White Papers
Ebola Preparedness Survey Results

White Papers

Environmental Health & Safety Compliance

Ensuring Fire Barrier Integrity for Patients, Staff and First Responders: Continuous Compliance through Information Management (677 kb)
This case study details the cost-effective program Brigham and Women’s Hospital and EH&E developed to resolve root causes of firewall breaches in hospitals and ensure proactive identification and resolution of fire and life safety deficiencies both during and after construction. The program achieved greater than 96% compliance with The Joint Commission and an estimated savings of more than $1 per square foot of floor area through the avoidance of post occupancy firewall repairs.

Best Practices for a Highly Functioning, Compliant Institutional Biosafety Committee (650 kb)
Learn current best practices that will help every Institutional Biosafety Committee (IBC) function optimally so that they can better meet their goal of protecting workers and the community.

Risks & Costs of Construction-Related Infections: New Approach to Containment Monitoring Protects Patients and Hospitals (1 mb)
Learn about a proven solution for improving patient safety and avoiding costly construction delays. The solution is a 24/7 automated system that monitors construction activity and issues "Smart Alerts" to instantly notify the construction team, so problems can be corrected before they negatively impact patients, staff or assets.

Getting Ambulatory Care Centers into Compliance: Key Challenges and Strategies (655 kb)
This paper discusses key compliance challenges for ACCs, the most common Joint Commission citations and root causes, and cost-effective strategies for ensuring that all ACCs affiliated with your hospital are compliant.

A Practical Guide to Implementing a BSL-2+ Biosafety Program in Laboratories (913 kb)
BSL-2+ is the commonly used term for laboratories where work with microorganisms is conducted in a BSL-2 laboratory with biosafety practices and procedures that are typically found at BSL-3. This hybrid approach has been in use for many years, however, most research institutions still find it challenging to decide when to use this approach and which BSL-3 practices to use, due to the fact that it’s not a recognized containment level. This paper outlines a practical approach for successfully implementing BSL-3 practices in a BSL-2 laboratory.

Microsoft SharePoint: A Powerful Solution for Environmental Health and Safety Programs (891 kb)
This white paper discusses the use of Microsoft SharePoint, an often-overlooked yet commonly available platform that can address many of the needs of both small and large EHS programs in a customizable, scalable and cost-effective way. Microsoft SharePoint offers EHS program mangers a powerful organizational solution that may already be present on their internal servers. This whitepaper offers practical examples and advice on developing EHS solutions using SharePoint.

A "Six-Step Process" to Investigate and Prevent Laboratory Accidents (225 kb)
Laboratories are potentially dangerous work environments, and while proper training, engineering controls and administrative precautions can help to effectively manage risk, accidents can and do happen. Accidents, while unfortunate, present an opportunity to improve the performance of a laboratory safety program. EH&E has outlined a six step process for an effective laboratory accident investigation program that will help to identify root causes, prescribe appropriate corrective measures, and implement performance metrics to insure a safer workplace.

The Joint Commission Emergency Operations Plan: 7 Common Vulnerabilities (158 kb)
EH&E performs many Emergency Management audits each year for hospitals and has found a number of common deficiencies pertaining to the Emergency Operations Plan at small to medium-size hospitals. Based on our experience, this white paper identifies the most common deficiencies by standard area along with our recommendations for how hospitals can better prepare for their next Joint Commission survey.

Making Occupational Safety & Health Really Work in Hospitals: (222 kb)
Healthcare is one of the most challenging environments in which to manage Occupational Environmental Health and Safety (OEH&S), yet the cost of even average performance can be high. We have found that average or underperforming OEH&S programs have similar root causes. This white paper identifies key management strategies that will improve program performance and minimize financial risk.

Managing Pharmaceutical Hazardous Waste in the Hospital (451 kb)
Hospitals and healthcare facilities have been cited by state and/or federal regulatory agencies for improperly disposing of pharmaceutical waste material. These citations have been applied to operations in both hospital pharmacies and patient care areas. This document outlines a six-step process for developing an effective and compliant Hazardous Waste Drug Program.

Infection Control in the Healthcare Environment during Construction (184 kb)
In April of 2001, the American Institute of Architects (AIA) issued directives in the Guidelines for Design and Construction of Hospitals and Health Care Facilities which formalized the Pre-construction Risk Assessment (PCRA) and Infection Control Risk Assessment (ICRA) process. Later that same year, The Joint Commission adopted the AIA guidelines as part of their regulations and established an enforcement date of January 2002. Since that time, healthcare facilities have been required to use the AIA guidelines and to provide documentation of compliance. This white paper reviews the elements of compliance and identifies a solution for maintaining PCRA documentation that has been successfully implemented at a leading teaching and research hospital in the United States.

Using Practice Interview Sessions to Strengthen Your Survey Preparedness Within the Environment of Care (330 kb)
Practice interview sessions with hospital staff are a great preparation technique for The Joint Commission (JC) surveys in the Environment of Care. This standard area spans a wide range of disciplines and departments in the hospital, and any survey involving the JC's tracer methodology will require participation by many to succeed. This white paper provides an overview of the practice interview technique and discusses “best practices” for conducting practice interview sessions.

Biosafety Review Key to Infection Control (196 kb)
Companies and institutions with biological laboratories understand the importance of complying with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) biosafety guidelines and the Bloodborne Pathogens Standard. Yet remaining in compliance can be demanding as research and development efforts continue to expand into new areas. Conducting a laboratory review to ensure compliance with existing guidelines and standards is a valuable investment. This white paper outlines the biosafety review process and tells you how to maximize the benefits of your biosafety review.

