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Cross-Contamination in Healthcare Facilities: Prevention Through Balanced and Integrated Design Approach
Working Together to Build Safer
Simona Besnea, CPP, Inc.
Cross contamination is one of the biggest concerns in hospitals. While cross contamination can lead to devastating circumstances in cases where people with compromised immune systems are exposed, it is also a threat to anyone who crosses the facility's threshold. Designing a modern and safe healthcare facility in the 21st century requires an innovative approach with a focus on safety, while keeping goals of optimizing energy efficiency in mind.
Early involvement of all team members and setting clear project goals are fundamental steps in creating a high-performance sustainable building. Knowledge specific to each system must be shared to achieve higher levels of building performance. To help provide adequate protection to both patients and health-care workers, organizational and engineering controls are needed. Through use of adequate engineering systems, the environmental conditions within the facilities are controlled to minimize the potential for transmission of airborne infectious diseases.
In this symposium, the Engineer will describe potential health and/or odor concerns associated with re-circulation of contaminated exhaust air back into the building. Based on results of exhaust dispersion modeling, it will be shown that a safe and energy-efficient stack and intake design can be achieved even under typical worst-case wind conditions. Properly located stacks discharging at an optimum height and velocity can derive energy efficiency savings, reduce building odors and mechanical noise, and ensure the safety of building occupants.
Influence of Research Laboratories in Patient Care and Infection Control.
Rohit Saxena, HOK
Patient care today has moved away from being physician-centered to patient-centered. Patient care teams now include not just the clinical care teams but a host of research and diagnostic teams. Medicine has moved into discovery based care where diagnostics and treatments are being offered based not on disease but on our genetic disposition. Research and teaching hospitals are getting integrated into our hospitals creating newer methods of delivering patient care. Translational medicine, which allows a feedback from clinical care teams to the laboratory researchers and back to the clinical teams, requires tight integration and cross collaboration between various teams. Laboratories are playing an important role in the health and well being of people.
In this symposium, Saxena discussed the changing trends in the delivery of healthcare at our institutions and the influence of laboratories in infection control. Laboratories tend to have significant containment issues in planning, design and construction that clearly impact our ability to provide healthcare emergency planning. Using project design and planning examples he discusses ideas and concepts to consider in planning such integrated facilities.
Balancing Sustainability and Infection Control through Healthcare Design
Michael Street, HDR Architecture, Inc.
Throughout history for all building types, architects have faced the challenges of balancing form with function, schedule with budget, and quality with quantity. Healthcare facilities, like laboratories, require specialized knowledge of functional operations and equipment. Despite best efforts of designers, hospitals traditionally are characterized as sterile, clinical, uncomfortable, frightening, inhumane, or all of the above. Recent trends in benchmarking patient outcomes have proven that a more hospitable, healing environment improves the patient experience, better supports staff at providing care and contributes to faster patient recovery. In addition, public awareness of our fragile environment has sparked an architectural renaissance of the new millennium. The early adapters of green building strategies have begun to motivate even the most stubborn hospital boards to improve their facilities. Healthcare architects now must balance the often conflicting goals of creating a sustainable healing environment with the necessity of a safe environment.
This presentation will discuss design strategies for the mitigation of infection control risks in the contemporary hospital. Many risks can be avoided through appropriate medical planning that focuses on flow segregation and optimized functional adjacencies. Additionally, technological advancements and integrated design have begun to transform the patient care environment and improve safety. Using project and theoretical examples, the presentation will explore key areas of the hospital to demonstrate that the balance can be achieved.
Cross Contamination and Infection Control Planning for Construction
Steve Black, JE Dunn Construction
The concern for controlling sources of cross contamination and infections during the construction process is critical for any health care, life science, or laboratory project. Whether it is a new, expansion, or renovation project, care must be taken to mitigate all medical risks during the construction process. The same concerns hold true for performing routine maintenance activities within an existing facility. Systems must be in place to address the safety of the patients and workers. Building a clean facility from the ground up is crucial.
