Author: healthfac_82

Halfway Right Is Still Wrong

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I came across this earlier this week while making my rounds through the hospital.  Some workers on the construction project had found a handy spot in the stairwell to leave a few items out of sight.  They were doing a few things right.  1.  They cleaned up after themselves and 2. They had a fire extinguisher handy.  Other then that, what were they thinking!  Storing items in a stairwell is a huge problem that violates the Life Safety Code (NFPA 101).   Specifically it prohibits anything that has the potential to interfere with egress. Not to mention any possible ICRA concerns.  

I quickly called the project superintendent and got everything moved.  He then trained the workers again on the importance of working within the approved area, and being mindful of creating hazards to staff and patients.  

 

Health Facility Pro’s Best Practice To Renew Your CHFM Certification

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Almost three years ago I earned my CHFM certification.  I will always remember my experience walking out of the testing center with that paper in hand with PASS printed on it.  ASHE has a three-year cycle for certification renewals and allows renewals to be filed anytime within the last year of the cycle.  Since I was within the renewal window, I recently went through the process of submitting the paperwork to renew my CHFM certification.  From sending the paperwork in, to getting the email back stating that my certification has been renewed takes about two weeks.  It will take another week to receive the updated certificate through the mail. 

I believe that certification renewal starts the same day a certification is obtained.  If you have a plan on how you will maintain your certification, it makes it a lot easier to maintain the certification.  The plan doesn’t need to be detailed and technical, but knowing that 45 credit hours ever 3 years breaks down to 15 credit hours every year- just over an hour a month provides a good scale on your progress.

How I earned those hours was a mix of reading Health Facilities Management (HFM) Magazine (10 issues a year = 10 hours of education per year) and a mix of other courses.  Some courses are free, some require payment.  Two important things to remember are the shortest course allowable is ½ hour (1/2 credit) and to count for credit it has to provide a certificate of completion.  There are other ways to earn hours as well, but the ones that work the best for me are the HFM credits, a mix of courses, and attending conventions such as the PDC Summit or ASHE Convention.  The conventions are both held annually, but I am not able to attend every year. 

After completing the test for each issue of HFM or obtaining a course completion certificate, I saved the certificate as a PDF into a dedicated folder on my computer.  I also created a spreadsheet that I use to track the courses and hours as they add up.  I modeled the fields on the spreadsheet on the fields on the ASHE renewal form.  These fields are similar for CHFM and CHC, so I am able to track this for maintaining my CHC as well.  One huge benefit when maintaining both certifications is the education requirements that count for one also apply toward the other.  I have attached a copy of the file I use so you can use it too.

Once I have the required number of hours, I print the excel file as a PDF.  I then combine the PDFs of the completed courses into one PDF, with the list of courses at the beginning.  I rename the file to something easy to find or remember such as “CHFM_Certificates_2018_to_2020” and save it to my computer AND email it to myself in a personal email account instead of a work-based account.  This makes it easy to find in the event that my renewal is one that is selected to be audited. 

I fill out the renewal form, print the excel file (don’t include the certificates!), fill them out, and mail in my renewal application including the renewal fee.  The excel file makes it easier than hand writing a list of courses or ways that I’ve earned education hours. 

A little bit of organization and record keeping along the way made the renewal process a breeze.  I’ve included below the Excel template of the renewal hours tracking form that I use.

CHFM Renewal Hours Tracking

The 2019 Health Facilities Management Salary Survey is out!

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Earlier this week I received the latest edition of Health Facilities Management in the mail.  It’s a pretty decent publication that has useful articles.  One of the issues that I look forward to every other year is the Salary Survey.  ASHE did their first salary survey in 2009, then repeated it in 2012, 2015, 2017, and now 2019.  

Reviewing the past four surveys, one item that is remarkably consistent is how much more people with the CHFM credential get paid.  Through them all it has been 20-25% greater pay for those with the CHFM credential.  

What are you waiting for?  If you’re feeling like you need something better, make your plan today and begin working toward it!  Your work and preparation will be worth it.  Don’t live with the regret of  inaction.  Looking back, you’ll be glad you committed, made a plan, and acted on it.  

 

Utility Shutdowns in a Hospital: Try, Try Again

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We’ve all heard the timeless rhyme “If at first you don’t succeed, try try again!”  Whoever said it first very well could have been referring to utility shutdowns at inpatient hospital facility.  

