Before doctors and nurses enter a hospital, engineers have been hard at work
The hospitals are known places of safety, healing, and comfort. Health workers do their best to provide care for the speedy recovery of their patients and comfort for their loved ones. But they are not the only ones who make sure the patients are safe: engineers have worked hard for it too.
Healthcare professionals such as doctors, nurses, and associated supporting staff constitute the majority of the workforce, while the engineers are a tiny minority of hospital staff. In fact, some hospitals have no engineers on staff but instead, contract that work out. They worked behind the scenes, under the ground and in between walls.
In today’s technology-intensive healthcare delivery processes, it is important to acknowledge that engineers too play an important role in providing patient care and by adopting a systematic approach towards healthcare technology management, they can help in achieving high levels of patient safety.
The Roles of Engineers in Patient Safety and Hospital Stability
Engineers also practice their expertise in the heath care sector, managing its infrastructural facilities with combined multiple specialties. The responsibilities of an engineer in ensuring the safety and functionality of a hospital don’t stop in building the structure itself.
They also cover looking after the building’s maintenance, ensuring supply of required quality and quantity of basic necessities like electricity and water, guaranteeing effective and safe management of the electrical installations, ventilation and air conditioning, and management and supply of medical gas.
The hospital being a specialized establishment for providing patient care, its infrastructure not only needs to satisfy all the statutory norms, but also needs to meet some additional specialized requirements, which can be closely linked to patient safety.
Thus, by referring to international standards and various guidelines, facilities engineers can enhance the safety of the infrastructure and thus, help in enhancing patient safety. Ample knowledge and expertise are needed from engineers, from building the structure itself, mitigating risks, problem solving to upgrading to newer technology in the future.
Here are the tasks and responsibilities performed by engineers to make sure hospitals are built and operate to institutional standards:
Facility Design & Project Management
Before a hospital can fully operate and function, engineers examine and design its key systems that are responsible of ensuring the comfort and safety of all the people inside the structures.
Facility design and project management services for hospitals include:
- Boiler plant systems
- Chiller plant systems
- Plant air systems
- Water systems, potable and domestic hot water
- HVAC & specialty HVAC systems
- Controls
- Fuel systems
- Medical gases & vacuum
- Dust collection systems
- Laboratory exhaust hoods & extraction points
- Data centers for utility & HVAC systems
- Pollution control & treatment
- Building envelope
- Fire alarm & protection
- Life safety
- Operating plans & specialized procedures
Building Inspections & Diagnostics
Engineers are also tasked to inspect hospital facilities and ensure that codes and building laws were carefully followed. They provide exacting analysis of all aspects to ensure that those who use it are secure, safe and have appropriate accessibility.
At the same time, engineers diagnose and inspect to help maintain a property’s market value and to ensure that any noncompliant matters are addressed.
Building inspection and diagnostic services include:
- Building envelope & façade inspections
- Fire protection & life safety
- Mechanical, electrical, plumbing (MEP)
- Process distribution systems
- Structural
- Parking garage surface, weathering & corrosion
- System vulnerability analysis
- ADA evaluation
Architectural
Engineers take part in a hospital’s architectural processes too, working hand in hand with architects and designers to:
- Develop material and personnel flow diagrams
- Review or develop room cards for client documentation
- Develop facility pressurization
- Design egress/security/pressure-gradient cascade control
- Design space layout for recovery rooms, operating rooms, halls, lobbies and its support spaces (office, lockers, cafeteria, storage)
- Repair, upgrade & retrofit
Specialty HVAC Performance Improvements and Upgrades
The design and operation of Heating, Ventilation and Air Conditioning (HVAC) systems of the hospital have a direct impact on the infection control strategy of the hospital. They have specific HVAC requirements expressly for their process areas.
In health care, diagnostics, treatment and examination areas have specific air charge, temperature and humidity requirements and standards for pressure relationships relative to adjoining spaces.
Engineers ensure that HVAC units do its job and maintain its quality to provide maximum comfort for patients, their families, and health workers alike.
Fire/Life Safety Consulting
“Life Safety” covers everything from egress pathways to lighting, signage, smoke control and prevention of the spread of fire and smoke, and all of these are part of providing a safe working or living environment.
The standard reference for fire and life safety is the National Fire Protection Association 101 Life Safety Code, which provides the guidance engineers need to assess occupant safety and design, changed uses or new construction.
Engineers are tasked to:
- Design space for fire and life lines
- Specify new fire protection and alarm systems
- Evaluate existing systems for compliance with NFPA Standards and effectiveness.
- Monitor code development
- Monitor code development and vote on adoptions, ensuring up-to-date standards and requirements set by the NFPA
Facility & Infrastructure Commissioning/Validation
Engineers also have the responsibility of eliminating uncertainties that help a medical facility set up for a more secure and successful management and operation—both health care wise and legally speaking.
The facility and infrastructure commissioning & validation services should cover:
- ASHE (American Society for Healthcare Engineering) health facility commissioning process
- Legacy system documentation
- Standard operating procedures (SOPs)
- Commissioning of new system designs
- Change control documentation
- IQ/OQ/PQ documentation generation and execution
Energy Management Services
Hospitals should also be aware of the power-consuming systems, how to control their usage, and reduce waste.
Engineers perform energy management services such as:
- Energy audits & comprehensive reports
- Energy conservation & building envelope upgrades
- Infrastructure analysis
- Cost-benefit analysis
- Design, plans & specifications
- Project management
- Controls
Medical Waste Management & Evaluation Survey
With numerous federal, state and local regulations regarding the storage, use and disposal of hazardous, medical and universal waste, a hospital’s policies and standard operating protocols for these wastes should be reviewed regularly.
Engineers are tasked to do an environmental audit of medical facilities to examine the current policies that address compliance with federal and state environmental regulation. After examining the policies and reviewing the practices, they compare the data they gathered for compliance with the regulation’s expectations and check with department managers to ensure that all staff members are familiar with the policies and are following the guidelines and procedures. A report will be made and filed by engineers to present the deficiencies they found and give recommendations for its improvement.
The U.S. Environmental Protection Agency has identified major federal environmental regulations applicable to various industries including hospitals, manufacturing and industrial; local authorities have additional regulations.
Environmental Consulting & Investigations
Inspections and reports made by engineers can be submitted in court as legal evidences. More so, they can also stand as witnesses given their expertise in the field as well as the evolving state and federal environmental laws, rules, documentation and policies that hospitals and medical facilities should follow.
Environmental consulting and investigation services include:
- Phase I Environmental Site Assessments
- Air, Water, Discharge Permit preparation, submission & reporting
- Annual regulatory compliance audits, training & record-keeping review
- Storage tank compliance review & reporting, replacement design
- Spill prevention (SPCC) plan preparation & review
- Stormwater management
- Regulations for EPA/NJDEP guidance & updates
SOURCES:
- https://www.lockatong.com/institutional/
- https://www.bls.gov/ooh/architecture-and-engineering/health-and-safety-engineers.htm
- http://www.fda.gov/downloads/MedicalDevices/Safety/MedSunMedicalProductSafetyNetwork/UCM371862.pdf
- https://www.fema.gov/media-library-data/20130726-1610-20490-7924/577_ch2.pdf
- http://www.healthcarepathway.com/Health-Care-Careers/hospital-maintenance-engineer.html