Emerging Regulatory Trends and Management Issues for New England
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Emerging Regulatory Trends and Management Issues for New England Hospitals and Healthcare Facilities. Robert Castaldo Director, EH&S Massachusetts General Hospital Boston, MA. Environmental Business Council of New England July 27, 2005. Partners HealthCare Network Founding Members

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Emerging Regulatory Trends and Management Issues for New England

Hospitals and Healthcare Facilities

Robert Castaldo

Director, EH&S

Massachusetts General Hospital

Boston, MA

Environmental Business Council of New England

July 27, 2005


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  • Partners HealthCare Network England

  • Founding Members

  • Massachusetts General Hospital*

  • Brigham & Women’s Hospital*

  • Other Members

  • Faulkner Hospital

  • McLean Hospital*

  • Newton – Wellesley Hospital

  • North Shore Medical Center

  • MGH Institute of Health Professions

  • Partners Community HealthCare

  • Partners Continuing Care

  • * Harvard Teaching Affiliate


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  • Third Oldest Hospital in US; Largest in New England England

  • 19,500 employees (includes 2,900 nurses)

  • 3,600 member medical staff

  • In- Patient Services

  • Available Beds: 893

  • Average Occupancy Rate: 80.47%

  • Admissions: 44,518

  • Average Length of Stay: 5.83 days

  • Admissions to Observe: 5,285


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  • Ambulatory Services England

  • MGPO Visits: 694,268

  • Clinics Visits: 417,203

  • Health Centers Visits: 299,232

  • Emergency Visits: 74,905

  • Total Ambulatory & Emergency 1,485,608

  • Surgical Services

  • In-Patient 17,957

  • Ambulatory 15,013

  • Total Surgical Cases 32,970

  • Births 3,604


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MGH Mission England

Clinical Care, Teaching and Research

  • Almost all staff physicians are on

  • the Harvard Medical School faculty

  • Largest hospital-based research

  • program in the US


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Downtown Campus – clinical & research England

Charlestown Navy Yard - research

Community Centers - clinical


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  • New Emergency Management Demands

    • HAZMAT Response Readiness

    • Biosafety

  • JCAHO

    • Periodic Performance Review Process

    • Patient Safety

  • Specific Continual Regulatory Oversights

    • EPA

    • MWRA


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    • Hospital Growth and Renewal England

    • Major additions on the main campus

    • Extensive backfill renovations

    • Preparations for next major rebuilding project

      • Impact on EH&S:

      • Keeps facilities-related safety issues as an everyday

      • priority

        • Construction Impacts – internal and external

        • Fire Safety Management

        • Life Safety Management

        • Environmental Impacts – asbestos, molds, ICRA


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    • Emergency Preparedness and Homeland Security England

    • HAZMAT Response Capabilities – Greater

    • expectations for hospitals

    • Chemical – Radiological – Biological Incidents: Mass

    • Casualty Management

    • Biosafety and Select Agent Rules: Public Health Security

    • and Bioterrorism Preparedness and Response Act

      • Impact on EH&S:

      • HAZMAT Incident Response – heightened and

      • continual readiness; mass casualty focus

      • More systematic oversight and control of biological

      • research – increased security re: personnel and

      • facilities


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    Chemical HAZMAT Response Teams England

    Risk Assessment

    Recruitment

    Training

    Drills


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    Location England

    Visibility and Accessibility

    Fleet Center

    Government Center

    Transportation Hubs

    MGH


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    • Protect our patients England

    • Protect our staff

    • Protect our facility

    • Preserve the ability of MGH to serve the community in a large-scale disaster involving hazardous materials


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    • JCAHO Periodic Performance Review Process England

    • Changes JCAHO 3-year auditing process

    • Now requires mid-cycle self-review

    • Performance Improvement Plan submission

    • Improvement Tracking

    • Engineering surveyors now on the JCAHO team

    • 2006 Patient Safety Goals

      • Impact on EH&S:

      • From a once every 3 year exercise to more continual

      • quality management process in all areas

      • Engineer surveyors up the ante with facilities-related

      • management issues

      • Align safety functions with current patient safety goals


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    • 2006 Patient Safety Goals England

    • Improve Accuracy of Patient Identification

    • Improve Caregiver Communication

    • Improve the Safety of Medications Usage

    • Reduce Care-Associated Infections

    • Reconcile Medications Across a Patient’s Care

    • Continuum

    • Reduce Harm from Patient Falls


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