Last night I had one of those experiences where we didn’t succeed at first.  I hope we only have one try again to be successful with it.  We are renovating space in a hospital tower that has surgery rooms, labor and delivery, ICU, as well as normal patient rooms all located within it on different floors.  When the facility was built there were very few valves installed on the water risers.  We’ve got an east riser and a west riser.  The contractor has work to relocate some of the lines on the east riser.  Due to the lack of valves, this work requires an outage and will take down water to one half of the tower.  

The outage was scheduled several weeks in advance, with the hospital going on “divert” for the inpatient areas about 12 hours in advance of the outage to allow the rooms to empty out.  Also, the scheduled outage was to begin at 10 PM, to reduce impacts on the patients as most are done with showers and toilet use by that time and are headed to bed.  A 6-8 hour outage  would mean water was restored prior to patients waking, morning showers, and breakfast time. 

In addition to the required work, the facility manager determined that installing additional valves on each floor at the mains from the riser, allowing each floor to be isolated, would be prudent.  

I showed up early ahead of the outage to check with each department and the status of their patients.  Even though they were on divert, sometimes expectant mothers show up to deliver their babies or critically injured people arrive in the Emergency Department needing surgery.

The first stop was the Emergency Department.  Oh-oh.  Two potential surgeries.  I checked with the other departments and the charge nurse at each gave a green light.  I met with the contractor and explained the situation.  

We determined it would be best to wait for an hour to see if the surgeries were needed or not.  The hour dragged slowly by.  It was kind of like sitting in traffic, we were unproductive and all had things we would rather have been doing.  We checked with the Emergency Department again.  They still were doing their final tests and evaluations on the two patients, and in the hour that had lapsed, another potential surgery patient had come in.  This was not our night!  

Even if we were to wait until all three patients were stabilized, we still were fighting against the clock.  If it was after midnight when we could start the outage, we would run into morning and definitely begin impacting the few patients that hadn’t been discharged.

We huddled up one more time, and I passed my regrets to the contractor.  On this night there would be no outage.  It was the right decision.  

As I walked out to my car at 11:00,  I glanced over my shoulder at the red ambulance lights flashing outside of the Emergency Department.  It was not a good night for more than myself and the contractors.  I said a prayer for those needing care that night.  We made the right decision to postpone the outage.  I hope next time we’ll be able to do the outage and get this work behind us.

Housekeeping: A Tale of Unintended Consequences

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The past several weeks have been trying ones on one of the construction projects at my hospital.  The contractor has subs going steadily with plumbing, electrical, gyp board, sheet metal, insulation all occurring in various places on the job site.  There is time dedicated to clean up the work area, but they always seem to be behind the curb.  The past few weeks they have upped their housekeeping game with dedicated laborers focused on housekeeping, as well as each sub dedicating someone to cleanup.  It’s making a difference, but the difference has been small compared to the level of effort.  We had a discussion today about safety, cleanliness, etc.  In fact, we’ve had several of these discussions recently.  
Let me rewind a little bit. In order to reduce the impact on the hospital, the contractor removed a window on each floor early on in the project.  This allowed demolition debris to be removed from the floor, without sharing a path with patients or staff.  It also allows materials to be brought in, again without interfering with the hospital’s flow.  Great idea!  This results in an overall smaller effect of the construction project, and reduces the chances for construction related infections.  We’re now at a stage in the project where the vast majority of demolition is complete and many items have been brought in for installation.  The removal of the windows has served its purpose.  
Move forward back to where we are- construction moving along, yet housekeeping remaining a problem.  The meetings today had a few new faces as some upper management from the contractor were in attendance as they were on site to survey progress.  Housekeeping efforts came up in the meeting.  In the ensuing discussion, an alternate perspective was offered.  Our problem with housekeeping is not a housekeeping problem at all, instead it’s a logistics problem.  With the floor space taken up by stacks of gyp board, piles of ducts, bundles of conduit, boxes of insulation, and other construction materials the work space is overly congested.  This impacts housekeeping as well as the ability to work unimpeded.  The problem isn’t with the housekeeping, it’s with the logistics planning.  In seeking to reduce the effects on the hospital by advance staging supplies through a removed window, an unintended consequence was created.  Too many items were brought in, this manifested itself as a housekeeping problem.  Instead of being the root-cause however, the poor housekeeping was a symptom of the logistics planning not fully considering the impact that lots of materials has in a limited space.  
The contractor is now considering what changes they need to make in material staging and storage in order to address their housekeeping struggles.  We’ll see what they can figure out.
Sometimes a fresh perspective can make quite a difference.  Other times experience gives the edge needed.  Good ideas sometimes can have unintended consequences, and being able to properly identify the root cause is the surest way to a timely resolution.

