Healthcare’s Physical Environment Shouldn’t be Your Last Consideration

Live…From Your Urgent Care Center?

Chevy Chase, an original cast member on Saturday Night Live, became known for the ‘pratfall’ immediately preceding his introduction of “Live from New York, it’s Saturday Night!”  It was the fall of the week and those of us who were around back then all watched for it.

He took Gerald Ford’s famous fall while exiting Air Force One to a whole new level and almost single handedly branded the President as a clumsy leader with his relentless impersonations of the President tripping and falling. But while Chevy had mastered the pratfall, a healthcare center’s employees and physicians, or worse – its patients and guests – aren’t typically as fortunate if they ‘Chevy Chase’ in the office.

While urgent care and other ambulatory healthcare providers recognize the value of the patient experience, the physical environment is too often neglected or lowest on the priority for spending and upkeep.  A great customer service and clinical experience will be quickly overshadowed by failure to promptly address stained ceiling tiles, broken lights, faulty A/C or a ‘slip and fall’ due to poorly maintained flooring.

Homeowners know that maintenance is essential to the current and future market value of their investment.  Owners and operators of urgent care and ambulatory care centers need a quality environment mindset to maintain or enhance the value of their businesses.

Competition on the Rise for Patients and Employed ‘Talent’

An internet search will readily demonstrate that urgent care operators are seeking physicians, advanced practice clinicians (APCs), medical assistants, radiology technicians, nurses and other talented professionals.  Urgent care centers are no longer in the ‘if you build it, they will come’ mindset.  Both patients and employees have choices.  What does the appearance of your retail healthcare center say about you?

A neglected site creates a poor brand image for not just the individual site but all other locations associated with that brand name.  Both new and current patients can be turned off quickly by an environment that’s not in pristine condition.  When it comes to healthcare, a patient’s mind quickly extrapolates actual poor physical conditions to perceived poor quality of care.

And employees can exhibit similar reactive behavior.  A good employee can be lured away for a modest pay bump, better benefits or simply because the physical environment is just that much more pleasing to spend 40+ hours in week after week.

Two of the questions on the famous Gallup Employee Engagement assessment that correlate to workplace loyalty include:

1. Do I have the materials and equipment I need to do my work right?
2. Are my co-workers committed to doing quality work?

Not surprisingly, there is a strong correlation between employee engagement and the sense that the organization they work for is committed to quality.  Healthcare operators need to know that lax attention to their physical environment can be a strong factor leading to costly workforce turnover.

Regulators Care about Workplace Safety So You Should Too!

The Occupational Safety and Health Act of 1970 mandated that all employers provide a safe and healthy workplace, yet 2013 data showed 244,800 hospital recorded work-related illnesses and injuries, of which 57,680 resulted in lost work days.  This relates to 6.4 injuries per 100 full-time employees…nearly twice the number for all other industries.

As a result, OSHA issued a memorandum to its inspectors for these healthcare settings to alert them to the high incidence of injury and areas of focus during inspections. Safety hazards specific to musculoskeletal disorders (MSDs) and slip, trips and falls (STFs) were specifically cited.  

While these alarming statistics applied to the inpatient setting, the physician office is hardly immune from environmental hazards.  Outpatient clinics, urgent care centers and ambulatory care settings are obligated to identify all chemical, biological, physical, ergonomic and psychological health hazards.

While many of the top five 2012 OSHA citations involving physician offices and clinics relate to bloodborne pathogen (BBP) standards, the fourth most cited related to poor housekeeping under the BBP standards.  The conclusions were that there should be a plan to regularly audit the safety and health compliance in the medical office.

OSHA estimates that work-related MSD’s cost employers as much as $20 billion per year.  That cost is just the start for medical practices across the country.  Additional costs include lost work time including payroll costs to replace the injured worker, a negative brand image and potential legal fees.

Think this can’t happen to your operation? The website of a West Coast law group states,

”Hospitals and Doctor’s offices are supposed to comport to strict sanitary and safety guidelines….If you have suffered from a slip and fall accident in a Doctor’s Office or hospital clinic, contact our Slip and Fall premises liability lawyers today.”

Improper use of floor mats and runners, lack of maintenance and upkeep of safety guidelines, poor drainage, poor lighting, uneven walking surface areas, managerial and staff negligence, and loose cords and wires are all cited as hazards or risks.   

Healthcare Accrediting Organizations Focus on Environment of Care

Urgent care centers and other ambulatory care sites have been seeking accreditation through one or more accrediting entities including the Urgent Care Association of America (UCAOA) and The Joint Commission.  Most pursue accreditation voluntarily while others do it as an ‘in-network’ payer requirement.  Recognizing the costs and risks associated with safety neglect, it is not surprising that accrediting organizations place significant emphasis on the environment of care.  Examples of standards as established for the urgent care environment by UCAOA include:

There is a plan to manage safety and security risks associated with the physical environment with controlled access to and from areas identified as security sensitive Risks are eliminated that might lead to slips, falls, burns, trauma or toxic ingestion Fire drills and a written fire plan Risks related to biomedical waste are addressed via written policy Up-to-date material safety data sheets (MSDS) OSHA standards/ training/ incident reports Medical equipment inspection and calibration at least annually

Benefits of pursuing accreditation that extend beyond injury and risk mitigation include the opportunity to distinguish the center with consumers (i.e., patients), payers and other referring medical providers.  A well-maintained healthcare location sends a positive message about the culture and the center’s commitment to creating a safe environment for patients, visitors and employees.

In this first post, we’ve explored how properly maintaining your healthcare environment is crucial, from delivering quality of care and retaining employees to meeting accreditation and regulatory requirements.  Bottom line, it’s good for your bottom line!

Now that you’ve seen the why – next comes the how.  How can you ensure that all your repair and maintenance is performed efficiently and effectively?  What tools and technologies have been built for healthcare facilities?  How does service automation software drive results for urgent care, ambulatory care and other healthcare centers?  

Our next post will dig into some of the ways smart healthcare operators ensure proper care of their facilities and what type of technology investments they’re making.

Laurel Stoimenoff earned a degree in Physical Therapy & Allied Medicine but quickly entered multi-site, multi-state management with leadership roles with physical therapy, diagnostic imaging and finally urgent care organizations.  In late 2011, Laurel and a colleague founded Continuum Health Solutions, a consulting firm with a focus on the urgent care industry. Continuum’s clients include hospitals, physician groups, private equity, occupational medicine organizations and entrepreneurs.  Laurel served seven years as a Board member of the Urgent Care Association of America, including its Treasure and Vice President.  She Chairs the Health & Public Policy Committee and Co-Chairs the Accreditation Committee. Laurel also serves as a Trustee of the Urgent Care Foundation.