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University of Nevada Evaluation Shows Effectiveness of ANSI-accredited Healthcare Construction Worker Credential

Wednesday, September 22, 2021 4:30 PM | Kim Pyszka (Administrator)

The COVID-19 pandemic is just one of many threats that must be addressed by healthcare construction workers whether in hospitals or in long-term care, such as nursing homes and assisted living facilities. Protection of workers, patients, staff, and the public during construction activity from minor repairs to new construction is of utmost concern. In addition to protection from COVID and other biological risks, workers need to be familiar with state-of-the-art best practices to reduce risks from disasters, fire equipment and systems, utility services, noise, vibration, odors, delivery/handling/storage of supplies and materials, waste management, and ventilation.

To help mitigate the risks of healthcare construction, renovation, demolition, maintenance and repair, The Joint Commission, the organization that accredits over 22,000 U.S. healthcare organizations, requires a comprehensive protocol known as a Pre-construction Risk Assessment (PCRA). An Infection Control Risk Assessment (ICRA), which is part of the PCRA process, is also required by The Joint Commission. Accredited healthcare organizations are required to develop a PCRA for all planned and unplanned healthcare construction from minor repairs to major construction.

Even prior to the COVID-19 pandemic, in "Environment of Care News", a publication of The Joint Commission, five authors advocated for more stringent requirements for PCRA/ICRA. The authors called for all construction personnel participating in pre-construction, maintenance, and construction activities on healthcare facilities to demonstrate their competence by possessing an ANSI/ASTM-accredited PCRA/ICRA credential.

To evaluate the impact of this credential nationally, the University of Nevada, Reno, Public Health Training Center was commissioned by the Nevada Office of Minority Health and Equity to pilot a workforce development project. Since currently Green Advantage, a non-profit organization, offers the nation’s only ANSI/ASTM-accredited Pre-construction Risk Assessment/Infection Control Risk Assessment (PCRA/ICRA) Certificate Program, project participants were solicited from those trained in the Green Advantage program. Below are excerpts from the evaluation’s conclusion:

The Green Advantage PCRA/ICRA certificate training is a successful program in improving the knowledge of PCRA/ICRA best practices. ….. Construction industry workers who were enrolled in the program were surveyed and assessed to demonstrate their pre-certificate and post-certificate confidence and knowledge while working in health care construction, as well as the readiness to protect themselves and others from increased risks and infection exposures. The survey results demonstrated that this knowledge and readiness improved among participants in the PCRA/ICRA certificate program ….. Based upon the survey analysis, it is advised that the Nevada Office of Minority Health and Equity put forth policy guidance on PCRA/ICRA certification for health care construction industry workers.

Public protection remains paramount in healthcare construction. In particular, the frequency and intensity of risks from infectious disease and disaster are on the rise and must be continually addressed. ANSI-accredited personnel credentialing offers an important tool to ensure that construction workers are trained and have successfully demonstrated their competencies to reduce these risks.


Green Advantage is the only organization that offers a PCRA/ICRA Certificate Program that meets these requirements. Note: The PCRA/ICRA Certificate Program has been approved by GBCI for 12 CE Hours.

The PCRA/ICRA Certificate Program prepares construction personnel to address the serious risks posed by healthcare construction. Learning objectives include:

•    understanding the need for PCRA/ICRA
•    knowledge about key concepts related to      infection control during construction
•    recognition of the pathogen transmission factors related to construction processes
•    awareness of the unique construction challenges represented by the hospital environment
•    familiarity with the regulatory context for healthcare facility construction
•    application of PCRA to healthcare facility construction activity
•    cognizance of the details of the PCRA process
•    awareness of construction impacts on building systems
•    familiarity with PCRA procedures
•    familiarity with Interim Life Safety Measures
•    knowledge  of approaches and best practices to ensure health & safety during healthcare facility construction



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