Construction projects that have early involvement of all team members, including the end user, often show a positive impact on the overall project cost, schedule, and user satisfaction. Early awareness of all team members to constructability issues and the need for creating temporary barriers for cross contamination is important to the success of the project. Doing so allows adequate time for planning, the development of standard operating procedures and creating awareness so that construction can flow well and the impact of risk is minimized.
In this symposium, the construction manager will address establishing cross contamination and infection control protocols for health care, laboratory, and life science projects. Implementation begins in the early stages of the project design and continues through the completion of construction and beyond. The issues of constructability, worker knowledge and training, coordination, installations, quality, finishes and the testing and commissioning of systems will be discussed. A "Build Clean" protocol will be presented that can be used to establish rules for entry, material transfer, construction activities, contamination control, and personnel conduct to be followed by all persons gaining access to designated health care, laboratory, life science, BSL-3, equipment, and HEPA filtered areas. A systematic method for maintaining indoor air quality during the construction process will also be described.
Biographies:
Simona Besnea, PE, LEED® AP, has recently joined CPP as a Senior Engineer for Air Quality Services. As an engineering leader with another major wind engineering company, Simona applied physical and numerical dispersion models to pollutant transport problems, exhaust design issues, and regulatory modeling projects.As a native Romanian, Simona holds a Bachelor of Applied Science (Honors) degree in engineering physics from the University of Bucharest. She also has a Master of Engineering degree in environmental engineering from the
University of Guelph in Ontario, Canada. She is a licensed Professional Engineer registered in Ontario, Canada and a LEED
Accredited Professional. The focus of Ms. Besnea's research is air quality and dispersion modeling. Specialty areas include numerical and physical air quality modeling and exhaust re-entrainment studies for the design of building exhaust and air
intake systems for laboratory, hospital, and other related facilities.
Rohit Saxena is a Senior Vice President with over 25 years of experience in architecture and is a market sector leader for the HOK Science and Technology group. His responsibilities include planning and management for science and technology oriented projects with special emphasis on academic research and teaching facilities. The majority of his experience has involved projects on university campuses in the southeast. He is very familiar with the challenges of working in and around existing buildings, fast track, and phased construction, and works collaboratively with facilities management departments and contractors. He is a regular speaker in industry conferences on laboratory design and sustainability. His current assignment involves heading HOK's new India operations where he has recently relocated with his family.
Michael Street is a Vice President and Design Principal with HDR Architecture in San Diego, California. Mr. Street has been instrumental in the design of numerous healthcare facilities throughout the United States and abroad. His healthcare experience encompasses a broad spectrum of projects including patient care units, surgical, emergency, imaging, and other ancillary services in both outpatient and inpatient environments, as well as comprehensive facility master planning. He also has extensive experience using advanced simulation tools to communicate design ideas, which simplifies decision-making, expedites project development, and provides continuous visual quality assistance throughout the project. The recipient of several peer awards, Mr. Street is well respected for his ability to interpret current and future clinical occupant needs, and to create designs that are flexible, adaptable and cost-effective. A LEED Accredited Professional and a licensed architect, Mr. Street is currently developing new design approaches to patient care based on five star hospitality management and the Disney model of "on-stage/off-stage" space zoning.
Steve Black is a senior project manager and senior MEP coordinator for the Health Care and Life Sciences Division of JE Dunn Construction in Kansas City, Missouri. Steve holds a Bachelor of Science in chemical engineering from the University of Tulsa, a Masters of Business Administration from the University of Missouri-Kansas City, and is a LEED Accredited Professional. Mr. Black's focus is on design, planning, cost estimating, construction, and commissioning of hospital, life science, laboratory, pharmaceutical, chemical, and environmental facilities. Areas of specialty include health care, research laboratories, vivariums, biotech and pharma equipment, BSL2, BSL3, classified clean suites, environmental rooms, high purity systems, cGMP manufacturing, HVAC, and central utility systems. Steve is a member of the Society for Life Science Professionals (ISPE) and a past member of the American Institute of Chemical Engineers (AIChE).
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