In today’s healthcare environment, collaboration between facilities management, clinical operations, infection control, and design and construction isn’t just a best practice, it’s a compliance necessity. As Joint Commission prepares to roll out Accreditation 360, two industry leaders, Tom Grice and Steve Van Ness of CREF, share how hospitals can break down silos, strengthen communication, and achieve sustained regulatory readiness across the care environment.
“There should always be great collaboration between clinical and facilities,” says Tom Grice, Vice President, Regulatory and Facilities, Cref, “but I still see instances where it happens infrequently. We still see organizations operating in silos.”
Tom and Steve’s discussion on the Healthcare Facilities Network offers practical insight into what collaboration really looks like inside hospitals — from Life Safety compliance to capital project planning.
We still operate in silos.
With decades of healthcare facilities management and Joint Commission survey preparation experience, Tom Grice sees the same issue nationwide: departments operating in isolation.
“EVS does their thing, nursing does theirs, and facilities does theirs,” he explains. “When something goes wrong, people say, ‘That’s not my department.’”
Through his mock surveys and Environment of Care rounds, Tom intentionally brings these groups together — facilities, infection control, nursing, and EVS — to build a shared understanding of the ‘why’ behind each standard.
“Once people understand why a door can’t be propped open or why an exit sign conflicts with a ‘Do Not Enter’ notice, it clicks,” he says.
That education-based approach is at the heart of CREF’s regulatory readiness philosophy. It’s not enough to know the codes; leaders must make sure staff understand how those codes protect patients and support Life Safety.
Tom emphasizes that this collaboration must be hardwired into daily operations. It can’t depend on personality or position; it has to be built into systems.
“You can collaborate all you want, but if turnover happens and there’s no foundation for collaboration, it disappears,” he says. “You need a program of collaboration, a program that is standardized and sustainable.”
He points to safety huddles as an example of how cultural practices can be institutionalized. What started as a trend, the safety huddle, has now become a standard component of hospital operations and patient safety programs.
Collaboration has to start early, in the planning phase.
Steve Van Ness views collaboration through the lens of healthcare design, construction, and capital planning. His perspective: If collaboration doesn’t begin early in planning, it’s already too late.
“The same issues Tom sees during surveys had their start much earlier than the survey,” Steve says. “Capital projects are often planned in silos, without facilities, infection control, or IT at the table.”
He recalls a recent project where a hospital’s design committee, composed mainly of physicians and administrators, created a plan that completely omitted mechanical space, IT infrastructure, and medical gas storage requirements. The oversight was caught before construction began, avoiding costly rework and future compliance risk.
“If you don’t integrate facilities’ needs with clinical and strategic goals from the beginning, you’re going to have trouble once the project is operating,” Steve explains.
He believes collaboration between planning, design, and facilities management must extend from early concepts to daily operations. That integration supports regulatory readiness, improves long-term efficiency, and reduces post-construction compliance issues.
Shared Message: Collaboration Starts with the 'Why'
Both leaders agree that collaboration begins with education and shared understanding. Tom routinely attended clinical and department meetings during his hospital career, using Life Safety drawings and real examples to bridge the gap between technical and clinical perspectives.
“When people see that corridor width or fire door ratings directly protect patient egress, it stops being just a code requirement,” he says.
He also invited frontline staff to participate in Environment of Care and Safety Committee meetings, not just leaders, ensuring those closest to the work were part of the compliance process.
This approach transforms compliance from a ‘survey-driven’ mindset into a constant state of readiness, a core principle of CREF’s regulatory model.
Summary: How Tom and Steve Define Collaboration
- Tom Grice focuses on operational collaboration, breaking down silos among clinical, facilities, and support services through education and culture.
- Steve Van Ness focuses on structural collaboration, ensuring interdisciplinary participation from the earliest planning phases.
- Both emphasize that collaboration must be designed into hospital systems, not left to chance.
5 Key Takeaways for Healthcare Leaders
- Hardwire collaboration into your organization, it can’t rely on individuals.
- Involve all disciplines early – facilities, clinical, IT, EVS, infection control, and PDC.
- Educate through shared experience, walk the space together and explain the ‘why.’ One visual is worth thousands of words.
- Make collaboration part of ongoing operations through huddles, joint rounding, and regular cross-department meetings.
- Operate in a constant state of readiness and don’t wait for a survey; make compliance part of the organization’s DNA.
Watch the Full Discussion with Tom Grice and Steve Van Ness on the Healthcare Facilities Network: Accreditation 360 and Top Life Safety Findings Explained
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