OPERATING THEATRES
Our UCV canopies create 500 air changes per hour in the clean zone, while an Exponential Flow feature common to all the Exflows blows the air down to create the required air patterns, but also then recirculates it back up to the return air grilles on the canopy. This gives a very high level of entrainment protection.”
Same dimensions for easy replacement
In developing the Exflow Evolution, Howorth maintained the same dimensions as the earlier Exflow canopies, which meant that in a retrofit installation its engineers could simply remove the ‘old’ UCV and replace it with the new without major structural modifications. Tom Ford added: “Without the screen, users have significantly more open space around the clean zone too. The screenless design also means users no longer face trying to manoeuvre, say, pendants and operating lights under a screen with a base just 2 m above the ground.” He added: “With the past 5-10 years’ significant shift to minimally invasive surgeries, and latterly to hybrid theatres, the Exflow Evolution’s lack of side screens has seen it installed in theatres undertaking both minimally invasive and hybrid surgery. These tend to feature both ‘standard’ operating equipment like endoscopes, C-arms, and monitors, but also additional, and quite bulky, scanning and diagnostic equipment With the Evolution, the various components can be moved in and out of the clean zone considerably more easily.” Today, Tom Ford explained, most buyers of a Howorth UCV canopy settle on the Exflow Evolution, although ‘the Welsh NHS hospitals haven’t moved across to screenless yet’. He elaborated: “We are in the process of convincing them of the technology’s benefits, and in fact are currently putting together a digital integration system for two theatres – used both for orthopaedic and other surgery – at a major acute hospital in South Wales.”
This brought him on to explain how Howorth diversified from the 1980s onwards from being predominantly a theatre canopy manufacturer, to a point where, today, it considers itself a leading turnkey operating theatre project specialist’. He said: “Over the past decade we have successfully completed hundreds of turnkey projects, and believe our experience is second to none.
Opportunity to offer a broader service
“In the earlier days,” he explained, “a customer would buy a canopy and ask us to fit it, and then perhaps request us to supply and install an operating light and integrate the two. By this point we had identified that there was an opportunity for us to offer a considerably broader
service, for instance removing the ceilings, and undertaking all the necessary M&E work.” While different turnkey projects require different approaches, Howorth ‘typically’ begins with a feasibility study, to ensure that the project is workable, and that the costs ‘stack up’, before helping the customer get the business case signed off. It then engages directly with the customer, taking control of all the design, project management, and commissioning, and employing sub- contractors for individual sections of work under its direct control. Every turnkey project site has a Howorth site and project manager overseeing the work of sub-contractors undertaking activities such as M&E work and medical gas installation. The company also has its own ‘in-house’ health and safety and quality control personnel, and has recently achieved the Constructionline Gold Standard qualification; it is already accredited to the ISO 9001: 2015 standard and OHSAS 18001.
Turnkey projects’ growing importance
Tom Ford said turnkey operating theatres and ITU projects ‘now probably account for 50 per cent of the Howorth Healthcare Division’s revenues’. What, though, does he consider the ‘standout features’ of Howorth’s turnkey offering? He said: “We pride ourselves on the quality of what we install, how we install it, and the service we give, plus we continually look for
innovative ways to save time and money, and to improve the engineering and performance of our products. “For example,” he explained, “we are currently working on incorporating EC fans – energy-efficient devices, with built in speed control – into our UCV canopies, and over the next few months plan replacing our current three-phase inverter-controlled fans with EC variants. While inverter-controlled fans offer energy efficiency, and the ability to increase speed to compensate for dirty filters or meet particular theatre criteria, if selected correctly, EC fans use less power. We have purposely waited until EC fans with the requisite performance criteria for our canopies were available before integrating them.”
Energy-efficient and quiet Tom Ford said these ‘latest generation’ EC fans would not only meet HTM 03-01 criteria for acceptable noise levels, but, with high energy efficiency matched to high performance, would also help healthcare users such as hospitals ‘hit carbon footprint targets’. He added: “They are space-saving as well. With the controls integrated with the fan, the control panel is considerably smaller.” Our discussions had principally focused on Howorth’s own-manufactured UCV canopies and other components, but Tom Ford stressed that the company is also happy to supply other manufacturers’ theatre equipment if requested. He said: “In 2015 we took on the exclusive UK distribution of high quality operating theatre lights and pendants, suitable for use in both ITUs and theatres, for Trumpf Medical Systems. With surgical processes evolving, we have become increasingly involved in supplying digital integration systems too, selling – as part of the overall ‘package’ to the hospital customer – theatre stacks, PACS viewers, wall and pendant-mounted monitors, and vendor- neutral hardware and software. The systems are capable of connecting many different manufacturers’ theatre components. We can provide a vendor- neutral ‘backbone’ for all the hardware, plus the software to ‘drive’ the theatre. These digital integration systems typically give surgeons features such as the opportunity to view patient scans prior to or during surgery, stream live footage to another location, or incorporate video and audio into reports for subsequent review.”
Flexibility
The Trumpf TruPort pendants – with ‘a unique modular design’ – are ‘among the market’s best’, Howorth maintains.
He continued: “The flexibility of our digital integration means, for example, that users can plug anybody’s endoscope, arthroscope, or microscope, into the system. Consequently, the team could buy a flexible scope for one theatre, and a rigid one for another, depending on the surgical team’s requirements and
June 2018 Health Estate Journal 55
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