Understanding the complex logistics of working in a live hospital environment is crucial to ensure uninterrupted care and the highest level of patient and staff safety. Here, Matthew Wall, Public Sector Director at Morris & Spottiswood, discusses the critical factors behind a successful hospital refurbishment project.
Hospitals are some of the most sensitive and complex live environments to operate in. The top priority for any refurbishment, retrofit or extension work should always be Infection, Prevention and Control (IPC), and ensuring the safety of patients and staff. However, there are also other factors that need to be considered.
Planning and early engagement
One of the most important considerations for a successful live-environment project is detailed planning, and therefore early engagement with the contractor is essential. This will help ensure that the design for the work can be optimised in terms of minimising the impact on the day-to-day operation of the healthcare facility. It can also help ensure project timelines are met as it allows any unknowns or issues to be addressed before they cause delays.
When brought onto a project, the first step for any contractor should be to fully understand the building and the environment they will be working in. The starting point will be the information that the healthcare organisation holds on the building. Where there are gaps in this information or additional detail is required, surveys may need to be carried out. For example, for buildings built before 2000, there is always a risk that the building fabric may include materials that contain asbestos. Identifying this as early as possible allows the full scope and requirements for the work to be established.
It is also essential to understand the building’s services and systems. Hospitals have many different systems including plumbing, drainage, power, ventilation and medical gas pipework. Depending on the type of work being carried out, sections of these systems may need to be isolated or disconnected. Therefore, interruptions of these systems may need to be planned months in advance and alternatives devised to allow necessary hospital operations to continue.
Logistics and control processes
When it comes to the work phase of the project it is essential that robust measures are put in place to protect patients and minimise the overall impact on the hospital. One of the most critical factors is infection control, which is primarily concerned with minimising the contact between the area where the work is being carried out and the rest of the hospital. As far as possible, the areas should be segregated and sealed off, ideally with a separate access point. Where this is not possible ‘HAI-SCRIBE’ processes should be used to prevent dust and debris being moved into the hospital environment. For example, airlocks, tacky mats to capture dust and debris from shoes and all waste materials being sealed and disinfected prior to removal. Controlling the movement of air is also essential through the use of negative pressure spaces, which prevents air moving from the workspace into the rest of the hospital.
Noise can also be a significant issue for healthcare environments and so how the work is carried out is considered carefully in advance of the operations. For example, noisy tasks may be carried out away from the building or it may be necessary for work to begin later and finish earlier than on a typical site to avoid disturbing patients’ rest.
Additionally, coordination with key hospital staff and other stakeholders throughout the project is essential to ensure that everyone is well informed about the work and that all requirements can be factored in.
Choosing the right partner
It is important to choose a contractor partner that has experience in the healthcare sector and understands the particular challenges of these environments. Any contractor who is experienced in this sector should be fully aware of the relevant regulations and guidance, such as the Health Technical Memoranda (HTM) / Health Building Notes in England and HAI-SCRIBE (Healthcare Associated Infection Systems for Controlling Risk in the Built Environment) system developed by NHS Scotland. As an example, Morris & Spottiswood has healthcare sector specialists who have in-depth knowledge of these environments so they can provide the best possible support and service to healthcare organisations. Drawing on the Group’s end-to-end service capability, combined with decades of specialised experience and strong supply chain relationships, ensures that each healthcare project delivers maximum value and performance for clients.
There is also a significant advantage to selecting a partner that offers a wide range of services from design to construction, fit-out and M&E to maintenance. Having one team that can take the project from concept to completion means a more seamless process with a single point of contact and no need to coordinate multiple service providers. This also allows expertise and best practice to be more easily shared across the different phases of the project, ultimately resulting in a better outcome.
Live hospital environments, perhaps more than any other, require careful planning, detailed information, robust control processes and specialist knowledge to successfully deliver a project. Engaging early in the process with a partner who has a proven track record in this sector will help ensure that the impact on patients, visitors, staff and hospital operations is minimised.
To find out more about Morris & Spottiswood, visit www.morrisandspottiswood.co.uk.
Featured in Public Sector Building Magazine.