By Deborah Deioma Danto, MBA, LEED AP, CGC

Construction for healthcare facilities must be well-thought out and planned, and then executed per the plan. With the advent of COVID-19, it’s even more critical to follow strict guidelines when it comes to construction within an existing healthcare facility.

One way to ensure that construction design adheres to the strict policies and needs of a healthcare environment is the use of an infection control risk assessment (ICRA) at the beginning of a project. These types of assessments started over 50 years ago and have become even more important to deal with the challenges of COVID-19.

COVID-19 is most easily transmitted via air droplets, as well as on surfaces. This means a wide range of precautions and steps need to be taken when it comes to construction within existing healthcare facility.

Interventions to prevent disease transmission may include:

• Barriers, such as plexiglass dividers, at building entry points and at various communication points with patients.

• Air filtration systems that address the airflow in HVAC systems, to capture and eliminate airborne pathogens,

• Isolating/pressurizing specific areas so that untreated air doesn’t mix with clean/treated air.

Health Facilities Management magazine outlines strict protocols for construction design requirements that includes addressing:

• the number, location, and type of airborne infection isolation and protective environment rooms needed

• special HVAC needs

• water and plumbing systems

Other health risks to be addressed during construction include:

• dust and debris (compromising the air quality)

• the circulation of airborne microbes or pathogen through the ventilation system

• water contamination

• waste reservoirs

• dustproof barriers

• the transportation of waste

• contaminated workers

If an ICRA (infection control risk assessment) is created by a healthcare facility, prior to construction work, construction-related requirements need to be specified and included into the contract documents so they can be reviewed, prepared for, and implemented during construction.

Facility protocols outlined by the Facility Guidelines Institute include the following considerations before starting a healthcare construction project:

• Patient placement and relocation plans

• Protection from airborne contaminants and pathogens (protective measures, such as barriers)

• Demolition

• Emergencies (e.g., planned and unplanned utility outages and evacuation).

• Phasing or temporary provisions for construction or modification of HVAC and water systems

• Training for staff, visitors, and construction personnel

• Construction worker procedures and protocols such as:

– construction worker routes

– elevator use (for personnel and materials)

– cleanup and debris

– bathroom and food facility use

CDC Guidelines for the construction industry also include the following protocols:

Wearing cloth face coverings in areas – such as healthcare facilities – where there is significant community-based transmission of COVID-19.

Cleaning and disinfecting frequently touched surfaces, such as shared tools, machines, vehicles and other equipment, as well as handrails, ladders, doorknobs, and portable toilets. Cleaning and disinfecting should occur within shifts as well as:

• at the beginning and end of every shift

• after anyone uses a vehicle, tools, or a workstation

Practicing proper hand hygiene is an important infection control measure for COVID-19. With the appropriate hand hygiene practices, it’s not necessary to wear gloves to protect from COVID-19 infection. When possible, workers should wash their hands regularly with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer containing at least 60% alcohol.

Key times to clean hands include:

• Before and after work shifts and breaks

• After blowing your nose, coughing, or sneezing

• After using the restroom

• Before eating and before and after preparing food

• After touching objects handled by coworkers, such as tools and equipment

• Before putting on and after taking off work gloves

• After putting on, touching, or removing cloth face coverings

• Before putting eye or face protection (safety glasses, goggles, etc.)

Finally, it’s important that construction workers don’t touch their eyes, nose, or mouth at work, if possible. And that they use tissues when coughing, sneezing, or touching their face, with used tissues thrown in the trash and hands washed or sanitized.

In sum, it’s critical that a wide variety of mitigating considerations and procedures take place while doing any construction within a healthcare facility, especially while COVID-19 and its variants are being transmitted in the local area.

Have a question about construction in the healthcare industry? Call (954) 229-2006, email debbie@dantobuilders.com or visit www.dantobuilders.com.

Sources:

https://www.hfmmagazine.com/articles/3867-infection-control-during-construction

https://www.ashe.org/infectionprevention

https://www.hfmmagazine.com/articles/3611-healing-environments-construction-and-engineering-roles-in-infection-prevention

https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/construction-workers.html



Marcus Neuroscience Institute is expanding its services to Boynton Beach, making breakthrough neurological care more accessible for northern and central Palm Beach County patients seeking comprehensive treatment for conditions affecting the brain, spine and peripheral nervous system.

