Overview: 1996 Joint Commission Environment-of-Care Standards

The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, has established five basic
environment-of-care standards: design,
implementation, measurement systems, social environment, and nonsmoking policy, says chief engineer Dean Samet.

Each of these standards is applied to the eight environment-of-care areas throughout the organization. Following is a brief summary of these standards:

* EC.1 - Design.

Requires designing environments of care that are safe, accessible, effective, and efficient, and that are consistent with the organization's mission, services, and law and regulation.

To meet this standard, an organization must build and/or maintain environments of care in compliance with the Guidelines for Construction and Equipment of Hospitals and Medical Facilities. In addition, an organization must have management plans in place that adequately address safety, security, hazardous materials and wastes, emergency preparedness, life safety, medical equipment, utility systems, and space.

* EC.2 - Implementation.

Requires providing safe, accessible, effective, and efficient environments of care consistent
with the organization's mission, services, and
law and regulation. Meeting this standard requires staff to be fully oriented to their specific environment of care. They must possess the knowledge and skills to perform their job duties under the environment-of-care management plans.

The organization must implement environment-of-care management plans; conduct emergency and fire drills; and regularly maintain, inspect, and test life safety, medical, and utilities systems materials and equipment.

* EC.3 - Measurement Systems.

Centers on an organizationwide information collection and evaluation system (ICES) that evaluates environment-of-care standards.

To meet this standard, an organization must collect, analyze, and distribute data gathered during safety inspections. The ICES must track current safety deficiencies and opportunities for improvement across the environment-of-care management programs.

* EC4 - Social Environment.

Requires providing social environments that support the organization's basic mission and services.

At a minimum, meeting this standard requires the organization to provide appropriate and adequate space for support services; space that fosters patients' positive self-images and preserves human dignity (for example, suitable patient clothing, door locks, and structural restraints); adequate privacy for patients; and activities to support patients' interests, skills, and growth.

* EC. 5 - Nonsmoking.

Requires communicating and enforcing the nonsmoking policy throughout the organization.

To meet this standard, all buildings of an organization must be designated as nonsmoking, and any exceptions made for patients must be based on criteria defined by the medical staff.

[Editor's note: For additional information about the 1996 Joint Commission environment-of-care standards, intents, scoring guidelines, and data aggregation rules, contact the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd., Oakbrook Terrace, IL 60181. Telephone: (708) 916-5800).] *

Source: Excerpted from the 1996 Comprehensive Accreditation Manual for Hospitals. (Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 1996), pp. 140-142.