4 year degree (or military equivalent), working directly in a healthcare setting.CBET: Certified Biomedical Equipment Technician. A formal certification by the International Certification Commission (ICC) for the BMET who achieve this certification
35S&C 14-07-Hospital S&C 12-07-Hospital Superceded A hospital may adjust its maintenance, inspection, and testing frequency and activities for facility and medical equipment from what is recommended by the manufacturer, based on a risk-based assessment by qualified personnel, unless:Other Federal or state law; or hospital Conditions of Participation (CoPs) require adherence to manufacturers’ recommendations and/or set specific requirements.For example, all imaging/radiologic equipment must be maintained per manufacturers’ recommendations; orThe equipment is a medical laser device; orNew equipment without a sufficient amount of maintenance history has been acquired.
36S&C HospitalThe organization inspects, tests & maintains New medical equipment or operating components of utility systems in accordance with manufacturers’ recommendations with insufficient maintenance history to support the use of alternative maintenance strategies.Maintenance history may be gathered from documented evidence such asProvided by the organization’s contractorsAvailable publically from nationally recognized sourcesThrough the organization’s experience over time
37ECStandard ECThe hospital manages medical equipment risksEC EP 1The hospital solicits input from individuals who operate and service equipment when it selects and acquires medical equipment.
38EC EP 2 Effective July 2, 2014For hospitals that do not use Joint Commission accreditation for deemed status purposes: The hospital maintains either a written inventory of all medical equipment or a written inventory of selected equipment categorized by physical risk associated with use (including all life-support equipment) and equipment incident history. The hospital evaluates new types of equipment before initial use to determine whether they should be included in the inventory.
39Maintaining Medical Equipment Inventory is populated based on one of two strategies:All equipment inclusionPhysical risk based processFor example, evaluating:FunctionRisk LevelsMaintenance RequirementUtilize resources, i.e. the FDA MAUDE reportAll life support equipment is includedAll new types of equipment evaluated for inclusion
40EC EP 2 continuedFor hospitals that use Joint Commission accreditation for deemed status purposes: The hospital maintains a written inventory of all medical equipment.
41Inventory Definitions Medical equipment—Fixed and portable equipment used for the diagnosis, treatment, monitoring, and direct care of individuals.Life-support equipment—Any device used for the purpose of sustaining life and whose failure to perform its primary function, when used according to the manufacturer’s instructions and clinical protocol, will lead to patient death in the absence of immediate intervention (for example, ventilators, anesthesia machines, heart-lung bypass machines, defibrillators).High-risk equipment—Any device or components of building utility systems for which there is a risk of serious injury or death to a patient or staff member if the device or component fails. High-risk equipment includes life support equipment.Source: Glossary from the Comprehensive Accreditation Manual for Hospitals, The Joint Commission.See also September 2014 Perspectives
42EC EP 3 Effective July 2, 2014The hospital identifies high-risk medical equipment on the inventory for which there is a risk of serious injury or death to a patient or staff member should the equipment fail.Note: High-risk medical equipment includes life-support equipment
43High-risk Medical Equipment High-risk equipmentIncludes Life SupportHeart/lung bypass machineAnesthesia equipmentCirculatory Assist EquipmentIABPLVADVentilationsAdult; Infant; MRI-CompatibleOther High-risk equipmentDefibrillatorsRobotic surgery devices
44Joint Commission Medical Equipment Medical equipment includes equipment used in for monitoring, such asBedside monitorsTelemetry monitors
45Joint Commission Medical Equipment Treatment, such asElectro-surgeryLasersDiathermyDiagnostic, such asLaboratory analyzersRadiology equipmentEndoscopesPatient support, such asPatient bedsSpecialty bedsLiftsTaken from the Environment of Care HandbookChapter 5 (page 73) 3rd edition
46CMS Inventory Medical Equipment includes Biomedical equipment Radiological equipmentPatient beds, stretchersIV infusion equipmentVentilatorsLaboratory equipmentEtc.
