EOC 73 - Impact of Infection Control Risk Assessment 2.0 at a Tertiary Cancer Center

Background: In April 2022, the American Society of Healthcare Engineering (ASHE) released an updated version of the Infection Control Risk Assessment (ICRA) for construction, known as ICRA 2.0. Notable changes include a new classification within the matrix, a “highest” risk area category and a more comprehensive list of risk areas. Applying this at our organization, a tertiary cancer center, all oncology areas are defined as highest risk. As a result, all future ICRAs are deemed higher in classification than feasible. Using the new guidance, and looking at risk within our population, the Infection Prevention (IP) team tailored ICRA 2.0 to meet realistic implementation needs of our institution.

Methods: To establish a baseline, prior completed ICRAs between 2021-2022 were reviewed to determine if classifications would change due to the new guidelines. Additionally, IP reviewed all patient care and non-patient care areas across the enterprise and each area was reassigned a risk level. The reassignment of risk levels was based on acuity, epidemiological data, and location type. We subsequently reviewed and made amendments to ICRA 2.0 classifications as a comprehensive approach to align the new guidelines with facility capabilities while prioritizing patient safety.

Results: Out of 25 previously reviewed ICRAs, we saw a significant impact to each classification. Most notably, there was an overall increase in the classification in 24 out of 25 ICRAs when aligning with ICRA 2.0. However, after our internal ICRA 2.0 guideline amendments, all 25 ICRAs showed a decrease in classification, with shifts observed across different classes.

Conclusions: Although ASHE ICRA 2.0 provides defined guidance for construction, it does not take into consideration specialty facilities such as cancer centers. Therefore, it is important that specialty hospitals review their areas and define their risk level based on risk assessments and epidemiologic data.