How to Conduct a Preconstruction Risk Assessment 

A tight preconstruction process is essential to reduce risk and ensure positive project outcomes. Take the healthcare industry for instance. Since building conditions like noise, safety elements, air quality, and more can have such a direct impact on building occupants, preconstruction is even more necessary – and exhaustive.  

Enter the preconstruction risk assessment (PCRA) an essential part of preconstruction planning for the vast majority of hospitals in the U.S. Beyond healthcare facilities, preconstruction risk assessments can be incredibly valuable tools for complex and high risk projects. Today, we explore the ins and outs of PCRA and how builders can improve their processes.  

Table of Contents 

• What Is Preconstruction Risk Assessment? 
• Importance of Conducting a Preconstruction Risk Assessment 
• The Challenge of Using Spreadsheets 
• Automating Preconstruction Risk Assessment 
• Preconstruction Best Practices for PCRAs 
• FAQS 
• Summary 

What Is Preconstruction Risk Assessment? 

A preconstruction risk assessment (PCRA) is a required standard from The Joint Commission. The organization helps maintains the standards for patient safety in hospitals, clinics, and healthcare facilities. Today, over 80% of hospitals in the U.S. are accredited by the The Joint Commission.  

For PCRAs, the organization lays specific requirements in Standard EC.02.06.05, which is part of the Environment of Care Standard for safety and health management. 

Compliance with PCRA standards is an essential part of preconstruction to reduce the risk of healthcare-associated infections (HAIs). It requires maintaining a complex list of safety protocols and procedures that have to be followed, and each task has to be documented. The list is extensive and includes specifics relating to air quality, infection control, noise, vibration, and other potential hazards. 

The Joint Commission has an eight-step process that they recommend for PCRA compliance: 

1. Create a detailed description of the project so you can identify potential risks. 
2. Look at the areas around the project that could be impacted, and assess risk. 
3. Detail the type of construction activity, which will make it easier to list potential hazards. 
4. Determine what control activities are required to prevent infection. 
5. Identify other potential risks beyond infection, such as noise or dust. 
6. List the steps you plan to take to mitigate risks other than infection (i.e., those listed in Step 5). 
7. Complete the interim life safety measures (ILSM) assessment, and choose the safety measures you need to implement. 
8. Monitor construction to ensure that you continue to use appropriate safety measures. 

Importance of Conducting a Preconstruction Risk Assessment  

No one likes construction risks. Beyond just healthcare projects, it’s critical to assess as many foreseeable risks as possible before construction begins and it eats into budgets, and timelines, or worse, threatens your team’s or future occupant's safety.  

Conducting a construction risk assessment helps find all at-risk areas, create awareness about the site's risk, issue measures to avoid the risks, look if the risk has been dealt with, and then decide whether it's safe to continue the construction process. 

Here are some quick facts on why a preconstruction risk assessment is essential, beyond just the formal PCRA in the healthcare industry: 

• One in every five worker fatalities in the United States is in the construction sector. 
• 1,069 construction workers died on the job in 2022. 
• Fatal construction injuries are estimated to cost the United States five billion yearly in health care, lost income, production, etc. 
• Workers’ compensation claims for nonfatal falls account for $1.4 billion.  

The Challenge of Using Spreadsheets for Preconstruction Risk Assessment 

The more details there are in the PCRA list, the more room there is for error, especially if you are tracking each step manually. It’s too easy for something to fall through the cracks.  

While many contractors turn to spreadsheets to manage preconstruction risk assessments, they pose a number of risks that can negatively impact project schedules and accreditation: 

• Incorrect documentation: Any PCRA checklist will go through multiple revisions. Trying to match a spreadsheet to changing risk assessment requirements may cause you to overlook something. 
• Version control: Even if you store data in a central data repository like the cloud, there is always a risk of losing track of the latest version. Someone could overwrite the file by mistake or duplicate it to support another process. 
• Incorrect data entry: Entering outdated or inaccurate information is always a possibility. Often, those types of entries are never spotted until it’s too late. The larger the project, the more likely there will be data entry issues. 
• Deleted data and incorrect formulas: When you have multiple managers or departments working on the same project, data gets deleted, and formulas get corrupted. Even naming one manager to control data entry won’t eliminate errors. 