47Scopes Number 6 on ECRI Top 10 for 2014, #8 in 2013 Score at IC. For infection control issues, and will result in follow-up survey under COP §482.42IC EP 1 &2 hi/lo level disinfectionIC EP 1 – 5 risk assess & surveillanceIC EP 1 for policy issuesScore at EC EP 6 for ventilation issues, will result in follow-up survey under COP §482.42
48EC EP 4The hospital identifies the activities and associated frequencies, in writing, for maintenance, inspecting, and testing all medical equipment on the inventory. These activities and associated frequencies are in accordance with manufacturers’ recommendations or with strategies of an alternative equipment maintenance (AEM) program.Note: The strategies of an AEM program must not reduce the safety of equipment and must be based on accepted standards of practice.An example of standards for a medical equipment program is ANSI/AAMI EQ56:2013, Recommended Practice for a Medical Equipment Management Program
49EC EP 5For hospitals that use Joint Commission for deemed status purposes: The hospital’s activities and frequencies for inspecting, testing, and maintaining the following items must be in accordance with manufacturers’ recommendationsEquipment subject to federal or state law or Medicare Conditions of Participation in which inspecting, testing, and maintaining be in accordance with manufacturers’ recommendations, or otherwise establishes more stringent maintenance requirements
50EC.02.04.01 EP 5 continued Medical laser devices Imaging and radiologic equipment (whether used for diagnostic or therapeutic purposes)New medical equipment with insufficient maintenance history to support the use of alternative maintenance strategiesNote: Maintenance history includes any of the following documented evidence:Records provided by the hospital’s contractorsInformation made public by nationally recognized sourcesRecords of the hospital’s experience over time
51EC EP 6For hospitals that use Joint Commission for deemed status purposes: A qualified individual(s) uses written criteria to support the determination whether it is safe to permit medical equipment to be maintained in an alternative manner that includes the following:How the equipment is used, including the seriousness and prevalence of harm during normal use
52EC EP 6 continuedLikely consequences of failure or malfunction, including seriousness of and prevalence of harmAvailability of alternative or back-up equipment in the event the equipment fails or malfunctionsIncident history of identical or similar equipmentMaintenance requirements of the equipment(For more information on defining staff qualifications, refer to Standard HR )
53EC EP 7For hospitals that use Joint Commission for deemed status purposes: The hospital identifies medical equipment on its inventory that is included in an alternative equipment maintenance program.
54ECStandard ECThe hospital inspects, tests, and maintains medical equipment
55Medical Equipment Testing EC The hospital inspects, tests, and maintains medical equipmentEP 1: For hospitals that do not use Joint Commission accreditation for deemed status purposes: Before initial use of medical equipment on the inventory the organization performs safety, operational, and functional checks.Before initial use of equipment safety, operational and functional tests are to be performed. Who does this may be driven by policy.‘A’ Category: Life Support devices must be maintained on time, with a 100% completion rate.
56Medical Equipment Testing EP 1 (continued): For hospitals that use Joint Commission accreditation for deemed status purposes: Before initial use and after major repairs or upgrades of medical equipment on the medical equipment inventory, the hospital performs safety, operational, and functional checks.Before initial use of equipment safety, operational and functional tests are to be performed. Who does this may be driven by policy.‘A’ Category: Life Support devices must be maintained on time, with a 100% completion rate.
57Medical Equipment Testing EC The hospital inspects, tests, and maintains medical equipmentEP 2. The hospital inspects, tests, and maintains all life support high-risk equipment. These activities are documented.Note: High-risk medical equipment includes life support equipmentBefore initial use of equipment safety, operational and functional tests are to be performed. Who does this may be driven by policy.‘A’ Category: Life Support devices must be maintained on time, with a 100% completion rate.
58Medical Equipment Testing EP 3: The hospital inspects, tests, and maintains non-life support non-high-risk equipment identified on the medical equipment inventory. These activities are documented. EP 4: The hospital conducts performance testing of and maintains all sterilizers. These activities are documented.Non-life support completion rate may be 90 – 100 % and considered compliantSterilizers are evaluated by discussing outcomes with the users and reviewing maintenance information with the maintainers.
59Medical Equipment Testing EP 5: The hospital performs equipment maintenance and chemical and biological testing of water used in hemodialysis. These activities are documented.EP 14: For hospitals that use Joint Commission accreditation for deemed status purposes: Qualified hospital staff inspect, test, and calibrate nuclear medicine equipment annually. The dates of these activities are documented.If the hemodialysis is under contract the water quality is still subject to the Medical Equipment Program.Qualified hospital staff are to manage the process, which could include a third party contractor.
60Medical Equipment Testing EP 17: For hospitals in California that provide computed tomography (CT) services: A qualified medical physicist measures actual radiation dose produced by each CT imaging system at least annually.Verifies dose displayed for adult brain, adult abdomen, and pediatric brain protocols is within 20 percent of actual dose delivered.Dates of the verifications are documentedIf the hemodialysis is under contract the water quality is still subject to the Medical Equipment Program.Qualified hospital staff are to manage the process, which could include a third party contractor.
