Medical Construction & Design

JAN-FEB 2015

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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BY MONTIE GARRISON, VON LAMBERT & DAVE POWERS I n the wake of recent concerns over the spread of highly infectious diseases, hospitals and healthcare organizations are searching for ways to better prepare facilities for potential pandemics and wide- spread viral outbreaks. Institutions must ensure facilities are code and regulatory compliant system-wide at all times, not just in times of outbreak. According to the Joint Commission, last year healthcare facilities in the U.S. were regularly cited for unsafe patient care conditions, including ventilation, temperature and humidity issues. Integrated building systems, main- tenance programs and technologies can enhance a hospital's ability to control infec- tion. Unfortunately, these features are often diminished — or cut out entirely — in order to save money. A misinformed approach to value-engineering healthcare projects can lead to solutions that may seem cost ef ective in the short-term, but actually in- crease costs over the long term. Healthcare organizations may be unaware of the long- term costs of omitting these features, not to mention the potential impact the absence of these features could have on the health of patients, visitors and staf . Looking ahead to maximize infection-control measures In the early stages of a healthcare project, owners and representatives should always keep the future facility's day-to-day operations in mind when value-engineering changes to the design. During design review and value-engineering sessions, it's imperative that decision-makers refrain from cutting certain features of the mechanical and electrical systems that will enhance infection control once the facility is up and running. Furthermore, opening a facility with minimum MEP systems can lead to long-term operational challenges and unanticipated costs. As time passes, healthcare facilities need to change or add systems to operation in order to stay current with regulatory and code compliance. Incorporating additional capacity into a facility's design allows for future expansion to its building systems. For example, the original design of Project X specifi ed 20 percent extra capacity in the electrical system for future expansion. The additional electrical panels and as- sociated materials, however, were deemed unnecessary and were cut from the project. Then, three months from completion, a sterilizer and some additional equipment were added to the system. Because the extra capacity was cut from the project, walls had to be opened and additional conduit and a new run of power had to be added. In the end, changing the design ended up costing three times what it would have cost to keep the extra capacity in place. Owners should be actively present during decision-making sessions at every Managing long-term costs of infection control FUTURE FOCUSED 21.8% Percentage of pneumonia and surgical site infections of total infections — the two are tied for the most common HAIs. 648,000 Number of inpatients at acute-care hospitals that had at least one HAI in 2011. CDC estimates 4 percent of inpatients will have an HAI. MCDM AG.COM | JA N UA RY/ F EBRUA RY 2015 | Medical Construction & Design 25

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