October 18, 2018 | Healthcare Risk, Quality, & Safety Guidance
If a restaurant needs reconstruction, it might close for a month. A school can start building a new wing over the summer. Even a home renovation can be scheduled at the owner's convenience. However, there is no such thing as a "convenient" time for construction in a healthcare facility. Hospitals by their nature are open 24 hours a day, seven days a week. It is a near certainty that construction will occur while patient care activities are ongoing. Thus, everything from the noise generated by a hammer to the route a carpenter takes to get lunch must be taken into account before construction can begin.
No matter how inconvenient, construction will occur. Beginning in 2010, healthcare facilities ramped up the implementation of construction projects that had been delayed because of the economic recession of 2008 and 2009. (Shortt) The reasons for the increase are numerous. For one, the increased scale and number of natural disasters in recent years has caused hospitals across the country to look into more resilient construction. Further, construction of outpatient facilities is expected to continue, as hospitals look to expand beyond their walls. (Burmahl and Morgan).
Finally, an aging population of baby boomers is also expected to propel construction in long-term care facilities. (Perkins)
The uptick in healthcare facility construction has come at the same time as attention has increased from regulatory agencies and the media about healthcare-acquired infections, and hospital construction increases the risk for such infections. An essential component of any construction plan is performing an infection control risk assessment (ICRA). Although some ICRA-related strategies are discussed in this article, a more detailed discussion of the ICRA process is presented in the guidance article Infection Control during Construction. It largely focuses on keeping workers, patients, and visitors safe from infectious agents raised in construction dust, as well as the surrounding legal and regulatory issues.
The Occupational Safety and Health Administration (OSHA) regulations define construction work as "construction, alteration, and/or repair, including painting and decorating." OSHA further says that its construction industry standards apply "to every employment and place of employment of every employee engaged in construction work." Furthermore, OSHA provides no regulatory definition for "maintenance." Thus, even routine repairs and decorating could fall under the definition of construction activities. (See Construction versus Maintenance.) A facility that is not planning major renovations will still need to manage worker safety. (OSHA...