Applying informed design and construction best practices for infection prevention and control in healthcare settings.
The design of an acute-care facility is a crucial factor in infection prevention and control. There is a balance in designing a healthcare facility which is open and accessible to the public, yet can reduce the risk of acquiring an infectious disease. To strike this balance, infection control must be a consideration from the initial planning and design phases of any new build or retrofit.
The SARS outbreak, a few years back, brought about recommendations to minimize risk of spreading infectious diseases in healthcare facilities. The recent Ebola outbreaks and the MERS outbreak in South Korea are reminders of the importance of infection prevention and control.
Prior to the initial planning and design, an infection control risk assessment is conducted with key stakeholders and the facility’s infection control team to identify potential risks and the appropriate procedures for minimizing them. We also partner with industry leaders in infection prevention and control, like Dr. Dick Zoutman, to ensure we have access to the latest information and research.
Informed design can reduce the risk of infection for patients and staff in two major ways; the design of the facility and the controls in place during renovations. Healthcare facilities can be designed with features that restrict the transfer of infection from person to person. The design and placement of hand wash sinks, the control of ventilation, the layout of waiting rooms and exam cubicles and the use of single patient rooms and isolation rooms can enhance the infection control strategies in the hospital.
During renovations dust and mould spores can be released which could harm patients, especially those with weakened immune systems. Construction specifications which require the construction area to be sealed and equipped with HEPA-filtered negative air units can help to contain these airborne contaminants. Contractors can wear coveralls and boot covers which must be removed prior to leaving the construction areas. With careful controls in place, the risk of construction-related infections can be reduced or eliminated.
Through from our work as members of the CSA Technical Sub-Committee for CSA 317.13-07 Infection Control during Construction, Renovation and Maintenance of Healthcare Facilities, Parkin has specialized knowledge of infection prevention and control standards and protocols for design and construction. Several senior staff members have been part of the Technical Subcommittee and all of our staff have received training on this standard as part of our on-going in-house education program.
In addition to our advanced knowledge and expertise of infection prevention and control during construction, we design healthcare facilities to meet the latest requirements of provincial infection and control committees. Recently there has been significant advancement in clinical processes and healthcare design to aid infection prevention and control. We are well versed in air handling provision, design and distribution of clinical hand-wash sinks, and matters of clean-ability. Moreover, we make every effort to integrate the facility’s infection control team into the development of the design and its implementation.
Infection Control Experience
Parkin Principal, Lynne Wilson Orr, is a member of the CSA Strategic Steering Committee on Healthcare Technology & Systems and a member of the CSA Development Committee for Emerging Materials and Technologies for Infection Prevention and Control. In addition, she has made presentations on infection prevention and control, and the implications for healthcare design to the:
- Provincial Infection Diseases Advisory Committee (PIDAC),
- Saint Justine Women’s and Children’s Hospital, Montreal,
- Sunnybrook Health Sciences Centre Infection Prevention and Control Coordinators, and
- Several international healthcare design conferences, in particular the Gravens Conference on ICU Environments for the High Risk Infant.
Additionally, Parkin Principal, Mark Michasiw, received specialized training in infection prevention and control through a program initiated by one of our healthcare clients for its staff.
On January 14, 2015, the Ontario Ministry of Labour issued Ebola Virus Disease Directive #1 for Hospitals. We have been retained by four of our clients (Woodstock General Hospital, The Ottawa Hospital (Civic and General sites), Brampton Civic Hospital and the New Oakville Hospital) to review the directive, develop an appropriate design solution and consult with the hospitals on the best methods to achieve protection of healthcare workers, while still providing a patient-centred facility. Many hospitals are expanding the concerns related to Ebola to other communicable diseases such as Tuberculosis, so it is essential to establish and review the specific parameters of the healthcare facility as issues and solutions are not “one size fits all.”
Dr. Dick Zoutman
Dr. Zoutman is Professor in the Divisions of Medical Microbiology and Infectious Diseases Division at Queen’s University. Dr. Zoutman is also a Professor of Pathology & Molecular Medicine, of Community Health & Epidemiology, and of Medicine at Queen’s University. A primary focus of his investigative work has been the use of modern Quality improvement methods in the prevention and control of healthcare associated infections as well as new sterilization and disinfection methods. He is past Physician-Director of the Board of the Community and Hospital Infection Control Association of Canada having served for 12 years and is an Honorary Member of CHICA Canada. During the 2003 outbreak of SARS in Toronto Dr. Zoutman chaired the Ontario SARS Scientific Advisory Committee responsible for advising the Ontario Government on management strategies of the SARS outbreak. As of 2004 Dr. Zoutman was appointed Co-Chair of the Ontario Provincial Infectious Diseases Advisory Committee. Dr. Zoutman has his Black Belt in Lean and Six Sigma for Health Care. Dr. Zoutman has recently assumed the role of Chief of Staff at Quinte Healthcare Corporation.