5 Keys to Maintaining Operational Integrity during Health Care Construction by Bill Wagner, VP Healthcare

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Providing a conducive healing environment and high-quality patient care are top-of-mind for healthcare providers and their contractors when undertaking construction projects in occupied spaces. Minimizing disruptions to day-to-day operations is essential for patients, visitors and medical staff impacted by the noise and general inconvenience of construction. There are five key factors to maintaining operational integrity during most construction projects.  Use these factors to help diagnose the potential problems and plan for solutions prior to beginning work on your next project.

How will patient movement (inpatient and outpatient) be affected?

Healthcare renovations or additions often interfere with egress and flow to the facility.  Parking and registration are often affected, and access from outside entrances to waiting rooms, admitting, elevators, imaging, laboratories, patient rooms, ED and other areas of the building during construction can be adversely impacted.

SOLUTION: Careful planning and phasing must be made to facilitate easy patient transport throughout the facility to maintain the quality of care. Using building information modeling, 3D “snapshots” can be created of each phase of the project digitally depicting egress and movement. This allows staff to view the potential impacts of construction and provide input prior to disruption.

Is infection control an issue?

Infection control is vital in a healthcare environment. Construction often produces a lot of dust and debris.

SOLUTION: Proper airflow management reduces the risk of exposure. This can be achieved by careful placement of proper negative airflow devices, partitions to separate construction areas from the rest of the hospital, and the use of surgical booties worn over construction workers’ boots when entering hospital spaces.

To make certain proper infection control is maintained, dust and debris must be minimized. Dust partitions, HEPA filters, and sealed containers for debris removal are usually necessary to control the unwanted migration of these contaminants. Only qualified and experienced builders understand all of the steps needed to maintain infection control throughout all phases of a project.

Infection control also involves vaccinations for construction staff, an often overlooked item on the pre-construction planning checklist. Properly immunizing workers before construction can prevent many of the most com­mon diseases from spreading. This not only protects the patient and staff, it also prevents construction workers from contracting illnesses, resulting in more on-the-job time, which leads to faster project completion.

Will construction noise interfere with the patient experience?

Construction noise can intrude on patient care and affect HCAHPS scores. Special procedures and equipment need to be put in place prior to construction to minimize audio intrusion.

SOLUTION: By coordinating construction activities and installing proper noise abatement procedures, audio intrusion into patient areas can be reduced or eliminated. Noise mitigation can include erecting sound absorbing partitions, using special tools that emit less sound and scheduling nosier activities around the hospital’s schedule.

Will med-gas, nurse call, fiber, electric, HVAC, water and fire protection tie-in affect our existing systems?

If new systems need to tie into the existing systems, they should be carefully planned and coordinated with facility personnel.

SOLUTION Proper planning ahead of time can prepare the technology staff for seamless transition and uninterrupted service of critical data and telephonic connectivity. To be effective, a construction team needs to coordinate with the facility staff and the information technology department. All shut downs should be scheduled months in advance with documented and written procedures.

What temporary evacuation procedures need to be put in place prior to construction?

Safety is a major consideration in a construction project—not just for the construction workers but also for patients, visitors and medical staff. During construction, many of the hospital’s normal emergency evacuation routes may be disrupted or moved, so alternative routes need to be in place for possible emergencies.

SOLUTION: Mapping out a series of new evacuation plans for each phase of the project and educating the facility staff of these plans can assure patient and staff safety in the case of an emergency.

If any of the above is a consideration for your project, you should consult a healthcare construction expert to help you plan for a safe, productive and efficient jobsite.

Bill Wagner is Vice President – Healthcare for S. M. Wilson & Co.   Bill has been involved in $1.5 billion of healthcare construction during his 37 years in the construction industry and has worked on a variety of healthcare and senior care projects.