Simplifying the management of the environment of care.

In 1995, the JCAHO introduced a new chapter for its manual called "Management of the Environment of Care (EC)." The chapter provides a common-sense organization to a department by grouping similar subjects around the common goals of safety, security, hazardous materials, emergency preparedness, life safety, medical equipment and utility systems. Its focus always remains on patient care. Forty-five individual standards are listed in the EC chapter under four categories: design, implementation, measuring outcomes and implementation, and social environment. Follow the step-by-step instructions to determine the policies and procedures you'll need to generate in your own organizational plan. Teaching becomes critical and requires nearly an almost continuous effort to maintain competency and ensure safety--no one can afford to take chances and put either patients or staff in jeopardy. For each of the standards in the design section, the JCAHO manual identifies exactly what to teach. Regarding medical equipment, the EC chapter indicates what to measure, along with the necessary steps for maintaining an information collection and evaluation system. When you design your quality improvement plans, evaluate how your medical equipment might improve the quality of patient care or staff safety. Evaluate your medical equipment plan (or policies) annually by asking your staff if it works.