Working toward realistic codes and standards

Hospitals across the country can benefit from a recent decision by the Centers for Medicare & Medicaid Services (CMS). CMS stated in an April memo that it would no longer require operating rooms to have at least 35 percent relative humidity as previously required. Instead, operating rooms must have a minimum of 20 percent humidity, a level now required by several codes.

This important change comes after years of work by ASHE members who identified the problem, raised awareness of the issue, studied the matter to ensure patients would remain safe if the requirement changed and helped to advocate for change. The story of the operating room humidity requirement underscores the importance of facility professionals' getting involved in advocacy work.

In 2006, Tony Moddesette, assistant director for administrative and special services at UC Davis Medical Center in Sacramento, Calif., was planning a new operating suite. Low humidity is almost never a problem in the area and he questioned why costly humidifiers were needed. He brought the issue to local and national organizations, including ASHE.

ASHE worked with experts from many fields to research the science behind the requirement. Once it was determined that the requirement was medically unnecessary, ASHE worked with code development organizations to push for the change. Eventually, the National Fire Protection Association agreed to the change, and the 2012 edition of the Life Safety Code references a 20 percent humidity minimum.

Still, CMS had to adopt the new requirement before hospitals could use it, and ASHE worked closely with the agency to urge that change. Eventually, CMS issued the memo allowing hospitals to use the 20 percent requirement — an advocacy victory for those who worked for the change.

There is still more work to be done. Currently, hospitals must go through a waiver process — documenting their decision to use CMS's categorical waiver — to be surveyed under the 20 percent requirement. ASHE is urging CMS to adopt the 2012 Life Safety Code, which would eliminate this extra step for hospitals.

Although the process of getting this code changed took years, the benefits are tangible. Hospitals across the country will save money on utility costs while keeping patients safe.

The code development process requires research, collaboration, cooperation and compromise. It also requires a network of people across the country dedicated to improving requirements for health care. The work is worth it. Better codes and standards can save our industry billions of dollars and make a real impact on individual facilities.

Involvement in advocacy efforts can range from simply alerting ASHE to a problem to serving on code-development committees. Either way, ASHE wants to hear from you.

If you know of an unnecessary code requirement that is negatively affecting your hospital, or if you'd like to volunteer to help push for better codes and standards, contact ASHE Director of Codes and Standards Chad Beebe at cbeebe@aha.org.

By Deanna Martin, senior communications specialist for ASHE.

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