61Equipment Survey Process Documentation is completed for High-risk, life support and non-high-risk devices on the inventoryAccuracy of InventoryAll High-risk and Life Support equipment must be on the inventory and identifiedPreventive maintenance frequencies must be clearly defined in writingConfirm work done as per scheduled activitiesEnsure appropriate work is scheduled based on maintenance strategiesEvaluate equipment failure and scheduled actions
62Survey Process: Staff Interviews Department LeaderEvaluate the qualifications of the leaderReview appropriate documentationEvaluate how the inventory was createdIf an alternative maintenance program is in use, evaluate the inclusion processEvaluate the Monitoring processesEvaluate the effectiveness of the programWhat criteria is used to evaluateEvaluate the Completion rate of maintenance activities
63Survey Process: Staff Interviews Equipment MaintainersEvaluate their understanding of the maintenance process/strategiesEvaluate staff knowledge related to the alternative maintenance programEvaluate assignment of maintenance activitiesEvaluate competencies based on repeat work ordersEvaluate work scheduled against completed
65Survey Process: Staff Interview Users of the EquipmentEvaluate equipment reliabilityEvaluate response time when equipment failsEvaluate emergency response processEvaluate “Culture of Safety”Appropriate training of staff related to equipment useCustomer satisfaction with departmentContract ServicesEvaluate the process used to ensure contractors use qualified personnelEvaluate reliability of equipment servicedEvaluate integration of the process
66Evaluating Program Effectiveness The equipment management programs must have written policies & proceduresEvaluating the program:How is equipment evaluated to ensure no degradation of performance?Consider miscalibration of equipmentConsider test equipment calibration confirmationHow are equipment-related incidents investigated?Could the malfunction have been avoided?Did the alternative maintenance strategy contribute to the malfunction?How to sequester equipment deemed unsafe?
67Evaluating Program Effectiveness Is there a performance process to evaluate if modifications to the maintenance strategy are needed?Evaluate the accuracy of the inventoryHigh-risk equipment segregated in the inventory?Equipment in an alternative maintenance program segregated?Grouping of like equipment is acceptableAre imaging/radiologic equipment and medical laser devices exempt from the alternative maintenance program?
68Evaluating Program Effectiveness: Miscellaneous Topics Survey should focus on High-risk equipmentAre appropriate operation manuals and maintenance schedules available?Verify the inspection, testing & maintaining activities and frequencies are documentedEvaluate the various maintenance strategies usedAre they appropriate?Are they effective?Is the equipment reliable?
69Equipment Not Found or In Use If a device is not available because it is not found or in useManage the situationCreate policy describing how the device will be looked forHow will the users be involvedHow it impact the usersIf the device was looked for “on time” then the PM Completion rate will not be impactedThe device must be reconciledSurveyors will be reviewing those “equipment not found” or “in use” for reconciliationExample: during the next month if 500 scheduled, 10 not found the total activities should be 510
70Equipment Not Found OR In Use If the device was looked for “on time” then the PM Completion rate will not be impactedThe device must be reconciledSurveyors will be reviewing those “equipment not found” or “in use” for reconciliationExample:Each month 500 activities are scheduledOne month 10 devices are “not available”Next month the 500 scheduled devices will be done plus the missed 10 devices
71Diagnostic ImagingThree phases of implementation for hospitals, critical access hospitals, and ambulatory care organizationsIncludes ambulatory care organizations that have achieved Advanced Diagnostic Imaging certificationPhase 1 Deferred to January 1, 2015Exceptions: not applicable to dental cone beam CT radiographic imaging studies performed for diagnosis of conditions affecting the maxillofacial region or to obtain guidance for the treatment of such conditions.Phase 1.5: minimum qualifications for radiologists performing CT scansPhase 2: fluoroscopy qualifications for non-radiologists performing imaging exams and cone beam CT, and for dental or oral surgical procedures
72Diagnostic Imaging Phase 1: Deferred to January 1, 2015 Computed tomography (CT), nuclear medicine (NM), positron emission tomography (PET), and magnetic resonance imaging (MRI)Minimum competency for radiology technologists, including registration and certification by July 1, 2015Annual performance evaluations of imaging equipment by a medical physicistDocumentation of CT radiation dose in the patient’s clinical recordMeeting the needs of the pediatric population through imaging protocols and by considering patient size or body habitus when establishing imaging protocols
73Diagnostic Imaging Phase 1: Deferred to January 1, 2015 Management of safety risks in the MRI environmentCollection of data on incidents during which identified radiation dose limits have been exceededMinimum quarterly review of staff dosimetry resultsNew, replacement or modification to roomsMedical physicist to perform structural shielding designNew equipment or rooms where ionizing radiation is emitted or radioactive material is storedMedical physicist to perform radiation protection survey
74Diagnostic Imaging Standards Comments Open to October 24, 2014 We are interested in your comments on standards changes that address the following areas:Minimum qualifications for radiologic and nuclear medicine technologists that perform computed tomography (CT) exams.Orientation of technologists on safe practices related to the provision of diagnostic imagingDocumentation of CT radiation dosefor more information
75Relocatable Power Taps (RPTs) Healthcare Interpretation Task Force (12/2007) stated NFPA 70, NFPA 99 and NFPA 101 all have regulations that control the electrical components and equipment in a patient room. It appears that it is the intent of these documents to restrict RPT use so that it is not used in conjunction with medical equipmentCMS 3/2014:“RPT’s are not to be used with medical equipment in patient care areas.This includes critical areas such as operating rooms, recovery areas, intensive care areas, and non-critical patient care areas such as patient rooms, diagnostic areas, exam areas, etc.”
