Construction in an Occupied Hospital Top Three Risk Factors Building Health
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Construction in an Occupied Hospital Top Three Risk Factors
Construction and Healthcare – somewhat like oil and vinegar but sometimes they need to go together for the benefit of health and progress. What makes construction in healthcare so challenging? The same thing that makes healthcare rewarding the patients. Construction is a field traditionally allowed to remain in its own rugged environment and therefore the marriage of these two requires some fineness and choreography.
In the process of building a new hospital environment adjacent to an occupied hospital space, it is critical NOT to contaminate the existing facility for fear of creating or spreading infections. Contractors are required to first perform a risk assessment to understand where cross contamination risks may exist so that appropriate mitigations can be put in place. Standard infection control procedures include:
Construct barriers to create a physical separation.
Build in a negative air system to draw in air contaminates and vent them to the outside air whenever possible.
Monitor the negative pressure to ensure everything is running as planned (24/7) – provide an alarm on your magnehelic so that a warning will sound if there is a breach in the system.
Document your environmental contaminants and be vigilant in maintaining good housekeeping. Keep your site locked when non-work is being conducted.
Given the 24/7 occupancy of a hospital, specific life safety concerns must be addressed. Specific to occupied facility construction, the team must:
Plan, document and communicate any new fire egress routes. In addition to coordinating and communicating plans with hospital staff, all re-routing information must be posted throughout the affected areas.
Establish a fire watch plan for any compromised fire systems or particular scopes of work that could spark a fire. For example, pouring hot asphalt on a hospital roof could spark a fire and therefore a fire watch plan must be in place both during the work and once it is complete.
Coordinate any fire watch plans with the local fire department.
Coordinate fire watch plans with a hospital life safety officer.
Risk Factor #3: Utility Disruption Similar to life safety, utility interruption in a hospital can be catastrophic. It is imperative to:
Plan all utility related work with the assistance of the hospital maintenance team and MAKE NO ASSUMPTIONS. Hospitals have generally been built over time, in phases, and documentation of existing conditions is not always accurate. It is generally always recommended to use a utility locator prior to commencing any major work for added certainty and precision.
Trace all existing lines – from source point to end point. Before work commences, the contractor must understand the exact path of medical gas lines, mechanical equipment etc. By doing so, the relationship and connections to neighboring spaces can be determined so that correct actions are taken. Proper tracing of lines might determine that work on an electrical system might affect the lighting in an occupied operating room down the hall. In that case it might make sense to install an isolation valve to ensure there are no disruptions.
Provide backup utilities during any shut down or planned interruption. It is always prudent to plan your utility work as though a failure will occur so all potential outcomes are planned for and prevented.
Healthcare is a challenging and rewarding field to work in for contractors. Proper planning and risk mitigation are essential to the success of both the hospital and contractor. Plan each activity as though your loved ones are the patients in the beds and the essential details will not be overlooked.
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