repay the initial investment at today’s prices. The solution with the shortest return on


investment period is with water. Two water saving initiatives have been


identified namely; The filtering and reuse of air conditioning blowdown water, which will reduce consumption by an estimated 50% and the use of sewage treated effluent (STE) for irrigation purposes, which will save in the region of 20,000 gallons of fresh water daily. This latter initiative will require the laying of a new DM main. In both of these initiatives the return on investment period is less than two years.


 Waste, and infection control Infection control is an issue that requires the input of all hospital staff at all levels, it is not just within the remit of the


there are a multitude of services and systems within a hospital that are not required in a residential or commercial property’


Housekeeping department. Staff training is reinforced on a regular basis and due to the wide variety of nationalities and languages extensive use is made of visual aides to reinforce the message to staff. One such item is the segregation of waste as the hospital disposes of over four categories of waste on a daily basis. The charges for the disposal of waste are such that clinical waste, which includes tissue, syringes, ampoules and clinical dressings, is over four times more expensive than general waste as the contractor has to be registered with the Dubai Municipality and all specialist waste has to go for incineration. Any contamination of general waste


with clinical waste results in the whole consignment being treated as clinical waste, with the consequential increase in charges and the potential for sanction from the Dubai Municipality.


the patient needs In the UK the average patient room size in a first class private hospital will probably be in the region of 20 square metres, whereas in the Gulf region this is more than trebled and for VIP patient rooms more than quadrupled. The finish and quality of furnishings again presents it own unique set of challenges to the housekeeping department. Operating rooms are the engine room of any hospital and there is no compromise on their availability or cleanliness. Cleaning and maintenance of the OR’s is to the highest standards and is carried out in an ever- evolving environment such that the attitude of staff is that we can always ‘do it better’. As a matter of good operational practise, swabs and air samples are regularly taken and analysed by a third-party laboratory. Filtration systems use HEPA filters, and maintenance is carried meticulously with photographic records kept for review by the Dubai Municipality and Department of Health. Unlike a residential or commercial facility, a hospital is a facility continually in flux due to the changing requirements of the healthcare needs of the local population. As a result of this, there is the constant requirement to utilise space for the maximisation of patient services. Whilst nobody wants to be ill or require


the services of a physician, it is unfortunate that the human body is such a sophisticated machine that now and then it requires a ‘service’ or diagnostic check up. To ensure these services are available, the only constant in a hospital is change. Whilst on the face of it a new clinic may be required, this may entail the complete redesign of an HVAC system or the installation of shielding to protect patients and visitors. There is also the requirement that any changes will require the upgrading of fire protection systems in line with National Fire Protection Association (NFPA) regulations. Consequently the Facilities Management


engineers have to turn a clinicians’ dream into an operational facility that can receive and treat patients. It can be likened to a magician pulling a rabbit out of a top hat. In reality, patients or visitors will never see 80% of the cost of a project. The underlying fact is that patient/visitor demographic in the region demands excellence in every aspect of the patient journey and quite rightly so. The provision of healthcare services in the region is not one that can be entered into lightly; it is a case of ‘seller beware’. HB


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