If you fail a safety audit due to sloppy bookkeeping, you can face a hefty fine, so maintaining an accurate checklist is essential if you want to comply with EC.02.06.05. 

Automating Preconstruction Risk Assessment 

PCRA is required for any construction, renovation, or maintenance work done in hospitals or healthcare facilities, which means contractors need to develop a detailed list of safety requirements before they can begin. The traditional methodology is to use spreadsheets to review and track safety activities, which is only one step above using a handheld clipboard. There is too much room for error, which can result in non-compliance.  

A better strategy is to use a centralized, cloud-based system that is part of the preconstruction workflow. Many tools today have built in checklists and templates to easily help you expedite the creation and tracking of documents like preconstruction risk assessments. Paired with more advanced risk analysis capabilities to find subcontractors and predict risk holistically, connected risk management tools can better enhance your preconstruction processes across the board.  

Preconstruction Best Practices to Improve PCRAs 

The best way to maintain an accurate PCRA process is by using automation. You need to start with a single data repository, so everyone has access to the same information. Then, you must maintain tight controls over shared reports. 

PCRA requires a project management strategy, just like any other aspect of construction. By using a cloud-based software platform, you can integrate data and processes from all involved departments, including infection control, facilities management, safety, clinical engineering, and compliance. Automating the workflow speeds up approval time and is more accurate, eliminating errors and data duplication. It also simplifies documentation to prove standards compliance. 

In addition to streamlining PCRA procedures, automated processes can be integrated with other business systems and software, simplifying tasks such as project bidding, workforce management, and managing bills of materials. 

FAQS 

What should a construction risk assessment include? 

A construction risk assessment should include four major things to work effectively: 

• Identifying hazards- Locate hazards on the site now and those that might arise during the project construction. 
• Assess the risk- After finding the risky areas, assessing the situation before taking action is essential. Take time to know what the best and most effective solution should be. 
• Identify actions- After you've assessed the hazards, find the most effective way to minimize or eradicate the risks found. Seeing a possible solution is very critical. You need answers that ensure the threat won't be there again. 
• Confirm corrections- After successfully dealing with the hazards or minimizing their occurrence again, it's essential to check repeatedly to confirm whether the risk has been completely dealt with. Assuming and not checking the corrected errors is bad for business. Fatalities or severe injuries might occur due to that, so confirming your corrections is crucial 

What are the four types of construction risk? 

To avoid or eliminate this threat from happening, one should categorize the types of risks at the site and know how to manage them. 
 
Risks at a construction site are categorized into various types, but here are four major construction risks: 

• Financial & economic risk: This is one of the risks that could affect a construction process. These risks include investment and inflation issues, non-availability of funds, changes in currency exchange rates, changes in tax structures, changes in costs of stone and sand, etc. 
• Design or technical risks: By technical, we mean everything that hinders you from achieving your client's expectations. For example, things like the uncertainty of resources, availability of materials, or even preliminary designs can be very risky and commonly occur if there are changes in project scope or requirements and errors or omissions. 
• Physical risk: Low procurement and unavailability of some materials, is lousy quality, or less quantity can also threaten a construction project. Other physical hazards affecting a project include harsh weather conditions, theft, and wastage. 
• Contractual risks: People need to take this seriously. Still, things like unreliable time schedules, extra work, payment problems, claims, and even disputes, among others, can be complicated issues at a site hence delaying the construction process. 

Summary 

Conducting a thorough preconstruction risk assessment is a critical step in ensuring the success and safety of any construction project, especially within highly regulated industries like healthcare. By moving away from traditional methods such as spreadsheets and embracing automated, cloud-based systems, contractors can significantly reduce the risk of errors, enhance compliance with safety standards, and streamline their overall processes. Ultimately, integrating advanced risk management tools not only fortifies preconstruction planning but also contributes to safer, more efficient, and more successful construction outcomes.  

Autodesk Construction Cloud  is the ideal platform for PCRA automation, providing a cloud-based project management solution for collaboration and accurate documentation. It eliminates errors, provides real-time access to checklists and procedures, and saves you time and money.