INTENSIVE CARE
Round-the-clock care in a temporary ITU facility.
instance, it meant that there was no need to increase the risk to patient safety by transporting critically ill patients off site for care. In addition, cost effective mobile healthcare eliminates the need for outsourcing to external providers. One advantage of adopting mobile
wards is that they have their own supplies of gas, electricity, water and ventilation, meaning that they can operate as standalone facilities. These facilities can provide the instantaneous capacity that the hospital requires and do not face the same challenges as a prefabricated solution might, such as the need for the installation of appropriate utilities and securing planning permission. On arrival at HIA Laveran, the team
took just two weeks to validate the units and install the equipment to produce a fully operational, replacement intensive care ward. The team also spent three days constructing covered link-way corridors from the facility to the main hospital building. This meant that staff were not disrupted as the corridor was linked to the space in which they would normally work, enabling teams to work effectively and safely.
Unique unit development Working in partnership with a specialist engineering company, Q-bital was able to redevelop its standard ward configuration to align with the requirements of an ITU space. By taking a consultative approach to the project and working closely with the hospital throughout the development procedure, Q-bital was able to provide two mobile ITUs tailored precisely to the hospital’s needs. The new facilities included four beds each and were configured to accommodate the huge amount of equipment required on an intensive care ward. The power supply to the facilities had to be increased, the gas system modified and several bespoke alternations made to the bed space in order to house the equipment. Additional fusion systems and European plug systems were also installed for the monitoring equipment. Mobile healthcare facilities traditionally offer beds for patients recovering post
IFHE DIGEST 2018
Clinical excellence inside a mobile facility.
procedure, meaning they might have a one or two hour stay before being transferred to another ward within the hospital. In an ITU facility like the one deployed at HIA, patients would need to be accommodated and cared for over a significant period of time, with staff in attendance day and night.
International challenges It was essential that members of the Q- bital team quickly familiarised themselves with French regulations. The electrical requirements were the most complex; French regulations for electrical capacity or over capacity are more complex than those in the UK and needed to be worked into the development of the units. The pipes that are used for gas also
differ between European and UK specifications and the types of general connection, such as plug sockets and gas terminals, are all unlike those used in the UK and needed to be factored into the alterations. It was critical that the project provided a safe and compliant environment that was inkeeping with the overall estate at HIA Laveran, where the highest standards of patient care could be effectively and efficiently maintained. To meet regulations and overcome any
international challenges, HIA Laveran sent experts, including biomedical engineers, electricians, water and gas experts, to the UK to view the ongoing development process. These experts continued to provide support for a period of three months before the facility was deployed at the hospital.
Logistics The logistics team delivered the uniquely engineered facility from the East of England to Marseilles, shipping from Portsmouth to Caen in Normandy. Both of the ITUs were transported on trucks and purpose-built trailers, which allowed the facilities to be moved around safely and carefully. The units have a number of hydraulic rams, which mean that they can be lifted off the floor to enable a trailer to slide underneath. As an undertaking, the project was logistically complex due to the
size of the units; when fully deployed they are each 6.5 metres wide, but when they are on the road they are compacted to 3.6 metres wide, allowing them to be transported on public highways. The team dealt with a number of additional challenges when they reached France, including restrictions on the country’s national road system. To move the units on French roads, the team had to have specialist escort vehicles and movement permits in line with local travel legislation. This meant that they could only travel on certain roads and at specified times. For example, abnormal loads can only be transported in Marseilles after 11.00 pm.
Project success The project at HIA Laveran lasted for eight weeks and the eight beds within the facilities were occupied continuously during this time. Integrating mobile healthcare facilities
into the existing hospital structure is a key consideration when planning an installation. Proximity to the main hospital operating suite is a crucial concern during planning for many sites; temporary facilities can often be attached via an enabling corridor where options for more immediate positioning are limited. The temporary facility was easy for
staff to use as it was collocated in an area where they would usually work, with a covered link-way corridor connecting the temporary ITU to the main ward. The equipment that clinical staff used was familiar, mirroring the standard fittings found in a French ITU. The facility’s integration into the existing hospital estate and the internal environment resulted in a seamless transition for patients, who were unaware they were being treated on a mobile unit rather than a traditional hospital ward. Speed of delivery was vital to the
project, and the Q-bital team was able to validate the wards in Marseille within a few weeks. The units were uninstalled after HIA Laveran resumed its delivery of patient care in the hospital’s upgraded ITU unit.
IFHE 55
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