The Parker File
- Associate director for life safety and physical environment at the Accreditation Commission for Health Care (ACHC), Cary, N.C
- Executive director of facilities, and director of facilities and construction, Tucson Medical Center, Tucson, Ariz
- Administrative director of non-clinical services and director of facilities services, Northwest Medical Center, Margate, Fla.
- Director of support services, Merit Health River Region Medical Center, Vicksburg, Miss.
- Director of support services, Las Colinas Medical Center, Irving, Texas.
- Arizona Society for Healthcare Engineering.
- American College of Healthcare Executives.
- American Society for Health Care Engineering.
- Master’s degree in business administration, Belhaven University, Jackson, Miss.
- Bachelor’s degree in management at University of Phoenix, Ariz.
Last year, Richard Parker, MBA, CHFM, FACHE, FASHE, was named associate director for life safety and physical environment at the Accreditation Commission for Health Care (ACHC), where he manages the life safety, physical environment and emergency management programs. This month, he reflects on his career and new position.
Why did you decide to move from facilities management to accreditation?
I worked as a surveyor for a few years while a facilities manager. Bringing practical hospital experience to support facilities managers facing challenges from an accreditation perspective seemed like an important opportunity.
During my surveyor orientation training, our process was presented as three components: observing and evaluating the physical environment; diving into the documentation, logs and reports for both physical environment and life safety; and educating by sharing best practices or talking through issues that present challenges.
ACHC’s emphasis on education is an approach I truly enjoy. My past experiences as a facilities manager and a surveyor have combined to give me a new way to make a difference in health care.
How has the American Society for Health Care Engineering (ASHE) informed and assisted your career journey?
My initial experience was with the local chapter, and my first event was with a consultant discussing new standards and how to comply. I was new to the field, but I felt he was speaking my language and confident that when I returned to my hospital, I would be ready. When I returned, the facilities director had resigned, and everyone was looking at me to prepare for an upcoming survey. I did a rapid gap analysis and put together a preparation strategy. The survey went very well.
My first national ASHE conference was humbling because it opened my eyes to how much I didn’t know. The Certified Healthcare Facility Manager (CHFM) program identified where to concentrate my development. After achieving my CHFM, I began working on other ASHE programs, earning Senior (SASHE) and then Fellow (FASHE) status. These programs provide a path for a health care facilities manager to follow for professional development and giving back to future leaders.
What does your new role at ACHC entail?
I review and update standards, guide surveyors, develop compliance tools and review survey documents related to the physical environment, life safety and emergency management. Knowing what it is like to be on the facilities manager side of the table, I have practical experience that serves me well when it comes to educating facilities managers or leaders before, during and after a survey.
What types of health care facilities does ACHC accredit?
We cover the continuum of care with 19 accreditation programs, 10 of which include deeming authority from the Centers for Medicare & Medicaid Services. We’re also very active in non-deemed areas like pharmacy accreditation and offer certification programs for various types of clinical care. All in all, ACHC accredits more than 20,000 organizations.
How would you characterize ACHC’s approach to accreditation and surveys?
We partner with organizations to meet their needs while providing the best possible accreditation experience. We know the survey process is stressful. We are there to find areas for improvement with an educational intent that truly sets us apart. When we cite a deficiency, ACHC surveyors spend the time to make sure the facilities manager understands the finding and to answer questions about possible solutions. Our surveyors have seen many different ways to resolve an issue. Sharing that experience is valuable to the organizations we serve.
What has been your role in the merger of ACHC and the Healthcare Facilities Accreditation Program (HFAP)?
The merger of ACHC and HFAP has been very successful. Hospitals that knew us as HFAP will find that the survey process hasn’t changed, but our ability to provide more resources and accreditation programs significantly increases our value to them. My role as a subject matter expert has expanded to provide counsel to additional programs such as ambulatory surgery centers and assisted living facilities.
What are some of the biggest compliance challenges you’re seeing?
The top four areas are ventilation, light and temperature controls; maintenance of ceilings; fire-rated barriers; and fire protection systems.
Our standard for ventilation, light and temperature controls includes an expectation for maintenance of lighting. I’m seeing this as a growing issue, particularly in sterile environments where maintenance staff make rounds less frequently. I also see it in areas like medication rooms and sterile storage. As facilities managers, part of our job is maintaining an environment that reduces the risk of error — and diminished lighting can be a contributor to error. Partnering with clinical leaders in these areas can improve the identification and communication of issues.
The fire protection systems and inspection, testing and maintenance (ITM) activities come up frequently. Maintenance of barriers, including acoustical ceilings, is a constant task. When organizations include information technology leaders on the safety committee, it can help bridge the knowledge gap and reduce the number of surprises during a survey. Facilities usually schedule and perform ITM on fire protection systems but tend to miss closing the loop on deficiencies. The inspection and test are important, but acting to correct problems is where facilities managers seem to struggle.
Many facilities managers are also responsible for the emergency management standards. Health care organizations have done well with this overall, but facilities managers need to be aware of changes that were prompted by the prolonged COVID-19 public health emergency (PHE). Taking lessons learned and documenting in our emergency operations plans (EOPs) what worked well and should become standard practice is important.
Updates in ACHC standards address emerging infectious diseases and patient surge response in both the hazard vulnerability analysis and EOP. We also experienced, and in some cases continue to experience, challenges in obtaining resources that may impact how we manage inventory and suppliers.
What challenges do you see on the horizon for health care facilities managers?
One challenge is change management. The PHE created multiple emergency responses for organizations. One positive takeaway was how quickly an organization can change when faced with a threat like COVID-19. Leadership pulled together, debated response and what processes needed to change, and initiated the change and staff education within days and sometimes hours.
A second challenge is around security. I encourage hospitals to think about security the way they think about fires. For fires, we have response plans, static building features of protection and dynamic features of protection. We perform regular training and drills around our fire response. If we were to think about security in a similar way, what might that look like? Using these activities as a blueprint for security follows a proven track record for keeping our hospitals safe for patients, staff and guests.
Michael Hrickiewicz is editor-in-chief at Health Facilities Management magazine.