INFECTION PREVENTION AND CONTROL
Lack of an audit / feedback cycle The current system of design, construction, and occupancy of buildings lacks an audit / feedback cycle / lessons learnt process to influence and improve future new-builds. There is a silo mentality in that design teams, architects, and construction firms, have often moved on to the next project before many of the issues become apparent, so are unaware of what works and does not work. No centralised system exists for collecting data on what goes wrong in new-builds, despite such occurrences resulting in patient morbidity and mortality on a potentially large scale. This lack of process would be unacceptable for a medical device or drug. The cost of undertaking remedial modifications once a building is constructed is extremely high, and potentially sucks much needed money out of the healthcare system, further impinging on patient care. Getting it right first time is not only safer, but also significantly less expensive.
In summary, even when the risks
are visible to all, there is currently no effective mechanism for ensuring that what we know to be best practice is delivered in a new-build. Guidance and compliance may also prevent progress. Guidance generates standards against which a product /or process needs to be compliant. Meeting compliance can now
become the target, rather than patient safety. Thus, manufacturers, for example, may aspire to go no further than ensuring that their product is compliant, while from the consumer perspective, the assumption will be that provided it is compliant, they can opt for the cheapest product. In both circumstances the thinking is flawed – compliance does not equate with ensuring patient safety; it is often a minimal standard. If, instead, the manufacturer and
consumer employed a risk-based approach and then then looked to see whether a product mitigated against the risks, it is likely that not only would better products ensue, but also that the consumer would choose the better products, and thereby drive a quality initiative across the industry. Compliance requirements, and the need to satisfy them further, drive the ‘value engineering’ process by allowing for lower quality systems to be installed that meet the minimum standard. As the risks of infection from hospital
drainage systems have not been fully recognised, industry is almost wholly unaware of the problems. Recognition of the risks is the critical first stage, followed by communication to all relevant parties – including manufacturers, designers, installers, and end-users – to assist in eliminating and reducing the associated risks.
Peter Orendecki
Peter Orendecki, Senior Contracts manager and Water AP at University Hospital Southampton NHS Foundation Trust, is an experienced Maintenance and Contracts manager with a demonstrated history of working in the healthcare, leisure, and travel and tourism industries. Skilled in customer service, water hygiene, mechanical ventilation, engineering, and maintenance management, he is currently studying for a BSc in Hospital Engineering.
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ECOSTRUXTURE_180x125.indd 1 May 2023 Health Estate Journal 43 03/04/2023 13:39
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