Compliance News: Increased Surveillance for ILSM's

By Robert Trotter, CBO, CFM, MCP



The Joint Commission’s 2010 Hospital Accreditation Standards for Life Safety describes the Interim Life Safety Measure (ILSM) for increased surveillance. LS.01.02.01 Element of Performance 8 states the following:

When the hospital identifies Life Safety Code (LSC) deficiencies that cannot be immediately corrected or during periods of construction, the hospital does the following: Increases surveillance of buildings, grounds, and equipment,  giving special attention to construction areas and storage, excavation, and field offices. The need for increased surveillance is based upon criteria in the hospital's Interim Life Safety Measure (ILSM) policy. (See also LS.01.01.01, EP 3)

In the example pictured, increased surveillance would have identified construction materials being improperly stored near electrical service equipment.