Animals and the Hospital Electric Grid

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The electricity at a hospital is critical to keeping the doors open.  Sometimes, the reliability of the power grid is literally life or death.  Imagine if your loved one was in on the operating table and the power was lost.  That’s not a good place to be!  The patients in the ICU or NICU on breathing apparatus also need power to sustain life.  As a response to the scenario of lost powers, hospitals have emergency power generators.  The generators don’t typically power the whole facility, but instead, provide adequate power to the most important and critical areas.  The generators are tied to transfer switches that as soon as normal power is lost, activate the generator to restore power. 

Reasons for the lost power are limitless and varied.  Storms, malfunctioning equipment, car accidents, lightning, wind, wildfires, and flooding have all caused power to be lost at healthcare facilities.  Oh, and animals too can cause outages.  We recently have had two animal induced outages in a short amount of time.   

The first outage was from the critter that came to be known as “Rocky the Flying Squirrel”.  Rocky suffered from an untimely demise due to biting an electrical line.  I was in a meeting when it happened, ironically discussing utility outages for a construction project.  We adjourned the meeting and set about restoring power.  The electrical utility was contacted, and in about 20 minutes normal power was restored and the generators were turned off.

The second outage was from a Great Horned Owl that spread its wings while perching on an electrical pole early one morning.  I made it to work shortly after it occurred.  It’s always sad to see one of those majestic birds suffer an early death.  Somebody at Hogwarts didn’t get their mail that day.

So what can we learn from this?  Two quite apparent lessons are 1). Don’t chew on power lines.  2).  Don’t stand on power poles.  But the advanced lessons are just as relevant to facility managers, if not more so.  1).  How reliable is your power provider?  2).  Do you have a plan in place for unplanned events that affect your power supply?  If you’ve got a plan, you can quickly and easily set things back and continue with your day.  Make a plan and follow it.  If your plan is that nothing unexpected or unplanned will happen, you don’t have a plan.  You need to show some leadership and take charge of planning and looking ahead and establishing a response for when unplanned utility outages happen.  

 

 

Merry Christmas from Health Facility Pro

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A few years ago my facility had a Christmas Tree contest.  It was a facility-wide competition, with the best tree winning a celebration lunch for the sponsoring department. Several departments pulled out their old artificial trees, plopped them into available corners, and decorated them to whatever whim they had.  A few of the more crafty ladies schemed and themed to make their Christmas trees truly outstanding.  But to be honest, they didn’t have a chance. Not that year.

Shortly after the contest was announced, the facility manager called the team around and shared with us the plan.  We didn’t have a tree, but that didn’t matter.  A 6 foot blue ladder would work just fine.  

We spent the next week and a half gathering materials and decorations.  Then one slow afternoon a few days before the tree judging we sprung our plan into action.  We opened the ladder and stood it in the corner, wrapped it with a garden hose, caution tape, and plenty of Christmas lights and started adding “ornaments”.  A few “gifts” under the tree added the perfect touch.  

Shortly after we finished, people began to trickle in.  Soon the trickle became a torrent, and then a flood.  Those crafty ladies with their carefully planned trees were flabbergasted.  A few of them even protested that we should be disqualified because we didn’t have a tree.  Everyone who looked at the tree knew instantly that the competition was effectively over.  

In early January we enjoyed our reward.  Boy was that lunch delicious!

The Importance of Above Ceiling Inspections

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Removing the cobwebs from the corner and dusting. Two essential bits of
housekeeping to keep a home looking nice. Some people enjoy this work
around the house, while others would rather be doing something a little
more substantial to keep their home in top shape. But both the small tasks
and big projects are needed to keep a home up to date, and functional for
those who live there.