The new location, at 2800 S. Seacrest Boulevard, Suite 160 in Boynton Beach, will offer neurology and neurosurgery services, including inpatient care.

Marcus Neuroscience Institute, based at Boca Raton Regional Hospital, was established with a lead gift of $25 million from the Marcus Foundation, initiated by Billi and Bernie Marcus, the founder and former CEO of The Home Depot. The Marcus Foundation has committed an additional $15 million to expand the Institute, which houses four dedicated operating rooms — including one equipped with intraoperative MRI and two with intraoperative CT capability. The hospital is also the first in the nation to feature both the highly sophisticated Siemens ARTIS Icono Biplane imaging equipment and the Corindus CorPath GRX Robotic surgical system in one place.

Using state-of-the art technology that promises to become tomorrow’s standard of care, the Institute recently performed their first robotic-assisted spine surgery using the highly advanced Mazor X™ Robotic Guidance Platform, which combines 3D pre-operative planning, robotic guidance and intra-operative surgical navigation.



By Daniel Casciato

Today, hospitals and other healthcare facilities in South Florida are being built to survive the strongest hurricanes.

With the threat of hurricanes, along with the accompanying winds, flooding, and systemic erosion, Charles Michelson, AIA ACHA LEED AP, President of Saltz Michelson Architects in Fort Lauderdale, FL, an architect of both new hospital projects and renovations, stresses that the design community is always prepared to design and engineer the proper solutions in the right locations.

Charles Michelson, AIA ACHA LEED AP, President of Saltz Michelson Architects

“We are trained professionals prepared to respond to the need and protect the medical facilities within our communities,” he says. “There has been ongoing work for years hardening existing medical facilities to the essential service criteria outlined in the building code. Recent FEMA money availability has reinvigorated this effort to protect the buildings through impact windows and doors, structural grills and louvers and the protection of our infrastructure; generators; chiller plants and oxygen tank farms.”

Building according to Florida code will allow hospitals to withstand hurricane strength winds of 185 miles per hour. While hurricanes are a common occurrence in South Florida, Michelson notes that structural reinforcement is only one part of the protection formula for the protection of medical facilities.

“Protection includes the redundancy of all systems; alternate sources of power before the generators kick on, as well as multiple forms of communication,” he says. “For existing buildings that fall below new flood criteria, there are waterproofing and opening protections that can be added to a building and site to protect against flooding. Many new products are on the market over the past few years to respond to this need.”

One of the new design/building trends that is playing an important role in building hurricane-resistant buildings is that they are being constructed at a higher elevation to avoid any flooding issues.

“In addition, all infrastructure is constructed well above flood criteria, so that not only is the structure protected, all systems that run the building are elevated; making them safe and secure as well,” adds Michelson. “Part of the site considerations include the access to the hospital since a protected building that the public can’t get to in an emergency won’t provide the necessary services it was designed to provide the public.”

Following devastating hurricane damages, there’s always talk of improving the resiliency of facilities in an effort to protect them from increasingly damaging storms. In the wake of recent hurricanes, this is an issue on the minds of just about everybody who lives in a hurricane-prone area such as South Florida.

Michelson says that some of the lessons learned over time demonstrated the importance of protecting ancillary systems that allow the hospitals to function.

“When the power goes down, hospitals have generators, but when the city utilities go down, how do you run a chiller plant when the city is no longer providing water?” he says. “What’s the plan when the city sewer plant stops for two or three days?”

Since more companies now want to build with resilient design in mind, collaboration with subcontractors and other vendors, who may not have experience with resilient design, becomes even more important.

“Construction is a team activity,” says Michelson. “When new systems are being designed and constructed, designers, contractors, owners, vendors, and industry representatives work together to analyze and respond to each unique situation. No two medical facilities are alike and as such, there are no cookie cutter designs that take care of every unique condition. We remained informed and adaptable to create new and updated solutions to our environmental issues.”

For more information, visit www.saltzmichelson.com.



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West Boca Medical Center recently unveiled its new Boca Center for Women’s Care. The center has a new name, but is still delivering the same quality care expectant moms can count on when getting ready to deliver their new bundle of joy. The hospital also has a new laborist program, which offers in-house physicians, who are specialized obstetricians and gynecologists. They are available 24/7 to care for all maternity, labor and delivery needs. The hospital also has aromatherapy, a celebration breakfast, postpartum snack pack and a Level III Neonatal Intensive Care Unit.