Maintaining safe, compliant non-acute healthcare environments requires coordinated facility operations, proactive maintenance and consistent standards across engineering, environmental services and other support teams. | Photo Credit: Courtesy of ABM
By Charlie Lange
As healthcare delivery continues to expand beyond traditional hospital campuses, maintaining consistent facility compliance across clinics, ambulatory surgery centers, medical office buildings and other non-acute environments is becoming increasingly complex.
Those challenges were the focus of a recent HC+O News webinar, “Beyond the Hospital: Facility Compliance Challenges in Non-Acute Healthcare,” presented Sept. 1 and sponsored by ABM. The session featured ABM representatives Michael Ream, Director of Sales for Enterprise and Healthcare Solutions; Chris Giannotta, Director of Sales, Enterprise and Healthcare Solutions; and Kimberly McMahan, Vice President of Operations; with session moderator Amber McMurry, Strategy Manager, B&I.
Panelists explored how healthcare organizations can strengthen compliance while navigating decentralized portfolios, limited resources and increasingly complex facility needs.
Standardizing Compliance Across Diverse Facilities
One of the central challenges in non-acute healthcare is determining what can be standardized across a portfolio while accounting for the unique risks of individual facilities.
“Compliance priorities vary by healthcare settings because each environment has its own different risks,” Giannotta said. An ambulatory surgery center may emphasize sterile environments and terminal cleaning, for example, while imaging facilities must account for sensitive equipment and MRI safety requirements.
McMahan said organizations can standardize elements such as governance, work-order processes, training, escalation procedures and documentation while maintaining site-specific requirements based on services, licensing, accreditation and occupancy classifications.
The challenge becomes greater as facilities move farther from a hospital’s centralized support infrastructure. Ream noted that a remote surgery center may not have daily access to the infection prevention, safety and facilities resources available on a hospital campus, even though it can face many of the same regulatory expectations.
Moving From Reactive to Proactive Operations
Limited staffing and resources can also push facilities toward reactive maintenance, allowing less visible compliance risks to remain unresolved.
“When you have limited resources and there’s an absence of a consistent way to prioritize risk, every work order is treated equally,” McMahan said.
She recommended maintaining accurate asset inventories, assigning criticality based on patient safety and regulatory exposure, and protecting preventive maintenance for high-risk assets such as fire protection, emergency power, water and systems supporting patient procedures.
Ream similarly encouraged organizations to move beyond minimum compliance requirements toward a culture of commitment.
“How do we create the best patient care environment? How do we take care of each other the best? How do we create the best safety?” he said.
Giannotta added that routine inspections can uncover seemingly minor problems before they grow. “The goal is really to catch those things early before they become bigger problems.”
Connecting EVS, Engineering and Patient Care
Panelists repeatedly emphasized that environmental services and engineering teams are integral to the clinical environment.
McMahan said facility teams support patient care by maintaining ventilation and filtration, room pressures, temperature and humidity, water quality, emergency power, medical gases and other infrastructure. Engineering should also be involved in infection-control risk assessments before construction or maintenance activities create dust, change pressure relationships or require system shutdowns.
On the EVS side, Ream stressed the importance of developing cleaning programs around healthcare-specific standards rather than treating clinical environments like conventional office space.
“You have to go space by space,” he said. “You have to look at what the best practices are, what the benchmarks are.”
That collaboration can extend into design and construction. Giannotta recommended involving facility vendors before or during the RFP and construction process so their operational experience can inform material and system decisions.
“The more you get all of your vendors included and involved in the process, the better it’s going to be,” he said.
Using Technology to Improve Visibility
Technology can help facility leaders replace fragmented compliance processes with a clearer view of portfolio-wide risk.
McMahan recommended using computerized maintenance management systems (CMMS) not only to track preventive and corrective maintenance, but also to establish risk-based asset and compliance registries identifying requirements, responsible parties, frequencies, supporting evidence and escalation paths.
“This also creates a nice foundation for the preventive maintenance, budgeting, staffing, audit readiness and capital planning,” she said.
EVS programs can likewise use digital inspections, cleaning logs, fluorescent-marker systems and ATP monitoring to verify performance. Ream said these tools can provide evidence beyond whether an environment simply “looks clean.”
For Giannotta, the benefit ultimately comes down to “visibility and accountability,” allowing leaders to identify overdue work and recurring problems. “It really helps the team move from being reactive to proactive,” he said.
Creating One Coordinated Facilities Team
Technology alone, however, cannot replace clear governance and communication. McMahan recommended developing an operating playbook that establishes ownership, communication routines, centralized reporting and cross-vendor performance management.
That approach is especially important when organizations rely on multiple service providers. Ream noted that some healthcare networks operate with numerous engineering, janitorial and maintenance vendors, increasing variability in training and processes.
Giannotta encouraged healthcare organizations to treat outsourced providers as extensions of their internal teams. “Give them the same expectations that you have for your own team,” he said.
“Include them in your meetings and inspections. Hold everybody accountable to the same standards.”
Ultimately, panelists said strong non-acute compliance programs must balance portfolio-wide consistency with the individual requirements of each care environment.
“There’s not one-size-fits-all solution for non-acute healthcare facilities,” McMahan said. “Understanding the variables and the complexities of each environment is just so important.”
For Giannotta, the common denominator remains the patient: “No matter what, the patient still expects the same safe, clean and welcome experience anywhere.”
View the recording of the “Beyond the Hospital: Facility Compliance Challenges in Non-Acute Healthcare” webinar here.