BRANCH EVENTS


Above: Guests and speakers at the 25th Anniversary Symposium, where among the topics discussed were Net Zero, climate change, ‘alternative’ and ‘greener’ energy, the resilience, running costs, and carbon footprint of high-rise hospital buildings, and the fast-developing Chinese healthcare market. Right: Professor Thomas KC Chan, Executive director, Building, MEP, at WSP (Asia), and a Fellow of IHEEM, discussed the latest thinking on the design of high- rise hospitals in the region to ensure they can withstand extreme climate events.


plant location and space planning. With a growing number of ‘high-rise’ hospitals in the region, he also stressed the need to embed sufficient electrical and other building services resilience. The next speaker, Professor Hiroshi


Yasuhara, has been President of the Hospital Engineering Association of Japan (HEAJ) since 2017. Before moving into healthcare engineering, he spent over 25 years as surgeon and a professor at Teikyo University and the University of Tokyo. He served as the OR Medical Director at the University Hospital of Tokyo, and from 2019-2022 as director at the Tokyo Teishin Hospital. His presentation focused on planning healthcare facilities, and HVAC design guidelines, in the wake of COVID-19, and some of the associated learnings.


COVID-19 case numbers Beginning with some statistical data on COVID-19 case numbers at various stages of the pandemic, he highlighted the importance of infrastructure adaptation in the early phases, before discussing research evidence around coronavirus transmission, explaining that the virus can be transmitted both via droplets – in common with some other infections – but also aerosolised during dental and medical procedures. He emphasised how the definitions used by clinicians and healthcare engineers for both aerosols and droplets – for instance as regards their size, behaviour in air, and exposure pathways – have changed with experience and emerging information. For instance, while an aerosol particle was ‘traditionally’ typically considered to be under 5 µm in size, ‘updated’ thinking indicates that aerosols can be particles less than 100 µm in size, and comprise a stable suspension of solid and / or liquid particles in air. Research has also demonstrated that they can remain airborne for extended periods, travel over 2 m, and build up in a room,


48 Health Estate Journal January 2024


where they can then be inhaled. Prof. Yasuhara also considered aerosol


and droplet transmission of coronavirus, and the extent of protection from surgical masks, highlighted some of the key differences between aerosol and droplet transmission, and scenarios when infection will pass from an infected to a previously uninfected person. He also discussed some of the key factors – such as particle size and numbers, humidity levels, and exposure duration, that determine symptomatic infection. He subsequently focused on the HEAJ Guidelines for Hospital Facilities for minimising airborne infection rates, recommended air change rates in private rooms to prevent infection, considered the impact of confined spaces with poor ventilation, plus the ‘pros and cons’ of CO2


levels as a marker.


The Professor touched on the ASHE Current / Updated Healthcare Facilities Ventilation Controls and Guidelines for the Management of Patients with Suspected or Confirmed SARS-CoV-2 (COVID-19), and some of the potential ‘interventions to mitigate aerosols infection in a clinical setting’, comparing current guidelines from Japan, the World Health Organization, and the CDC in the US. Another focus was the WHO’s global guidelines for the prevention of surgical site infection. Prof. Yasuhara also considered evidence of the degree of effectiveness of laminar airflow ventilation in preventing infection during orthopaedic surgery, US-derived recommendations on appropriate ventilation in theatres, and some of the ‘important issues’ still to be solved. Among such COVID-19-related issues were the ‘simplified relationship between coronavirus and ventilation in complicated indoor structures’, that there seems ‘little differentiation between ventilation and airflow’, ‘no assumption that patients wear face masks’, and the need for cost/performance analysis when renovating existing HVAC systems.


Prof. Yasuhara was followed by Dr Bjorn


Werner of the Association of German Engineers (VDI) and German Industrial Engineers, who is MD of Health Tec, part of the HT Group. In his presentation, ‘Prefabricated and sustainable room solutions from a single source’, he discussed how Modular Integrated Construction ‘can reduce contamination and infection in healthcare facilities’. He began by looking at some of the key elements of MiC, and its practical and economic benefits, comparing its use to more ‘traditional’ construction. He showed slides of MiC in practice in a variety of healthcare settings, before discussing modular-built intensive care units, and what Health Tec dubs its ‘flexible isolation rooms’. His presentation included reference to several case study hospitals – including in Germany, Switzerland, and Malta – where the company has provided ICU isolation rooms for patients with a range of infectious diseases. He explained how the flexibility of the design Health Tec offers enables such facilities to be tailored to the particular hospital’s needs, while reducing the risk of infection spread. One of the examples he referred to,


as he switched to the impact of ‘healing architecture’, was a study of a ‘pilot ICU’ at Berlin’s Charité Hospital, where modification of the ICU environment (involving elements including lighting, colours, noise reduction, workflow optimisation, and infection control), had shown a ‘significantly reduced incidence of delirium’, with shorter stay lengths, reduced drug dosages, and lower mortality.


Opportunities for hydrogen With an increasing focus on renewable energy sources in the face of climate change, opportunities for use of alternative fuels are now, literally, a ‘hot topic’, and Cynthia Zhu, CEO of Sinosynergy


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88