EC.8.10: The "other" EOC standard

Dear medical staff leader,

When consulting with clients, I frequently ask them how they are complying with EC.8.10, one of the lesser known environment of care (EOC) standards. Many times I receive blank looks and answers indicating they were not aware of this standard.

While the seven well-known EOC standards are usually closely followed, EC.8.10 does not receive as much attention, even though it requires hospitals to establish and maintain an appropriate environment. Each of the first seven sets of EOC standards requires a written management plan, but EC.8.10 does not, which may explain why it is often overlooked. This can easily get a hospital in trouble, because Joint Commission surveyors will ask just as many questions and want to see as many supporting documents indicating compliance with EC.8.10 as they will for the first seven sets of standards.

So, let’s look at what you need to do to ensure compliance with EC.8.10.

• Interior spaces for the patient should be appropriate to the care, treatment, and services provided
• Interior spaces for the patient should include a closet and drawer space for storing personal property
• Longer-term care hospitals (more than 30 days) should allow for good recreational interchange
• Longer-term care hospitals should have equipment for rehabilitation
• Furnishings and equipment shall be maintained to be safe and in good working order
• Furnishings and equipment should reflect the patient’s level of ability and needs
• Furnishings and equipment should help normalize the patient’s living environment in longer-term care hospitals
• Outside areas should be provided when required by the care, treatment, and services provided by longer-term care hospitals
• Outside areas should be appropriate and safe when provided by longer-term care hospitals
• Areas used by the patients should be safe, clean, functional, and comfortable
• Lighting should be suitable for the care, treatment, and services provided
• Interior spaces should have acceptable levels of temperature and humidity
• Interior spaces should be equippped with adequate ventilation to remove odors
• Locked doors should be consistent with the needs of the patients, the program, and applicable regulations.
• Emergency access should be provided to all locked, occupied spaces

EC.8.30 deals with maintaining an environment appropriate for the care of patients during construction and renovation. Similar to EC.8.10, EC.8.30 is critically important to Joint Commission accreditation, yet hospitals often overlook it. To ensure compliance with EC.8.30, hospitals and longer-term care facilities are required to:

• Use applicable state laws and regulations when planning renovation
• Use the American Institute of Architects Guidelines for Design and Construction of Hospitals (2001 edition) when planning renovation
• Conduct a pre-construction risk assessment prior to demolition or construction that proactively identifies the impact on the care provided by the hospital
• Perform a risk assessment prior to demolition and construction to address the impact it may have on infection control, utilities, noise, vibration and emergency procedures
• Implement proper controls based on the results of the previous two risk assessments

Brad Keyes, CHSP
Consultant
The Greeley Company