Conducting an FGI safety risk assessment

Whether health care facilities managers are contributing maintenance and operations feedback on new construction projects or managing the project themselves, a key component to a successful health care construction project is conducting a Facility Guidelines Institute (FGI) safety risk assessment (SRA). 

When a project is required to follow FGI Guidelines, an SRA is to be conducted with the goal being the safe delivery of care. The FGI SRA components are comprised of seven key areas of risk: infection control; patient handling and movement; fall prevention; medication safety; behavioral and mental health; patient immobility; and security. If one of these categories is not applicable to a project, it may be skipped.

The facilities project manager typically leads the SRA process by scheduling the review meetings and is responsible for timing and filing. The architect and engineer of record work with a health care facility team comprised of facility leadership experts to complete the SRA. The goal is to align design with operations and mitigate harm to patients, staff and families.

The SRA is most useful early in design and must be on file with the institution when undergoing regulatory design review. The Center for Health Design shares an evaluation scale that is helpful as a guide for team members to assess each risk category and develop design solutions to mitigate the risk.  

The Center for Health Design also has an online toolkit that may be used for conducting studies and creating a standard template. The intent of the SRA is to prompt discussion and provide guidance in considering latent design vulnerabilities that may lead to harm. A template or tool is the most useful way to standardize the process for stakeholders participating in the reviews. 

Per the FGI, a facility shall maintain the project FGI SRAs, and they may or may not be reviewed during inspections. Filing with the project database keeps it with the associated project. The SRAs are also helpful for participants new to the process or project type to use as examples on future projects. 

Mary Alcaraz, PE, LEED AP, senior facilities project manager, Children’s Hospital of Philadelphia.