Occasionally at my home we see a spider creeping stealthily along the
wall. Sometimes on sunny days and from the right angle I can see dust in
the air. Usually the dust is more noticeable if someone has just
vacuumed. But generally I don’t see the dust settle, or the spiderwebs
being woven. Usually it’s after walking by the cobweb in the corner for
the hundredth time, or after I pull a book from the shelf and see the lack
dust where it just was that I notice these things.

Why do I bring this up? Overhead inspections. How much overhead work
happens at your medical facility? Systems popping a ceiling tile here to
run a data drop, maintenance lifting another one to exercise a valve, etc.
Much like the dust settling over time, or the cobweb clinging to the
corner, these small activities can have a great impact above ceiling. They
can result in findings at your next Joint Commission survey. More
importantly, and heaven forbid, a fire breaking out and finding weakness in
your fire barriers.

Recently I was doing some overhead surveys and came across a few
violations. Others also found several. Pictures are posted below. Lets
play “can you spot the violation”? These were all noted and quickly
corrected. This remains a good teaching moment. Overhead inspections are
important. It’s never convenient to get out ladders and navigate past
equipment and furniture, but overhead inspections are an important practice
that should be part of your hospital or clinic’s preventive maintenance
program.

Wow, look at this electrical junction box!  It is literally packed too tightly to fit on a cover.  A knockout plug is missing.  I’m certain that this is at least three violations of the National Electric Code.

This violation is a little more difficult to spot.  The barrier is nicely marked, but adjacent to it is an opening that hasn’t been properly fire caulked.

How many cables can you secure to a fire sprinkler line?  The correct answer is none.

Again, these cables are improperly secured to a fire sprinkler line.  

These cables should be properly supported, instead of being draped over a fire sprinkler line.

Do you have a picture or story you’d like to share? I’d like to hear it!

Preparation Timelines and Studying for Exams

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I have a coworker who is currently studying for the Professional Engineer (PE) exam.  Every morning I walk in to work and find him studying.  He has been very focused and diligent in his preparation, and I have no doubt he will pass the exam.  Watching him brings back memories of studying I have done when preparing for the CHFM exam.  Seeing him jump in enthusiastically at first, then as time and study fatigue have set in, he’s gotten to the point where studying is not so much anticipated and enjoyed, but rather endured.  Now the end in sight is all that keeps him engaged in studying.  It’s why many of us after walking out of an exam say “I’m never going to take that exam again!” 

I’ve been thinking about the preferred timelines when studying for a professional certification.  There is definitely a sweet spot to begin that isn’t too far ahead of the exam, but not too late either.  Beginning too early, you lose focus and drive, resulting in not being prepared when the examination day arrives.  Beginning too late, and you risk not truly learning the material. I think the ideal timeline is below.
Greater than 6 months out- work and get experience in the field of study.  This is generally where you are presently at.  Become aware that the certification exists and is attainable and relevant to your career path. 
4-6 months out- determine that you actually want to begin studying for the certification. Search out others who have the certification and speak with them about their experiences.  While it’s unethical to ask for questions on the test, they can direct you to study materials they used and found helpful.  Collect study materials and begin studying.  Check on exam registration dates.  Some exams are only offered at limited times during the year.  If your exam is like this, take note of the booking window and plan accordingly.
2 months out- book the exam.  This will help lock you in and help you remain focused.  You now have a deadline to work toward.  
6 weeks out-  take practice exams.  This will help your confidence in testing situations, and will also help with recall.  Practice exams also help direct you to weaknesses in your knowledge so you can go back and study those areas.
1 week out- you should feel reasonably confident in your readiness.  Review all of the material at a high level, then at a deeper level of anything that you feel needs final polishing.  If there are any equations or calculations, take special note to understand each one and its application.  Continue taking practice exams.
1 day before- let up on your studying.  If you don’t know it by now, any studying you do will be too late.  Rather than study, take the time to relax and get in a good mental state.  This will help you more than cramming.
The day of the exam- lightly review your notes and major topics.  Plan to be at the testing center 30-45 minutes early.  This will allow you to not be stressed if traffic is bad.  Take a snack with you and enjoy the snack before you go in for the exam.  Any time you have after arriving but before the exam starts gives you one final opportunity to brush up and confirm that you know your stuff.  Walk in and be there five minutes early.  Sit down and enjoy your exam.  You’ve worked hard and you know your stuff!