Purpose

This presentation demonstrates how a whole-building, engineering-driven analysis can challenge the long-held assumption that High Air Change Operating Rooms are cost-prohibitive.

By sharing a real-world case study of Allina Health Abbott Northwestern's new Surgical and Critical Care Center, attendees will learn how evaluating HVAC systems beyond the operating room—using a structured A3 methodology—can align first cost, improve system performance, and deliver measurable gains in patient safety, staff conditions, and long-term facility operations.

Abstract

For decades, High Air Change Operating Rooms have been viewed as cost-prohibitive—largely due to incomplete, room-level evaluations.

During the early planning of Abbott Northwestern’s new Surgical and Critical Care Center, the project team challenged this assumption by applying lean construction principles and conducting a comprehensive, whole-building analysis of the HVAC system.

Rather than evaluating High Air Change Operating Rooms solely within the operating room, the team assessed impacts on air handling systems, ductwork, electrical infrastructure, building construction, and overall building performance.

This systems-based approach revealed that while High Air Change Operating Rooms increase airflow well beyond ASHRAE minimum requirements, they also create opportunities to reduce upstream mechanical infrastructure.

When evaluated holistically using an A3 framework, these tradeoffs aligned first costs while improving overall system efficiency and overall value. The resulting design enhanced contaminant removal, improved staff comfort, reduced operational risk, and supported long-term facility performance.

This session will walk attendees through the project team’s structured decision-making process, including how clinical, operational, engineering, and construction stakeholders collaborated to evaluate cost, performance, and patient safety.

Attendees will gain practical insight into how whole-building analysis can uncover hidden value and support better-informed decisions for complex healthcare environments.

Learning Objectives

• Explain why room-level cost comparisons can misrepresent the true financial impact of High Air Change Operating Rooms.
• Describe how a whole-building HVAC analysis can identify upstream infrastructure savings and system efficiencies.
• Apply an A3 decision-making framework to evaluate complex healthcare design alternatives.
• Identify the patient safety, staff comfort, operational, and long-term facility benefits associated with High Air Change Operating Rooms.

Purpose

This session will help healthcare facilities professionals understand how fragmented regulatory information creates operational risk and how a continuous regulatory intelligence model can establish a single, trusted source of compliance information across the organization.

Abstract

Healthcare organizations operate within a complex regulatory environment shaped by federal requirements, state regulations, accreditation standards, local authorities, organizational policies, and evolving interpretations.

Too often, these requirements are managed in separate departmental silos. Facilities, safety, infection prevention, emergency management, clinical operations, and compliance teams may each maintain their own documents, spreadsheets, reference materials, and interpretations.

This fragmented approach makes it difficult to know which requirement is current, who is responsible for implementation, how changes affect existing policies, and whether the organization is consistently applying the same regulatory expectations.

This session introduces a continuous regulatory intelligence approach that consolidates requirements, interpretations, policies, evidence, ownership, and change management into one coordinated system.

Attendees will explore how healthcare organizations can move beyond periodic survey preparation and create an ongoing process for identifying regulatory changes, evaluating operational impact, assigning responsibility, updating policies, tracking implementation, and maintaining evidence of compliance.

The presentation will also discuss how a shared regulatory framework can improve communication between facilities and clinical stakeholders, reduce duplicate work, strengthen accountability, and support more confident decision-making.

Learning Objectives

• Identify the operational and compliance risks created by fragmented regulatory information and departmental silos.
• Describe the key components of a continuous regulatory intelligence model.
• Explain how a centralized regulatory framework can improve ownership, communication, policy alignment, and evidence management.
• Recognize practical steps for transitioning from periodic survey preparation to continuous regulatory readiness.

Purpose

This presentation will provide healthcare facilities professionals with a practical understanding of AAMI TIR119 and explain how facilities, sterile processing, infection prevention, and water management teams can work together to support the water quality needed for medical device processing.

Abstract

Water is a critical component of medical device cleaning, rinsing, disinfection, and sterilization. Variations in water quality can affect equipment performance, cleaning outcomes, instrument integrity, process reliability, and patient safety.

AAMI TIR119 provides guidance for establishing and maintaining water quality appropriate for medical device processing. While sterile processing teams are directly responsible for many aspects of device reprocessing, facilities professionals play a central role in the systems that produce, distribute, monitor, and maintain the water used throughout the department.

This session will translate the technical guidance in AAMI TIR119 into practical considerations for healthcare facilities teams.

Attendees will learn about the different categories of water used during medical device processing, common water quality concerns, sampling and testing considerations, system responsibilities, documentation expectations, and the importance of coordinated response when results fall outside established parameters.

The session will also discuss how facilities, sterile processing, infection prevention, clinical engineering, and water management partners can establish clear roles and communication pathways.

By approaching water quality as a shared operational responsibility, healthcare organizations can strengthen process reliability, reduce avoidable equipment and instrument issues, and support safer patient care.

Learning Objectives

• Explain why water quality is important to medical device cleaning, disinfection, sterilization, equipment performance, and patient safety.
• Describe the primary water quality concepts and categories addressed in AAMI TIR119.
• Identify the roles of facilities, sterile processing, infection prevention, clinical engineering, and water management teams.
• Recognize practical considerations for monitoring, documenting, communicating, and responding to water quality concerns.

