Medical Construction & Design

NOV-DEC 2017

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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MCDM AG.COM | NOV EMBER / DECEMBER 2017 | Medical Construction & Design 17 TRENDS continued page 19 >> being introduced into the space. Energy-effi ciency goals typically fall on the HVAC system, as it is one of the largest energy users in the hospital. However, airside energy recovery measures, such as energy recovery wheels or plate and frame heat exchangers, are not compatible with most healthcare applications due to the potential for cross contamination of the air streams. Pathogens present in the exhaust air stream could be entrained back into the supply air stream, potentially spreading the pathogen to other areas of the hospital. A liquid-coupled heat ex- changer, also called a run-around coil, is the only viable energy recovery option for a hospital HVAC system. This is a much less effi cient system than a wheel or plate and frame heat exchang- er, but it does not have the same cross-contamination risks. Some control methods are available to help reduce the energy impact, such as having unoccupied ACH and demand control ventilation strategies to help reduce outside air and system volumes. These help reduce energy used in off -peak hours, but peak energy demand is still high and HVAC equipment still has to be sized based on the peak load requirements. Building architecture is one area that is often overlooked for energy-effi ciency improvements. Not all spaces within a hospital have large outside air or air change requirements and are susceptible to typical building envelope construction. Large glass facades, creating increased daylighting and exterior views, increase building heating and cooling loads. Energy modeling tools can help with creating better building envelopes through materials and building orientation. Architectural building elements should be considered as part of any energy- effi ciency goals. Trend #2: Budget restraints Budgets provided for new healthcare projects have become less fl exible, putting pressure on design teams to provide quality designs within a limited bud- get. The capital requirements for hospital HVAC systems are higher than other building types, sometimes making up 35-45 percent of the total construc- tion cost. With such budget constraints, value-engineering exercises are common. Since the capital costs of HVAC systems are so high, they become the prime target for these VE exer- cises. Unfortunately, many times these exercises end up remov- ing many of the patient safety and infection control measures aff orded by the HVAC systems. Performance and functionality are reduced to the minimum standard to achieve a budget reduction, which is typically a set percentage based on the budget overage that each trade must achieve. Pseudomonas and staphy- lococcus, commonly found in HVAC systems, are the bacte- rial cause of HAIs. One hospital spent $50,000 to help upgrade their HVAC systems and save an estimated $850,000 due to a reduction in infections and reduced use of antibiotics, while another reduced HAIs by 40 per- cent with additional investment in their HVAC systems (Rodak, S. [2013, June 03], "Improving Environmental Hygiene: Shining the Light on Air Systems to Cut Infections"). Initial cost may be reduced during the project, but the potential cost impact to the hospital through litigation and additional healthcare costs incurred by the hospital can out- weigh the initial savings. Trend #3: Compressed project schedules The fi nal trend aff ecting HVAC systems in hospitals is 1.800.428.4065 TOLL FREE V Behavioral Healthcare Lavatory Healthcare Fixtures That Last! © 2016 Willoughby Industries Inc. e Fixtures That Last! Conceived to minimize ligature points for behavioral healthcare environments. Engineered with a 1,000-lb. ZHLJKWUDWLQJDQGVSHFLÀF features for bariatric patients in healthcare environments. Fabricated from all-welded 14-gauge type 304 stainless, these sinks come in a variety of FRQÀJXUDWLRQVZLWK²VWDWLRQV BHS-3123 WBL-2320 Stainless Steel Scrub Sinks V V Infection Control Lavatory 'HVLJQHGVSHFLÀFDOO\WR minimize splashing and reduce the spread of infectious disease. CSA Z8000 compliant! WICS-2222 EWSSS Now we're even easier to specify! Bariatric Healthcare Lavatory V » ,QIRUPDWLRQVKHHWVDQG5(9,7ÀOHVDUHDYDLODEOHDWZLOORXJKE\LQGFRP thcare Lavator y WS SS Photos: Cameron Triggs

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