• Art Goguen

How to Develop a World-Class Healthcare Construction/Renovation Program


Undertaking construction projects in operational healthcare facilities is risky business.

Regrettably, many professionals underestimate the level of risk.


Across the U.S., hospital-acquired infections related to construction and renovation activities account for more than 5,000 deaths per year, according to Judene Bartley MS, MPH, CIC.


These deaths are preventable, but effectively managing contractors during healthcare construction projects takes significant preparation. It also requires a commitment to continuous improvement.


What Does an Effective ICRA Program Look Like?


Thoroughly vetting contractors is only the first step to protecting the health and wellbeing of both patients and healthcare workers. Continued monitoring of contractor compliance with site infection control risk assessment (ICRA) programs – including periodic training refreshers – is paramount to building a mature, comprehensive construction infection control program. Program reviews should also be continually enhanced to support strategic goals of zero infections due to construction and renovation projects.

Consider the following framework when creating a comprehensive infection control program for healthcare construction/renovation projects:

  • Policy on construction with support of all department heads,

  • Prequalifying all contractors who will work on the project,

  • Performing periodic ICRA risk assessments,

  • Pre-start training with identification of those who have been trained,

  • Recurrent training review programs,

  • Diligent incident monitoring,

  • Corrective action planning, and

  • Continuous program review and improvement.

Prequalification includes conducting a thorough review of the contractor’s own ICRA program to see if it aligns with the standards and objectives of the healthcare facility. This process also involves vetting key superintendents and project managers for adequate healthcare experience, and reviewing the contractor’s OSHA compliance safety programs, including:

  • Job hazard analysis,

  • Containment and anteroom design,

  • Pre-task planning,

  • Work permit systems,

  • Periodic review of contractor’s ICRA compliance,

  • Ongoing communication with the contractor and client, and

  • Commitment of staff and time to patient safety and infection control.

Contractor training objectives should be defined well in advance of project start and thoroughly reviewed to ensure they closely align with the healthcare facility’s objectives. These training objectives should then be periodically reviewed to ensure that all new contractors are adequately trained and prepared to properly perform construction work in a healthcare environment.


Finally, there should be a continuous program review with set milestone timeframes for assessing and auditing safety and infection control compliance during critical aspects of the project, e.g. proper containment and anteroom design, maintaining infection control precautions, monitoring possible HEPA efficiencies, and overseeing contractor compliance. The bottom line is: Never establish goals without following-up on a regular basis to ensure those goals are being met.


Without adequate training, there are many potential pitfalls that can lead to an increase in hospital-acquired infections. Improper containment and anteroom design, for example, is a common vulnerability that often goes unnoticed, potentially allowing significant construction contaminants into the hospital environment.


Every World-Class Construction ICRA Program Involves Setting Protocols, Guidelines, and Best Practices

For more than a decade, Higgins and Associates, LLC has worked with many hospitals and other healthcare clients by supporting safety and infection control efforts during their construction and renovation projects throughout Colorado. We assist clients with proper containment design, ICRA training, containment oversight, contractor training, and air/water sampling during construction projects large and small.


Worried about potential deficiencies in your construction project ICRA plan? Concerned that your contractor may not be prepared to meet your environmental infection control protocols?


Don’t hesitate to contact us. Our EHS experts are trained to perform detailed assessments and help address deficiencies before they become significant problems.


For more information, contact Art Goguen, Director of EHS, at (303) 994-8122. You can also visit our website to learn more about all of our healthcare EHS services.


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