Renovating the space housing the Blood and Marrow Transplant/Cellular Therapy (BMT/CT) Program at the Hospital for Sick Children in Toronto provided the design team with numerous challenges related to infection prevention and control (IPAC). To address these challenges, the project team studied IPAC standards, best practices and lessons from other projects. Using this project as a case study, this presentation will describe the process used to integrate IPAC requirements in health care design and construction. The session will detail the make-up of the interdisciplinary design team, how the hazard vulnerability analysis (HVA) and infection control risk assessment (ICRA) were conducted, how standards were followed, ways construction requirements were documented and managed and how COVID changed requirements. The session will present lessons learned by sharing successes and opportunities for improvements. Participants will be invited to ask questions to help them apply concepts and approaches to their future projects.

Renovating and expanding an emergency department is challenging — current needs and urgent health issues must balance alongside long-term strategies. What presentday and forward-looking items should be considered? How does a project team handle this significant task? In this presentation, representatives from Leggat McCall, NBBJ, BR+A and Skanska will discuss five ways they managed the ED balancing act to design and build the 52,000 SF expansion and renovation of the Brigham and Women’s Hospital emergency department. With design and construction efforts prioritizing efficiency, safety, security and the well-being of patients and staff, the recently completed ED will be a resilient, welcoming and healing space for many. Building off their experience, the project team will also share five key recommendations for attendees looking for best practices that can benefit most health care settings.

Ventilation of Health Care Facilities Standard Chair Michael Sheerin, Design, Construction, Operation of Sustainable, High-Performance Health Care Facilities Chair Doug Fick, and committee member and ASHE Senior Associate Director of Advocacy, Jonathan Flannery will provide a lively overview of the progression of these important health care facility standards, highlighting important and recent changes. Ventilation and sustainability have been critical factors evaluated and modified in the health care built environment this past year, so the speakers will also discuss the committees’ recent review of the standards related to pandemic readiness and changes enacted or considered as an outcome of the COVID-19 crisis.

In a first for Northwestern Medicine, the renovation of a medical office building (MOB) in Bloomindale, Ill., featured prefabricated modular exam rooms. More than 70 exam rooms were built as pods off-site in an assembly-line fashion and delivered to the MOB site, where they were slid into place for final connections. The pods were 95% completed at the off-site shop with drywall, insulation, ceiling tiles, cabinets, sinks, electrical wiring and plumbing. Nearly all finishing touches were completed as well, including the tile, paint, wall covering and millwork. Computer arms, blood pressure monitoring equipment, sharps needle containers and coat hooks were attached to the walls before delivery. The main advantage of modular pod construction is a more advantageous speed-to-market solution for project delivery, as well as the efficiency, safety and quality control of building in a controlled environment compared to a traditional project setting. While prefabricated modular units are common in the hospitality industry, the process is gaining traction in the health care industry. It is very helpful for medical providers to be able to walk into any exam room and know exactly where everything is and what to expect. Standardization helps significantly with flexibility, allowing different specialties to use the same exam rooms depending on volume, which makes the real estate footprints more efficient.

Commissioning is a common practice performed at the end of a project, but this process only verifies that the systems are operating and performing as designed. Acceptance testing can add additional value to the owner by identifying defects related to manufacturing and installation that will likely manifest themselves after the warranty period ends. Acceptance testing standards need to be developed during the design phase of a project and included in the contracts. Not everyone understands the difference and often the terms can be inappropriately interchanged. It’s helpful for stakeholders to understand how they are different to be sure expectations are aligned.

Delivering health care in the US contributes roughly 7% of our nation’s greenhouse gas emissions, the largest share of any country in the world. Pressure to improve an organization’s sustainability is mounting, from federal to local levels. Strategic investments in sustainability can lead to better cost outcomes, proactive compliance, and a cleaner environment. In this panel discussion, Mazzetti and Hospital Energy will share the lessons learned from working with clients across the country, and Kaiser Permanente will share their perspective on how to best finance energy sustainability. This builds on the ASHE monograph “Best Practices for Financing Energy Sustainability” published in 2021.

Now that the pandemic is behind us, we can get back to normal – right? Oh, wait. There are still new variants (and other natural and manmade disasters) that continue to plague our society and in turn, our health care facilities. So, if a facility was ahead of the curve and was proactive in creating or utilizing an alternate care site to accommodate COVID patients, what do you do with the site now? This team will discuss when COVID provisions can/should be migrated to an alternate use and how to change them back (if necessary) while sharing insight on what makes the task easier or more challenging. The group has presented many COVID-related programs but now feels it is time to address the elephant in the room and talk about what to do with all the facilities after the urgent need for the initial use has decreased.

Ever wonder why a regulation changes? In this session, participants will learn about the key changes to the Guidelines 2022 outpatient regulations as well as see how the regulation has evolved over the years. Influences such as code interpretations, industry adjustments, research and public comment influence the regulation changes. Participants will gain knowledge about how and why the 2022 changes were decided upon.

Facilities, security and operations professionals can turn to sophisticated technology innovations that integrate and unify complex systems for fast, accurate and cost-effective monitoring of activities and practices across the entire health care system enterprise. Current information on these technology advances can help staff make informed decisions on implementing cost-effective measures that adhere to the exacting and stringent health and safety protocols for staff and patients while scaling solutions to fit an expanding footprint as new structures are built in high-growth markets. These advances can help:
• Proactively identify potential warning signs to help prevent workplace violence.
• Locate wandering patients with analytics that can quickly notify patient care staff and can also trigger video location.
• Help protect infants and at-risk children from potential abduction while helping ensure patient safety.
• Monitor staff hygiene practices.
• Address workflow inefficiencies that impact the bottom line.
• Monitor/track patient throughput.
• Comply with Joint Commission standards.
• Improve HCAHPS scores.