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Hospital environmental risk assessment template

Hospital environmental risk assessment template

Assessing environmental risks in hospitals requires thorough documentation. This template guides you through identifying hazards, managing tasks, and maintaining compliance.

Use this template
or download pdf
Hospital environmental risk assessment template

Assessing environmental risks in hospitals requires thorough documentation. This template guides you through identifying hazards, managing tasks, and maintaining compliance.

Use this template
or download pdf

About the Hospital environmental risk assessment template

When assessing environmental risks in a hospital, every detail matters, from managing chemical storage to monitoring air quality. This hospital environmental risk assessment template helps you and your team identify hazards, document findings, and implement solutions using one organized tool. Designed for healthcare professionals and facility managers, this template empowers you to maintain safety standards while staying compliant with industry regulations.

How to use the hospital environmental risk assessment template

This customizable template helps streamline your workflow and ensures your reports are thorough and actionable. Here’s how you can make the most of it:

  1. Customize the template to your facility’s needs. Feel free to add specific sections relevant to your hospital, such as unique hazards or regulatory requirements. With Lumiform’s digital form builder, edits are intuitive and quick.
  2. Assign roles and responsibilities. Clearly define who will be involved in completing the checklist. This might include the maintenance staff for documenting noise pollution sources and lab technicians for handling chemical storage reviews.
  3. Conduct on-site assessments with mobile accessibility. Team members can use the template on their phones or tablets to capture real-time data, including photos of potential hazards for precise documentation.
  4. Log issues and set action tasks immediately. Highlight critical areas, like waste management or PPE availability, and assign follow-ups within the app. Tracking action items leads to prompt resolution and better compliance.
  5. Review and analyze the collected data. Use the built-in analytics to identify patterns or recurring risks. Share these insights in team meetings to drive continuous improvement and maintain a safe environment for staff and patients.

How to customize your hospital environmental risk assessment template

The template is fully editable, so you can add hospital-specific hazards to reflect the unique challenges of your facility. For example, you can include dedicated questions about monitoring radiation sources near X-ray or CT scan rooms, or areas with biohazard waste like laboratories and patient isolation units.

You might also modify sections based on local environmental regulations. Regulations may vary based on your location, such as specific protocols for hazardous waste disposal, air quality thresholds, or water contamination standards.

The app allows you to leverage multiple response types to capture data effectively and streamline form completion. Use dropdowns to document common hazards like chemical spills or noise pollution. Another option is to add a notes field for insights or photo upload options for documenting evidence of risks.

Download Lumiform’s hospital environmental risk assessment template today

Streamline your risk management with a template designed to meet your needs. Whether you’re tracking waste disposal or identifying pollution sources, this tool simplifies even the most detailed assessments. Use it to prioritize safety, delegate tasks, and keep your reports clear and practical.

Related categories

  • Health and safety management templates
  • General templates
  • Risk assessment templates
Preview of the template
Page 1
General Information
Hospital Name
geolocation!!!
Responsible Person
Assessment Date
Environmental Hazards
Are there any potential sources of air pollution (e.g. exhaust vents, chemical storage)?
Are there any potential sources of water pollution (e.g. improper waste disposal, chemical spills)?
Are there any potential sources of soil/ground pollution (e.g. underground storage tanks, improper waste disposal)?
Are there any potential sources of noise pollution (e.g. generators, HVAC systems)?
Are there any potential sources of radiation (e.g. X-ray machines, radioactive materials)?
Waste Management
Is there a comprehensive waste management plan in place?
Are infectious/hazardous wastes properly segregated, stored, and disposed of?
Are waste storage areas maintained in a clean and orderly manner?
Are waste collection, transportation, and disposal practices compliant with regulations?
Chemical Management
Are all chemicals properly labeled and stored?
Are Material Safety Data Sheets (MSDS) available for all chemicals?
Are staff trained on safe handling and storage of chemicals?
Are spill prevention and response plans in place?
Emergency Preparedness
Are emergency evacuation plans and routes clearly marked and communicated?
Are emergency equipment (e.g. fire extinguishers, first aid kits) regularly inspected and maintained?
Are staff trained on emergency response procedures?
Are emergency drills conducted on a regular basis?
Occupational Health and Safety
Are staff provided with appropriate personal protective equipment (PPE)?
Are staff trained on the proper use and maintenance of PPE?
Are ergonomic assessments conducted for workstations?
Are staff trained on safe work practices (e.g. manual handling, sharps management)?
Environmental Monitoring
Are regular inspections conducted to identify environmental hazards?
Are environmental monitoring data (e.g. air quality, water quality) collected and analyzed?
Are corrective actions taken based on monitoring results?
Are records of environmental monitoring and corrective actions maintained?
Continuous Improvement
Is there a process for staff to report environmental concerns?
Are environmental performance goals and targets established?
Are environmental management programs regularly reviewed and updated?
Are lessons learned and best practices shared across the organization?

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Frequently asked questions

What are common environmental risks in hospitals?

Hospitals face a variety of environmental risks, including air pollution from exhaust vents and HVAC systems, water pollution from improper waste disposal, and soil contamination due to chemical spills or underground storage tanks. Noise pollution from generators and equipment, as well as radiation exposure from X-ray machines or CT scanners, are also significant concerns.

How do hospitals manage chemical storage safely?

Proper chemical storage in hospitals involves clear labeling, secure containment, and separate storage areas for incompatible substances. Material Safety Data Sheets (MSDS) should be accessible, and staff must follow strict handling protocols. Adding spill kits near storage areas and training staff on immediate response procedures further reduces risks.

How can I assess noise pollution in a hospital setting?

Start by identifying major noise sources, such as HVAC systems or generators. Measure sound levels in high-traffic areas using decibel meters to determine if they exceed safe limits, and ask staff and patients for feedback. You can then implement noise-reduction measures like soundproofing or quieter equipment.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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