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Healthcare Construction : More than Meets the Eye

Highlighting the necessary processes and mentality of performing work in occupied medical facilities

Austin Conley

on 30 May 2013

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Transcript of Healthcare Construction : More than Meets the Eye

Franklin Team Facts: Oversee Multiple Projects at 33 Different Locations
AP Staff : 3 PMs, 4 Assistant Supts, 9 Carpenters/Laborers
In the Last 12 Months - 500+ Different Subcontractor Personnel
7 Different Kaiser PMs, 3 Different Architects, 3 Different Engineers
Average 14 Different Job Pay Apps a Month
Average 6 OAC Meetings a Week - Each Dealing With Different Departments
Outbreaks: SARS,H1N1,Flu Season
24 hr On Call For Emergencies Risk Of Infection Any infection that is a result of treatment in a hospital or a healthcare service unit. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge
The Centers for Disease Control and Prevention estimate that roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year.
Patients Affected: Immune Deficient, Cancer Treatment Patients, Asthma Patients, Lung Disease any patient in a surgery
Cost for Treating nonsocominal infections is approx. $5 billion a year. Estimated that 5% are construction, renovation maintenance orientated. That is approx 250 million Dollars Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires' disease in the U.S. However, many infections are not diagnosed or reported, so this number may be higher.
The Legionella bacteria is found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings
Symptoms are Pneumonia like
For construction this means no dead end pipes. Water treatment Nonsocomial Infection Legionellosis Aspergillus Aspergillosis describes a number of diseases involving both infection by and growth of this fungus, as well as allergic responses against aspergillus. Aspergillosis can occur in a variety of body organs, in both humans and animals. Infections can effect any area of the body, but by far the most common are the lungs and sinuses
Patients at high risk are those in intensive care units, newborn nurseries (especially neonatal intensive care and dialysis units), operating rooms, and invasive procedure areas.
Recent discoveries linking patient deaths directly to contamination from construction dust
As many as 30 percent of all fatal infections among patients with acute leukemia and lymphoma are believed to be caused by the fungi. Infection Control Temp Walls
Critical Barrier
Establish Neg. Air
Set up Monometer/Call out
Build Ante Room
Sticky Mats
Seal off Exhaust & Supply
Make up Air
Staff Training Methods Of Procedure Negative Air
Neg. Air Machine
2000 CFM
Hepa Filtered
Containment area sq/ft determines number of machines along with desired level of negative air pressure Monometer tracks Neg. Air
Neg. Air .020 – CDC and FGI guidelines require .030 at critical areas
Monometer Tracks Negative Air
Monometer Can be downloaded to a Computer for archiving files
Hospitals require Monometer records upon completion of project During Construction
Constant Monitoring
Fill Out Construction Site Monitor Daily
Change Sticky Mat Constantly
Trash Removal
Covered Dumpster
Clean After Every Portion of Work Construction Barrier Removal
Sterile Clean Prior to Removal
Infection Control Inspection
Barrier Removal
Sterile Clean Again
Final Air Quality What Else Makes Healthcare Different
Critical Systems: HVAC, Med Gases, Specialty Equipment
Hours of Operation
Coordination with IT (HIPPA) and Security Departments/Badging
Occupancy: Patients, Emotions, Illness
Owner Medical Equipment Coordination
Special Tolerances
TJC Inspections, Epidemiologist
Technology Changes
Large equipment Deliveries Joint Commission Project Phasing Requires Coordination between staff across a variety of departments
Special consideration given to meeting the demands of patient flow and department needs
Coordination of installation and demolition of critical systems across phase lines The Difference Performing renovations in an occupied medical facility poses different risks than that of typical construction. AP healthcare has identified these hazards and has developed a culture among its personnel to minimize and even eliminate these hazards. Competent staff and processes are essential to the safety and success of any healthcare construction process. Third party inspection of hospital life safety
Failure to pass these inspections could result in funding being revoked - Medicaid / Medicare
This committee can close down a medical facility for non compliance
Any ongoing construction is subject to these inspections
Other Governing Agencies Include: ASHE, ASHRAE, Facilities Guidelines Institute (FGI), CDC and all NFPA Guidelines Information Boards are a useful tool to keep staff and public informed of areas under construction Site Specific Orientation For All Personnel Keys to Success

Constant collaboration with staff, owners, Architects and Engineers
Developing strong relationships with facility engineers
Training staff and subcontractors of what is expected of them in an occupied medical facility
Foresight to plan for phasing, shutdowns and off hours work
A mentality that any action, no matter how small, can result in putting a sick patient at an even higher risk of infection, complication and even death
Full transcript