Who needs to be on the ICRA team for a hospital construction project?
An ICRA team must be multidisciplinary: at minimum, an infection preventionist, facilities/plant engineering leadership, the construction project manager, a nursing or clinical representative from affected units, the safety officer, and the contractor’s superintendent. Environmental services (EVS) and administration join for larger projects. No single discipline can do an ICRA alone — infection prevention understands the patient risk, engineering understands the building systems, and the contractor understands the work.
Core members and their roles
- Infection preventionist: assesses patient risk, determines the class of precautions, approves the ICRA permit. The clinical authority on the team.
- Facilities/engineering: owns HVAC isolation, pressure relationships, utility shutdowns, and ILSM coordination.
- Project/construction manager: defines scope, schedule, and activity type; implements the barriers and controls.
- Nursing/clinical rep: speaks for the affected patient population — acuity, immunocompromise, and whether patients should be relocated.
- Safety officer: fire/life safety, ILSM measures, hot work, egress.
- Contractor superintendent: executes the precautions daily and owns worker compliance.
- EVS (as needed): terminal cleaning protocols before barrier removal and after project completion.
When the team convenes
The team meets before design is finalized — not the week construction starts. The ICRA assessment shapes the construction documents (barrier locations, HVAC isolation points, phasing), and retrofitting precautions after bid is expensive. The team reconvenes when scope changes, when monitoring finds problems, and for the pre-demolition verification that barriers and controls are in place.
The ICRA is a team product, not a form one person fills out.
See how to perform an ICRA before a renovation and the ASHE ICRA 2.0 matrix.
FAQ
Who leads the ICRA team?
Typically the infection preventionist (clinical risk authority) working jointly with facilities/engineering — neither leads alone.
Does the contractor sit on the ICRA team?
Yes — the contractor’s superintendent or project manager must be at the table; they’re the ones who build and maintain the controls.
When should the ICRA team first meet?
Before design is finalized, so the assessment shapes the construction documents rather than chasing them.