Preventing a possible outbreak through emergency response and remediation

A facilities management team member wraps up their shift on a Friday afternoon when they get an urgent call that the new 4-story ambulatory care facility — scheduled to be opened on the following Monday — experienced a burst hot water pipe and that water has flooded several spaces on the first floor. The contractor who provided this urgent notice also shared that it is likely the pipe burst happened a day or two earlier. What should the team do? Here are six steps: 

1. Escalate the situation to leadership, as it may require the activation of incident command.
2. Implement immediate remediation measures (i.e., stop water intrusion and begin cleanup.)
3. Assess for mold contamination in collaboration with infection prevention and control and an industrial hygienist.
4. Inspect and test moisture levels in walls and surfaces prone to contamination using a moisture meter or other equipment and develop an appropriate remediation strategy. 
5. If remediation includes removal and replacement of affected materials, this may involve mobilizing a contractor. The remediation strategy should include dust containment, monitoring of work and clearance evaluation for reconstruction of damaged areas. 
6. Follow and implement hospital policy for terminal cleaning and disinfection before turning spaces over for clinical use.

The bright side of the scenario presented above is that the leak and water damage were identified prior to occupancy of the new facility. 

However, leaks and floods regularly occur in occupied facilities, and the facilities team should be familiar with processes and plans so they can implement assessments and remediation in a safe manner while maintaining daily operations. Additionally, identification of mold contamination in buildings often occurs while the facilities team is completing routine work orders for the physical environment, and the facilities manager should be prepared to follow established policies and plans for remediation. See also, the Centers for Disease Control and Prevention’s  Targeted Environmental Investigation Checklist for Outbreaks of Invasive Infections Caused by Environmental Fungi (e.g., Aspergillus, Mucormycetes) for more guidance. 

To learn more about the case above, read “Assessment of mould remediation in a healthcare setting following extensive flooding,” published in the Journal of Hospital Infection in 2024. See also the CDC’s overview and recommendations for addressing possible healthcare-associated mold outbreaks: Guidance for Healthcare-Associated Mold Outbreaks.