Australia’s first public hospital opened its doors in 1816, fittingly nicknamed ‘The Rum Hospital’ because its builders were given a monopoly on the distribution of 60,000 gallons of spirits.
Today, Australia has more than 1,300 public and private hospitals that collectively provided almost 30.9 million days of patient care in 2018-19. All require regular maintenance and periodic refurbishment.
Ultimately, those refurbishments benefit patients and staff by maintaining standards and improving the overall environment. They do, however, involve disruption and upheavals that can be stressful for staff and may delay care for patients.
Is there a way to refurbish a hospital and maintain uninterrupted patient care?
Refurbishment can only wait so long
Hospital refurbishment may be required for many reasons, including:
- Ensuring the hospital remains fit for purpose
- Creating a more appealing and comfortable environment for patients (evidence-based design helped the Cleveland Clinic create a quieter night-time environment for patients)
- Replacing outdated infrastructure
- Removing asbestos (unfortunately many Australian hospitals are riddled with it)
- Restoration after storms, fires or flood (many Australian hospitals were built on cheap land near rivers)
- Compliance with new standards (such as fire safety upgrades at Fiona Stanley Hospital and Royal Perth Hospital)
- Expanding clinical capacity (examples include Royal Perth Hospital and Wangaratta Hospital).
Sometimes, refurbishment is part of a planned upgrade. At other times, it is unexpected but unavoidable if existing facilities have been damaged.
Either way, refurbishment is far more than a cosmetic facelift. It is an essential part of facilities management. If it is neglected for too long, a hospital may be exposed to regulatory risks that could result in closure.
Choices and challenges in maintaining patient care during refurbishment
When a hospital undertakes a major refurbishment, it will not be able to continue normal operations in that wing for some time.
That leads to difficult choices about how to maintain patient care.
Should surgeries be postponed? Few organisations would choose that option these days. Many are only just beginning to address the backlog of procedures delayed by COVID over the last two years.
Should the hospital continue to function as normally as possible while the upgrades take place? That may be possible, depending on the work involved. It’s not for the faint-hearted though.
Nosocomial infections are a serious risk to patients, especially those who are vulnerable due to age or health status. If renovations are not carefully managed, they easily become a source of infection by dispersing contaminated dust or compromising water supplies.
There is a well-recognised link between hospital construction works and healthcare-associated invasive aspergillosis, which causes infections in the lungs and other organs. Indeed, it has been estimated that construction or renovation works within the hospital or surrounding areas account for approximately half of healthcare-related Aspergillus outbreaks.
For vulnerable patients, this can be a serious infection. The Centres for Disease Control (CDC) reports that ‘Even with antifungal treatment, aspergillosis can cause death in more than half of infected patients with weakened immune systems.’
Then there’s Legionnaire’s disease, a form of pneumonia that can occur when water supplies are shut down or depressurised due to construction works, leading to bacterial growth in the system. The CDC notes that Legionnaire’s disease proves deadly for 10% of infected people.
Hospitals that try to conduct renovations while maintaining nearby patient care must put in place stringent procedures to control infection risks, minimise allergen loading and manage risks relating to hazardous materials.
Noise should also be considered. Hospitals are meant to be healing environments where patients can rest and recover, and staff can concentrate. Incessant banging, drilling and clanging is not conducive to quality healthcare.
Noise problems can be reduced by scheduling works at certain times, using sound-reduction panels to screen off certain areas and monitoring decibels to see whether further adjustments are needed. While noise can be reduced, it will not be eliminated.
That’s why some hospitals choose to outsource their patients to another hospital. However, outsourcing patients can be costly and risks disconnecting the patient from the continuum of care that orbits around their local hospital.
None of these three options is ideal. Each one has significant disadvantages. That’s why some hospitals are now taking a different approach to maintaining patient care during refurbishment.
Creating additional capacity within the existing health service
The best model for ongoing service delivery during hospital refurbishment is to create additional capacity within the existing health service.
An interim solution for refurbishment is a powerful tool that enables a hospital to retain control of the patient journey by meeting patients’ needs onsite. Hospitals are able to provide uninterrupted patient care, comply with requirements and meet waiting time targets by preventing operational downtime. Almost any procedure that does not involve heavy robotic equipment can be done in a mobile and modular facility. Leading Australian hospitals have already used flexible solutions including laminar flow operating theatres, endoscopy suites and central sterile services departments. Other opportunities include day surgery facilities, endoscope decontamination facilities, outpatient clinics, hospital wards or visiting hospitals.
Hospitals are complex ecosystems with their own unique needs. Flexible infrastructure creates a tailored solution that enables hospitals to maintain surgical capacity whilst undergoing a period of refurbishment.
Maintain patient care during hospital refurbishment
Facilities managers have to mitigate numerous risks associated with building works such as sealing off construction zones, ensuring air quality and creating safe routes for pedestrians, all with an eye to COVID-safe protocols and other infection control requirements.
Using flexible infrastructure to maintain patient care eases the process of hospital refurbishment. Patient care continues in a purpose-built, high-quality environment that is undisturbed and uncontaminated. Staff continue to have a functional working environment with the tools they need to provide high-standard care. And the refurbishment itself can proceed more easily because it is no longer tangled up with the day-to-day needs of patient care.
Contact Q-bital Healthcare Solutions to learn more about how flexible mobile and modular Healthcare Spaces can maintain and increase capacity throughout periods of refurbishment.