Purpose

The purpose of this presentation is to describe and highlight an organization-wide implementation of ICRA 2.0 in a healthcare system, showing how collaboration between Infection Prevention and Facilities helped standardize maintenance and construction-related infection control practices.

Abstract

Healthcare construction, renovation, and maintenance activities present ongoing infection prevention risks that require a coordinated and standardized approach.

To strengthen its systemwide Infection Control Risk Assessment process, Essentia Health implemented a comprehensive ICRA 2.0 initiative aligned with ASHE guidance and organizational workflows.

A critical factor in the success of this work was the strong collaboration between Infection Prevention and Facilities leadership. This partnership allowed the process to move forward efficiently while supporting healthy discussion, shared problem-solving, and joint resolution of challenges.

The project began with a thorough review and revision of existing policy and standard work to ensure alignment with ASHE’s ICRA 2.0 framework while maintaining consistency with Essentia processes.

After the updated policy and standard work were finalized, in-person training sessions were developed and delivered to infection prevention and facilities and maintenance staff, including contractors.

These sessions used a multifaceted learning approach that combined lectures, case scenarios, and hands-on activities to promote practical understanding and application of ICRA principles.

In response to several large-scale projects across the healthcare system, additional targeted sessions were held for contractors to ensure consistency in expectations, communication, and implementation of ICRA 2.0 standards.

Following completion of training for key operational staff and contractors, a condensed course was created for quality partners, leaders, Environmental Services, and other multidisciplinary team members who may participate in ICRA activities.

This expanded education strategy helped build awareness, strengthen accountability, and promote broader team engagement in infection prevention practices.

With stakeholder support in place, a weekly ICRA approval meeting was established to standardize review of active and upcoming construction and maintenance-related work.

Required materials include the draft ICRA permit, project timeline, workforce details, mitigation class, and blueprints. ILSM and Hot Work permits are also incorporated into the process.

During these meetings, multidisciplinary leaders review project risk, confirm controls, address barriers, and ensure documentation is complete for regulatory readiness.

This initiative improved consistency, communication, and engagement across the system. The partnership between Infection Prevention and Facilities leadership was central to its success and created a sustainable process for supporting patient safety and life safety during construction and facility work.

Learning Objectives

• Describe how a multidisciplinary healthcare system aligned policy and standard work with ASHE’s ICRA 2.0 framework.
• Identify strategies used to educate and engage infection prevention, facilities, contractors, and multidisciplinary team members in the ICRA process.
• Explain how collaboration between Infection Prevention and Facilities leadership supported efficient implementation and problem-solving.
• Recognize the value of a standardized weekly ICRA approval meeting in supporting risk mitigation, communication, and regulatory readiness.

Purpose

This session will empower healthcare facilities professionals to bridge the gap between mechanical design intent and real-world operations by showing how ASHRAE 170 design requirements can be operationalized through an ASHRAE Guideline 43-based Ventilation Management Plan.

Attendees will learn how to manage temperature, humidity, and pressure excursions using clear thresholds, workflows, roles, and risk-based decision pathways that support patient safety, compliance, and operational continuity.

Abstract

Healthcare ventilation systems are designed with clear intent, but they are operated in a much messier reality.

Extreme heat, extreme cold, aging infrastructure, space renovations, control strategies, clinical expectations, and regulatory requirements all influence whether temperature, humidity, and pressure relationships can be consistently maintained.

This session brings together mechanical design expertise and systemwide healthcare operations experience to examine what happens when ASHRAE 170 design requirements transition into daily clinical use.

Darin May, PE, FPE, LEED AP BD+C, will explain how healthcare spaces are engineered to meet ventilation requirements, including temperature, humidity, pressure relationships, air changes, and filtration.

He will also address an important reality: even properly designed and fully functional systems have limits. Under certain conditions, environmental drift may be predictable before occupancy ever begins.

Ryan Schramm, CHFM, CHC, MECH, FASHE, will then share how Banner Health operationalized ASHRAE Guideline 43 through a systemwide Pressure, Temperature and Humidity Policy.

This case study will show how a very large, multistate healthcare system aligned facilities operations, infection prevention, perioperative leadership, regulatory partners, and building automation logic around a common response model.

Attendees will explore practical questions every healthcare facility team faces: What should happen when humidity reaches 60.5 percent? When does an out-of-range condition become out of compliance? Who makes the decision to continue operations, escalate, restrict use, or remove a space from service?

The session will provide a repeatable framework for managing ventilation excursions through defined thresholds, standardized workflows, risk assessment, documentation, and clear ownership between clinical and facilities teams.

Attendees will leave with practical strategies to strengthen compliance, reduce unnecessary shutdowns, and protect patient care environments under real-world operating conditions.

Learning Objectives

• Recognize how mechanical design parameters, system limitations, and extreme weather conditions can contribute to environmental drift even when ventilation systems are operating as designed.
• Identify the essential components of a resilient Ventilation Management Plan, including thresholds, escalation workflows, roles and responsibilities, documentation expectations, and risk-based decision pathways.
• Distinguish between out-of-range and out-of-compliance conditions to support appropriate response actions without creating unnecessary clinical disruption.
• Apply practical strategies that align engineering intent with daily operations to maintain safe, compliant, and resilient healthcare environments.

Purpose

Abstract

Learning Objectives