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International Accreditation of Healthcare Facilities

Standards › Standard 2C › Plans and templates

Plan / template · ENV-PLN-002 · Version 1.1 · Approved by the ASF Expert Committee

Supports: 2C.2

At a glance

  • Write the facility sustainability goals in plain words, one page maximum.
  • Share them with all staff at induction and at least once a year.
  • Post a plain-language notice for patients and visitors, in the languages the facility uses.
  • Offer a simple way for staff and patients to suggest ideas.
  • Record each communication.
  • Stop and get help straight away if: the goals are only in an internal document, or staff cannot name one goal when asked.

1. Purpose

To make sure staff and patients know the facility sustainability goals in plain words, and can help reach them [E-006, EC].

2. Scope

Applies to Chief executive, communications lead, facilities manager, all staff
Locations Staff areas, waiting areas and the facility website at the facility
When Goals reviewed yearly; communicated at induction and at least once a year
Does not apply to Detailed programme actions, which stay in ENV-PLN-001

3. Definitions

Term Meaning
Goal A specific, measurable sustainability aim with a date
Plain language Words a patient or new member of staff understands on first reading

4. Background

People can help a goal only if they know it. Criterion 2C.2 asks for goals to be communicated, not confined to a policy nobody outside management reads.

5. Responsibilities

Role Responsibility Competence
Chief executive Approves the goals and the statement Executive leadership
Communications lead Writes the plain-language notice; keeps the record Communication
Staff managers Brief their teams Induction and briefing

6. Materials and equipment

Item Requirement Condition
Plain-language goals statement One page, approved by chief executive Current
Patient and visitor notice (ENV-FRM-007) Posted in waiting areas Current, legible
Idea box or feedback route Paper or online Checked monthly

7. Safety

8. Before you start

9. Procedure

Step 1. Write the goals.

  • Write up to five goals in plain words, each with a target and date.
  • Check each goal against the programme and the review.

Key point: Plain words, with a number and a date, are what people remember.

Step 2. Tell staff.

  • Brief all staff at induction and at least once a year.
  • Ask each briefed group to name one goal. Record the result.

Key point: Asking staff to name a goal is the test that the message landed.

Step 3. Tell patients and visitors.

  • Post the notice (ENV-FRM-007) in waiting and entrance areas.
  • Make the statement available on request and on the facility website.

Key point: The notice must be understandable without reading the programme.

Step 4. Collect ideas.

  • Provide a simple route for staff and patients to suggest ideas.
  • Review ideas each quarter and record the decision.

Key point: Two-way communication keeps the goals alive.

Step 5. Record and update.

  • Record each communication on ENV-REG-001.
  • Update the goals when the review changes them, and tell people again.

Key point: Changed goals that are not communicated are the same as no goals.

10. Decision points

11. Special situations

Situation Action
Patient with limited literacy or another language Offer the notice in the language they use, or a verbal explanation.

12. Escalation

13. Monitoring

Measure Target Frequency Owner If not met
Staff who can name one goal (sample) At least 80% (EC) Yearly Communications lead Re-brief
Notice posted and current in each entrance and waiting area 100% Quarterly Communications lead Replace within 14 days
Ideas received and answered each quarter 100% Quarterly Communications lead Escalate

14. Records

Record Kept in Retention
ENV-REG-001 Sustainability Communication Record Communications file the period set by the facility’s records policy years
ENV-FRM-007 Notice (current and superseded) Communications file the period set by the facility’s records policy years

15. Training

16. Related documents

ID Title Use
ENV-FRM-007 Staff and Patient Sustainability Notice Patient notice
ENV-REG-001 Sustainability Communication Record Communication record
ENV-PLN-001 Environmental Sustainability Programme Source of goals

17. Evidence

Reference Note
E-006 ASF Policy Framework v1.2. Adapted.
E-009 ASF Expert Committee consensus. Notice wording and target languages to be agreed locally.

18. Change history

Version Date What changed Approval
1.0 the date of approval First version Approved by the ASF Expert Committee
1.1 the date of approval Internal quality review: corrected cross-references, status wording and document control Approved by the ASF Expert Committee

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