Pre Construction Risk Analysis April 1, 2014

What is Pre Construction Risk Analysis (PCRA)? When Planning for new, altered, or renovated space, the hospital uses one of the following design criteria: State rules and regulations Guidelines for Design and Construction of Health Care Facilities, 2010 edition, administered by the Facility Guidelines Institute and published by the American Society for Healthcare Engineering. When the above rules, regulations, and guidelines do not meet specific design needs, use other reputable standards and guidelines that provide equivalent design criteria CMS Pre Construction Risk Analysis

What is Pre Construction Risk Analysis (PCRA)? PCRA is more than ICRA & ILSM PCRA consists of 7 elements ICRA ILSM Noise Vibration Utilities Air Quality Other Hazards A PCRA is required for all projects. The PCRA should be completed by the End of Feasibility and should be updated as project knowledge changes. Pre Construction Risk Analysis

ICRA It is the PM’s responsibility to ensure that the controls indicated on the ICRA form match the controls in place. If something changes, work with Infection Control (R. Vogel) and submit a new form, indicating the updated protection. Having Level IV protection, on a job where Level II is indicated on the ICRA form is an issue. Surveyor assumes a problem caused the change. Pre Construction Risk Analysis

ILSM Revision to “Daily” Surveillance EHS has revised their policy to require the PSO to submit surveillance forms for 2 inspections for any weekend work (1 each at start and end of shift). Surveillance will only be required when the site is active. A form will be required to be filed to note that the site was not active. Revisions to the Daily Surveillance Form Forms include the other elements of PCRA: Noise Vibration Air Quality Other Hazards Forms are posted on the Facilities Portal. Pre Construction Risk Analysis

These are coupled since they are usually present together. Noise & Vibration These are coupled since they are usually present together. The Assessment works very similar to the ICRA: There are types of Construction Activities and Risk Locations that form a matrix. Select the Activity and Risk location to choose from the matrix. For Level III & IV risks, the NYP/PM should consider using a Noise Consultant and perform baseline testing prior to the start of construction. Ie: Cerami & Associates Pre Construction Risk Analysis

Utilities This Risk Assessment encompasses several aspects: Planning for new project needs. Evaluating current capacity via existing conditions survey. Review and sign off of design drawings. Availability of Emergency Power in case of contractor damage to power system. The Campus Engineer will help address issues of Capacity and planning Utilize FD&C-E for design review using the new Engineering Standards as well as Capacity Planning along with FO Pre Construction Risk Analysis

Air Quality How is this different from ICRA? ICRA is essentially Dust Control. Dust control is achieved using negative pressure and HEPA filters. Air Quality encompasses things other than Dust: Odors Particulates other than dust The Air Quality Risk Assessment will identify risks other than Dust Control and provide mitigation measures for: Reduction of particulates using exhaust filters on internal combustion equipment. Wherever possible, internal combustion equipment should not be used Use of adhesives, paints, and other odor producing items should be evaluated and wherever possible, non-odor producing alternatives should be used. Ensure MSDS is sent to EHS for evaluation. As with ICRA, be aware of where your negative pressure fans discharge! Check for fresh air inputs that could be affected! Omega and Lawrence can provide these services. Pre Construction Risk Analysis

Other Hazards What are other hazards? Anything that does not fall into the other 6 Risk categories: Traffic Neighborhood disruptions Leaks Any other potential disruption and change that could affect patient care, not identified in one of the other 6 risk assessments What does a PM do? Ensure that the PSO, Contractor, PM, and PM backups are all listed correctly on “Document B”. Ensure that the Project Administrator and ALL adjacent departments have all been notified of what to do if an issue arises from the project site. No one can think of everything, but plans can be put in place to deal with any thing! Pre Construction Risk Analysis

Summary Do as we say and say as we do! A PCRA is required for all projects. Even if no hazards are indicated on the Risk Assessment, the forms must be on file to show that the assessment occurred. We are already doing most of the PCRA’s, but in many cases, we need to have Policies and Procedures that say we are. Do as we say and say as we do! The easiest way to get caught in this area is to do something different than what we say we will do OR to say we do something and do it differently. Pre Construction Risk Analysis

Questions? Pre Construction Risk Analysis