76Relocatable Power Taps RPTs may be used in anesthetizing locations if they are part of the equipment assembly. See NFPA (2)Ceiling drops are acceptable. See NFPA (3)RPTs may be used for non-patient care equipment such as computers/monitors/printers, and in areas such as waiting rooms, offices, nurse stations, support areas, corridors, etc.Precautions needed if RPT’s are used include:ensuring they are never “daisy-chained”preventing cords from becoming tripping hazardsinstalling internal ground fault and over-current protection devicesusing power strips that are adequate for the number and types of devices used
77S&C: LSC 9/26/2014CMS is permitting a categorical waiver to allow for the use of power strips in existing and new health care facility patient care areas, if you are in compliance with all applicable 2012 LSC power strip requirements and with all other 2000 LSC electrical system and equipment provisions.The organization must follow all requirements of the categorical waiver processThis includes identifying where they are located at the unit level
78Categorical Waiver Process If the organization decides to use this categorical waiver they mustEnsure full compliance with the appropriate code referenceDocument the decision to adopt the categorical waiverThe Relocatable Power Tap is not a LSC issue but an Environment of Care issueFor Environment of Care items document by Minutes in discussion at the Environment of Care Committee (or equivalent)Declare the decision at the beginning of any surveySee also November 2013 Perspectives
79Definitions From NFPA 99-2012 Patient bed location is defined in section as the location of a patient sleeping bed, or the bed or procedure table of a critical care area.Patient-care-related electrical equipment is defined in section as electrical equipment that is intended to be used for diagnostic, therapeutic, or monitoring purposes in the patient care vicinity;Patient care room is defined in section as any room of a health care facility wherein patients are intended to be examined or treated. Note that this term replaces the term “patient care area” used in the 1999 NFPA 99, but the definition has not changed.Patient care vicinity is defined in section as a space, within a location intended for the examination and treatment of patients (i.e., patient care room) extending 6 ft. beyond the normal location of the bed, chair, table, treadmill, or other device that supports the patient during examination and treatment and extends vertically 7 ft. 6 in. above the floor.
80RequirementsPower strips may be used in a patient care vicinity to power rack-, table-, pedestal-or cart-mounted patient care-related electrical equipment assemblies, provided all of the following conditions are met, as required by section :The receptacles are permanently attached to the equipment assembly.The sum of the ampacity of all appliances connected to the receptacles shall not exceed 75 percent of the ampacity of the flexible cord supplying the receptacles.The ampacity of the flexible cord is suitable in accordance with the current edition of NFPA 70, National Electric Code.The electrical and mechanical integrity of the assembly is regularly verified and documented through an ongoing maintenance program.Means are employed to ensure that additional devices or nonmedical equipment cannot be connected to the multiple outlet extension cord after leakage currents have been verified as safe.
81RequirementsPatient bed locations in new health care facilities, or in existing facilities that undergo renovation or a change in occupancy, shall be provided with the minimum number of receptacles as required by sectionPower strips providing power to rack-, table-, pedestal-, or cart-mounted patient care-related electrical equipment assemblies are not required to be an integral component of manufacturer tested equipment. Power strips may be permanently attached to mounted equipment assemblies by personnel who are qualified to ensure compliance with section
82RequirementsPower strips may not be used in a patient care vicinity to power non-patient care-related electrical equipment (e.g., personal electronics).Power strips may be used outside of the patient care vicinity for both patient care-related electrical equipment & non-patient-care-related electrical equipment.Power strips providing power to patient care-related electrical equipment must be Special-Purpose Relocatable Power Taps (SPRPT) listed as UL 1363A or ULPower strips providing power to non- patient-care-related electrical equipment must be Relocatable Power Taps (RPT) listed as UL 1363.
83Department of Engineering 630 792 5900 George Mills, MBA, FASHE, CEM, CHFM, CHSP, Green BeltDirectorAnne Guglielmo, CFPS, LEED, A.P., CHSP, CHFMEngineerJohn Maurer, SASHE, CHFM, CHSPEngineerKathy Tolomeo, CHEMEngineerJames Woodson, P.E., CHFMEngineer83
84The Joint Commission Disclaimer These slides are current as of 10/1/ The Joint Commission reserves the right to change the content of the information, as appropriate.These slides are only meant to be cue points, which were expounded upon verbally by the original presenter and are not meant to be comprehensive statements of standards interpretation or represent all the content of the presentation. Thus, care should be exercised in interpreting Joint Commission requirements based solely on the content of these slides.These slides are copyrighted and may not be further used, shared or distributed without permission of the original presenter or The Joint Commission.84