Andrew Woodrow of Pure Projects leads hospital decision-makers through complex projects such as refurbishments, extensions or new builds. Modular facilities offer one way to maintain service provision during construction. So, what do hospital leaders need to weigh up when considering whether or not to commission modular facilities?
Having taken part in many discussions on this topic, Woodrow believes decision-makers need to consider:
- Patient safety – infection control and transport
- Which area(s) of the hospital will be affected by capital works
- How long the works are expected to take
- Options for maintaining service provision
- The size of their overall budget and the proportion that would need to be set aside for a modular facility.
Consideration 1: Patient safety
“We get involved with health clients from the start of the job,” says Woodrow. “We start off by doing feasibility studies on what they need to accomplish for their health plan. When we’re working in live hospitals, it’s very difficult to try and do refurbishments or extension works and keep the hospital going. You’ve got to be aware of infection control, noise, dust and many other issues. And through it all, you’re trying to ensure that a hospital is still a place where patients can rest and heal.”
A place where patients can rest and heal – that’s hard to achieve on a construction site.
Infection control and patient transport are two issues Woodrow particularly highlights. Hospitals that opt to work around construction, putting patients in other areas of the hospital, must carefully manage infection risks, potentially over many months (or even years).
Those opting to use modular facilities avoid many of those issues by keeping patients well away from the construction site. Patients are now in a fit-for-purpose environment that meets all relevant codes and standards. Creating a few covered walkways can help to integrate the modular facility with the main hospital site to enable a smoother patient journey.
Consideration 2: The affected area of the hospital
Some of the most difficult areas for capital works are the operating rooms and central sterile services department (CSSD).
“We’re doing a couple of projects on the CSSD areas, theatres and perioperative areas. You can’t physically do the work inside these areas to extend or refurbish them and keep the theatres going. You really can’t have people walking in and out of there due to infection control measures,” says Woodrow. “But, if you shut down the operating room and CSSD, you’re shutting down a major part of the hospital, which has a big impact on patients and on business.”
Hospitals that try to maintain service provision while works are underway must work out how to get materials and trades in and out, build containment areas and enclosed corridors to separate construction from treatment areas and adhere to rigorous infection control protocols. It all takes time and money – and can double the duration of the job, according to Woodrow.
Commissioning a modular solution separates the capital works from the question of maintaining service provision. It’s a beautiful way of untangling those knotted threads so that each element can progress without being affected by the other.
“If you can just strip it all out and have the trades come and go as they need to, it’s often more cost-effective than doing the work in smaller, slower stages that takes double the time compared to putting modular theatres and wards in a car park and running services out there. You can get the modular area set up ahead of time, transfer everything out and then hand over the vacated area to the construction team.”
Using a modular facility often creates a better working environment for staff. It’s a purpose-built environment – compared to the awkward workaround solutions often required when trying to main service provision in the main hospital.
“The modular facilities I’ve seen offer a very good environment for surgeons to work in,” says Woodrow. “Once the clinicians see the space, they’re pretty good with it.”
Consideration 3: How long the works are expected to take
Hospitals undergoing significant rebuilding after floods or fires and those seeking to extend long-term capacity without major capital works may stand to gain the most from commissioning a bespoke modular facility that caters to their unique needs.
If your capital works are only likely to last a few months, a mobile facility may suit you better. These meet all relevant codes and standards but are an off-the-rack solution rather than a bespoke one.
A mobile operating suite, for example, will contain (as standard), an:
- Anaesthetic room
- Operating room
- Scrub area
- 2-bed, first-stage recovery area
- HEPA-filtered environmental air
- Integrated medical gas banks
- Changing room
- Utility area.
Consideration 4: Options for maintaining service provision
Your options for maintaining service provision are linked to your location and your expected timeframe.
A city hospital closing its theatres for a few weeks may choose to divert patients and surgical staff to a nearby hospital and make use of their operating rooms by running extra shifts. It means surgeons can’t pick their preferred times and may have to work weekends or evenings for a short time but it can be a cheaper option if clinicians are willing to bear some short-term pain.
Regional hospitals don’t have that option because the nearest hospital is just too far away. “You’ve got to keep their operating theatres open,” says Woodrow. “If there’s a car accident or an emergency in a country town, you’ve got to have a working OR to treat critical patients.”
Local staff, too, cannot be expected to travel several hours per day to a new workplace. “While the surgeons may just drive up from the cities for a few days each month, the nurses tend to live locally and it’s problematic for them to travel long distances each day for weeks or months,” says Woodrow.
On the plus side, regional hospitals often have more available land to house a modular facility. And many regional hospitals are on one level, meaning it is already easier to transfer patients from the modular facility’s OR and recovery area back to the general surgical ward.
Consideration 5: The budget
Ultimately, many decisions come down to the budget. If you’re undertaking large-scale capital works with a big budget, then the set-up and hire costs for a modular facility are only likely to represent a small fraction of it.
However, if you’re working with a smaller budget, commissioning a modular facility will take up a greater proportion of your available funds. If that’s a concern, you could consider:
- Using a mobile facility instead
- Gaining longer-term value from the modular facility – once your capital works are complete, why not repurpose the modular facility and use it to reduce your elective surgery waiting lists.
How can Q-bital Healthcare Solutions help?
Q-bital Healthcare Solutions provides mobile and modular healthcare facilities to support hospitals when refurbishing or extending capacity. If you’d like to explore how your hospital could benefit from a mobile or modular healthcare facility, please contact Q-bital Healthcare Solutions.