INFECTION PREVENTION AND CONTROL
Tool ‘tracks’ IPC design, derogation, and risk
In the first two of three infection prevention and control (‘IPC’)-themed articles published late last year in HEJ (October and November 2024) from senior architects at HLM, associate director for healthcare, Neil Orpwood, and head of Healthcare, Melanie Jacobsen Cox, focused on the need for early collaboration between designers, architects, and IPC teams, in creating safe healthcare environments, and an apparent lack of knowledge on the subject among some healthcare design teams. In the third, Neil Orpwood explains how HLM developed an improved internal design tool to help its architects implement, manage, and track, IPC design, derogation, and risk.
Below right: Starting with HBN 00-09: Infection control in the built environment (pictured), and given the requirement to interface with other spreadsheets, HLM’s ‘in-house’ tool was developed in Microsoft Excel, and consists of several individual worksheets.
Below: Requirements for the adequate provision of waste and associated storage are included within the HLM-developed ‘in-house’ tool.
As healthcare designers, part of our skillset is to provide assurance that we are meeting all the requirements stipulated in guidance and legislation documents. Increasingly, we are asked to evidence the thought processes behind our design to ensure we have identified, assessed, and mitigated risk. Patient safety is inherently about not causing harm; thus proactively addressing risk in healthcare design is crucial both for positive impacts on patient care and exemplar service delivery. Successful risk management requires whole- system-thinking, along with technical knowledge insight gained from the delivery of multiple complex healthcare projects. Rarely in healthcare design is there just one simple thought, but rather a need for the intricate weaving into one technical solution of often conflicting requirements. With evidencing now required, increasingly toolkits are being utilised as a way to make this integral to the design process, and support the ‘golden threads’ of compliant decision making and the resulting information.
IPC education and upskilling work As part of the IPC education upskilling work that HLM undertook at the end of 2023, it was identified that an improved internal design tool, which could help implement, manage, and track, IPC design, derogation, and risk, would greatly enhance our ability to positively impact on IPC measures within our designs, as well as ensuring that we had followed and left a clearly defined audit trail. Our initial thoughts around an improved tool were that it should: n Be workable across all the RIBA stages. n Include other disciplines to allow us to undertake our lead consultant role.
n Include items for construction works to be included within prelims, employers’ requirements, or risk assessments.
n Record design decisions. n Be formatted to align with the 2023 revised NHS derogation schedules.
n Be supportive of, and linked to, HLM CDM risk registers, assessments, and schedules, and the practice’s CDM Design, Access, Maintenance, Adaption, and Disassembly strategy.
n Record ‘golden thread’ for risk through identification, assessment, mitigation, and management.
n Comply with HLM’s ISO 9001 Quality Management System.
n Provide an ‘instant dashboard’ to flag status.
IPC within wider standards, legislation, and requirements ISO 9001 is an international standard that specifies the framework for a quality management system, allowing companies to demonstrate their ability to consistently provide services that meet customer and regulatory requirements. This encourages process- based approaches and risk-based thinking, alongside a culture of continuous improvement and documented information. Within ISO 9001 sits our responsibility to comply
with the Construction (Design and Management) Regulations 2015. Documents such as the NHS Blue Book, covering the appointment of architects and engineers for commissions in NHS estates, are very clear about the role
44 Health Estate Journal January 2025
AdobeStock / LunaStar
Courtesy of the Department of Health & Social Care
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