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Administrative (Non-Clinical) Policy
UWHC only (Hospital Administrative-entity wide) UWMF only (entity wide)
UWHC Departmental (indicate name) UWMF Departmental (indicate name)
UWHC and UWMF (shared)
Policy Title: Storage Policy
Policy Number: 12.36
Effective Date: July 1, 2015
Chapter: Environmental Safety
To establish procedures for the storage and movement of equipment, furniture, and supplies in the
Equipment, furniture and supplies must be stored in appropriate locations and must not obstruct corridors
or exits. It is the responsibility of the owner of equipment, furniture and supplies to provide appropriate
storage or have the items removed to another approved storage site.
A. Department managers must determine when the equipment is needed. Because unit based storage
area is limited, only that equipment, furniture and supplies used for patient care, (this includes but
is not limited to IV poles, wheel chairs, sleep chairs, cribs, etc) is appropriate for unit based
storage. Seasonal decorations and items cannot be stored on units; these should be sent to the
B. Unit based storage is only allowed in designated areas. Designated areas must meet all of the
1. One side of an internal corridor that is not a means of egress;
2. Flammable liquids are not stored in the area;
3. Exits are not blocked;
4. Fire extinguishers, hose cabinets and medical gasses/air zone valves are accessible;
5. Corridors are not less than eight (8) feet in width before storage;
6. Designated storage suites in the E5/6, E5/5 and E5/4 modules.
C. Each unit has the responsibility to move items stored in secondary fire evacuation routes when a
Code Red (Fire Alarm) is activated. Code Red procedures must be well communicated to all staff
working in or assigned to the unit.
D. Temporary storage of equipment and furniture may be possible on a space available basis.
Supplies may not be stored in the basement or hallways (except where designated for storage).
Departments/units with equipment requiring temporary storage must complete a Plant
Engineering Service Form. Departments/units, which want to surplus equipment, must contact
Plant Engineering and complete both a service request and Equipment Transfer Form. All
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equipment stored will be dated according to the date it was placed in storage. After a three (3)
month period, stored items will be sent to surplus. Written justification will be required to request
approval for extended storage time.
E. In the E5/6, E5/5 and E5/4 modules there is designated space for surplus and other non-required
equipment and furniture. Items to be removed from the unit may be tagged and left here for daily
removal. Tags are located in the soiled side of the E5 ACCO's and can be used to denote either
(1) Throw Away; (2) Store/Hold, (3) No Longer Needed or (4) Repair. Items properly tagged will
be removed each day by either transportation staff or Environmental Services staff. Items
improperly stored in the corridors will also be removed.
F. It is important that all egress corridors (hallways with Exit signs at ends above doors) are clear of
equipment, carts, and beds at all times. Plant Engineering and Environmental Services staffs must
limit the time their service carts are congesting the corridors. Prior to the acquisition of
equipment, it is the responsibility of the department managers to secure appropriate storage space.
G. The responsibility of this policy rests with each department manager. During rounds, the
Environmental Rounds group will report any discrepancies to the Director, Life Safety who will
provide follow up. Monthly rounds completed by Environmental Services and Nursing will
document areas not in compliance with this policy.
Sr. Management Sponsor: VP, Facilities & Support Services
Author: Director, Life Safety
Review/Approval Committee(s): Environment of Care Safety Committee, Administrative Policy &
President & CEO
Previous revision: 072012
Next revision: 072018