PROFESSION-WIDE EXPERTISE
spread of COVID-19 in hospital environments, drawing together the insights of relevant individuals and organisations (see also page 8, Institute News). The review is not meant to be comprehensive; it is part of the engineering community’s input to government to inform the ongoing development of advice and policies. One of the striking features of the inputs we gathered to the Rapid Review was the complexity of the challenge of hospital-onset COVID-19, and the wide variety of ways that engineers could inform the approaches being adopted – from decontamination methods to room layout, plumbing, ventilation, PPE, digital tools, and robotics – illustrating both the diversity of engineering expertise required, and the value of including an engineering voice alongside the clinical and public health assessments.
Advice will ‘evolve’
This advice is not static, and is expected to evolve as we learn more about this particular coronavirus. One of the ways in which we are building our understanding is by harvesting insights and good practice from partners around the world and, in particular, through the international network of engineering academies. For example, we are currently seeking comparative information about the uptake of different decontamination products and processes used across different hospitals, both in the UK and internationally, in order to inform evidence-based decision making on this topic.
Another key observation made in the Rapid Review is the importance of adopting a systems approach. This requires us to put the people involved at the centre of the approach, ensuring that their needs are understood, and that interventions are trialled and tested with them before implementation, as well as proactively managing the risks. It requires true partnerships between engineers and social scientists, psychologists, and users, in order to fully understand the behavioural aspects of how people use buildings, and how technologies for infection control can help in real-world contexts. In addition, the partnerships must engage clinicians, healthcare practitioners, and patients, to understand how solutions play out in practice on busy wards or in care homes with competing demands.
The role of engineering innovation The scale of the COVID-19 outbreak has shone a light on clinical needs that many in the engineering community were previously unaware of. This elevated awareness of challenges experienced in healthcare (and social care) contexts is already driving rapid and creative
innovation in the engineering community, with many researchers and businesses adapting existing technology and prototyping new ideas. It has also been interesting to see how many new partnerships and collaborations have been formed to enable these ideas to be progressed – involving companies (large and small) and academic researchers, as well as clinicians and end-users. The multi-faceted nature of hospital- onset COVID-19 infection means that engineering innovation can bring most benefit when it addresses a clear need and complements rigorous training, operating procedures, and good practice. The Rapid Review covers a wide range of both existing technologies and engineering controls that could be more rigorously applied, and technologies that are currently the subject of active research, or where promising innovations are in the pipeline. For example, decontamination of hospital rooms, facilities, and equipment, is a key focus
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for engineering applications to limit hospital-onset infection. Chemical cleaning is the primary decontamination mechanism, but this can be supported by a series of other technologies.
UV robots for sterilisation Many hospitals already use UV robots for sterilisation for room cleaning between patients, and a range of innovations are being proposed to improve performance. For example, Finsen Technologies has developed a system that uses radar technology to map its surroundings in order to establish that the room is clean and eliminate human error. Vapour cleaning systems are also being used, filling the room with hydrogen peroxide that distributes evenly through the space regardless of the room configuration, although this may carry the risk of damage to sensitive equipment, and requires closed rooms. Robotic fogging devices are being explored, but have not yet been proven in a clinical setting.
We are currently seeking comparative information about the uptake of different decontamination products and processes used across different hospitals, both in the UK and internationally, to inform evidence-based decision making on this topic
M Squared’s SolsTiS, an advanced laser system that creates continuous-wave, tuneable, precision light.
July 2020 Health Estate Journal 25
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