Environmental Health & Safety Compliance in Laboratory Operations: Common Deficiencies Encountered During Audits (178 kb)
Environmental health and safety (EH&S) compliance programs for companies that house laboratories are complex and not easily maintained. Even the most basic plan involves keeping a variety of permits up-to-date, performing regular employee training, conducting inspections, complying with a myriad of chemical storage and handling requirements, and keeping a number of contingency plans current and complete. This white paper identifies the most common pitfalls and four simple steps to keeping your EH&S program current.

Continuous Joint Commission Compliance: Responding to the 2006 Unannounced Survey Policy within the Environment of Care (168 kb)
In an effort to encourage hospitals to maintain a state of continuous compliance, The Joint Commission has announced a new policy of conducting unannounced surveys. This new policy will take effect January 2006, and clearly puts added pressure on healthcare institutions to strengthen their EOC programs and processes to ensure they are always ready for a compliance audit. The most common barriers to maintaining continuous compliance are...

Three Proven Strategies for Upgrading Your Lab Environmental Health & Safety Program (2 mb)
By analyzing patterns in EH&S compliance deficiencies, we identified three systemic root causes of the vast majority of compliance issues. Our EH&S staff then developed strategies designed to address these root causes within several large research institutions and immediately experienced positive results. This whitepaper describes the three strategies used to improve program performance and summarizes the field results observed.

Cape Cod Hospital’s Transition to Continuous Compliance Status within the Environment of Care (217 kb)
Cape Cod Hospital made a concerted effort to upgrade their Environment of Care program in preparation for The Joint Commission’s continuous compliance requirements and unannounced survey policy. As part of this effort, the hospital adopted EH&E’s web-based EC compliance support site that provides program organization, centralized access to documents and data, policy and plan templates, databases and reporting tools. This case study is an interview with Cape Cod Hospital personnel with key roles in the effort to upgrade the hospital's compliance program.


The Untold Truth About Energy Cost Reduction: What Healthcare Executives and Financial Officers Need to Know (469 kb)
Steward Health Care boosted their bottom line by $2 million annually through a new approach to energy management called Building Energy Optimization. Learn why this new approach succeeds where other energy initiatives fail; and how it was implemented with great success at Steward Health Care.

LEEDing the Way With Green Design at Brigham and Women’s Hospital (698 kb)
Healthcare facilities present unique challenges such as 24/7 operation, intensive energy consumption, infection control, traffic, and developmental density. This paper uses Brigham and Women’s Hospital’s new 440,000 square foot, cardiovascular care facility as a case study to present some of the unique approaches used and lessons learned in certifying a large healthcare facility for LEED.

The First (Big) Step to Reducing Your Campus Carbon Footprint (290 kb)
When developing a campus-wide sustainability effort, retro-commissioning of existing buildings is often overlooked. However, retro-commissioning will have an immediate impact of 10% or more on energy use across a campus. This white paper details the advantages of retro-commissioning as the first step in a campus energy reduction strategy.

Profiting through Campus Sustainability: Financial Tools and Strategies (359 kb)
Truly integrated sustainability projects often result in favorable long-term returns, whether they are in the form of economic, environmental, or social benefits. In times of economic downturn and recession, successfully integrating sustainability into campus operations can stabilize operating costs and provide a solid foundation for long-term economic planning. This white paper takes you through the basics of sustainability finance, including life cycle costing and information on rebates, grants, and other incentives available to the institution.

Striving for Climate Neutrality on Campus: 7 Steps to Writing a Climate Action Plan for a Reduced Carbon Footprint (294 kb)
A climate action plan (CAP) is a university-sanctioned strategic infrastructure planning document that provides a roadmap for achieving a greenhouse gas (GHG) reduction target. It provides the decision-making framework to prioritize GHG mitigation efforts while balancing institutional growth and programming goals. This paper outlines seven distinct steps to creating a successful climate action plan.

Indoor Environmental Quality

What You Need to Know About Managing PCBs in Construction Materials — An Emerging Environmental Issue (477 kb)
PCB-containing building materials represent a newly discovered and significant liability for building owners, developers, and others. This white paper details a proactive strategy to avoid regulatory mishaps and to accurately assess the costs of required remediation efforts prior to construction so that these costs can be predicted and minimized in the project budget.


Getting the Building You Paid For (331 kb)
This white paper describes a growing trend in the construction industry towards building being occupied prior to final systems completion. This invariably leads to significant cost to the owner. The issue is outlined, and a process described to minimize the problem through tracking of key contract deliverables during the construction process.

Getting a Better Performing Building Through Recommissioning (68 kb)
Commissioning of new construction is becoming increasingly accepted as a quality assurance tool to deliver performance, reliability, and efficiency in building systems. But what about existing building stock? If a building is meeting its functional requirements, can we assume optimal performance? The answer is no.

Haven't I Already Paid for This? (104 kb)
This is a question owners often ask when commissioning is discussed. However, a more relevant question is: did I get what I paid for?

Five Key Elements in Completing and Delivering Your Building to Expectations (290 kb)
Using a case study, this white paper focuses on the five key elements of building construction completion: installation, start-up, control, balance, and performance verification. It also discusses the relationship and resulting impact of the overlap of these five completion elements with the three stages of completion.

Disaster/Emergency Preparedness

H1N1 Influenza - Now is the Time to Prepare (153 kb)
Commercial businesses should be prepared to deal with the ramifications of an influenza outbreak. The CDC recently estimated that as many as 40% of the population could become infected.

Natural Disaster Readiness Self-Assessment (64 kb)
This checklist is designed to assist in the identification of conditions that could jepordize the safety of a building and to protect a building and its contents from damage. In addition to calling out steps for improving building safety, this checklist can be used to prioritize decisions regarding building upgrades and maintenance.