AAMI webinar: Guidance to minimize hospital disasters undergoes revision
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The title change—from “NFPA 99: Standard for Healthcare Facilities” to “NFPA: Healthcare Facilities Code”—reflects a distinction in the size and scope of the document. “The important thing to recognize is that it is suitable for adoption into law,” said Lipschultz. “It is NFPA’s expectation that this will be adopted into law.”
The Authority Having Jurisdiction (AHJ), which could include state, county, and municipal governments, as well as The Joint Commission, can adopt the codes into law, said Lipschultz, who stressed the importance of finding out who their AHJs are. “And you may have more than one AHJ in your area,” he said.
The new 2012 edition, which is currently available in electronic format, is risk based, instead of occupancy-based as it was in past editions, said Lipschultz, because many of the procedures that occurred only in hospitals 10 years ago are now done in an office setting. And conversely, some parts of hospitals are now used as medical offices, he said.
Among the fundamentals of the document, devices must be evaluated based on the worst outcome of the failure’s impact, and there are four categories by which that is measured in the revised document, according to the presentation.
Category one includes facility systems in which failure of equipment is likely to cause major injury or death. Those systems are expected to work or be available at all times to support patient needs. Category two includes systems in which failure is likely to cause minor injury, and systems are expected to provide a high level of reliability. Category three includes systems in which failure of equipment is not likely to cause injury, but may cause patient discomfort, and normal system reliabilities are expected. Category four has no minimum requirements, as failures are not expected to impact the patient.
“A critical care room is designated as a category one, a general room is designated as a category two, a basic care room is designated as a category three and a support room is designated as a category four,” said Lipschultz.
Operating rooms may fall under new requirements as a result of the revision, as well.
“One of the things that was very contentious in the last go-around, was wet procedure locations,” said Lipschultz. “Although the definition of the term did not change, how it is applied changed with respect to operating rooms.”
Operating rooms will be considered wet procedure locations unless a risk-assessment conducted by the healthcare governing body determines otherwise. “This is brand new material, it was a requirement that on behalf of AAMI I strongly opposed, right up to an appeal to the overall NFPA and their standards council. All of those were rejected,” said Lipschultz. “Whether or not your operating rooms are wet procedure locations depends on an assessment by the healthcare governing body.”
A substantial amount of content was removed from the previous edition, including a chapter aimed at manufacturers and another applying to anesthetizing locations. “Nice to have” text was also removed, because of the intent for the document to be adopted into law, explained Lipschultz.
“The reason for doing that is that, since codes are meant to be adopted into law, the committee didn’t want to have required text that was nice to have in the previous version,” he said.
The revision also includes other changes to standards, requirements and terminology. The updated version is available for purchase here.
Proposals for revisions are currently being accepted for inclusion in the next edition, scheduled to be published in 2015. Submissions can be made until June 22, 2012, at www.nfpa.org/99.