EBME
hours, spending time away from their families to help make sure the hospital was ready and functional,” commented David Rolfe, UK&I chief executive officer at Althea. “One of the key challenges was coordinating the arrival of the equipment with the commissioning and installation. It was a very dynamic time with frequently changing information about what equipment was coming, in what quantity and at what time. The engineers on site had to be flexible enough to deal with whatever came through the door. “We also had to make sure that our own workforce engineers were able to work in as safe an environment as possible, so they were not exposed to the virus themselves – this included social distancing, obtaining PPE, and changing servicing practices to lower the risk of transmission of the disease from wards with COVID 19 patients.” While setting up the Nightingale hospitals, the clinical engineering teams had to contend with national and international shortages of equipment. While 4,000 beds had been planned for the site, obtaining 4,000 ventilators in two weeks was an impossible task. “It wasn’t just the UK looking for additional capacity, it was virtually every country in the world. As a result, we had to accept many items that we hadn’t seen
We could learn a lot from the military and the way they respond to incidents, particularly in terms of their use of
centralised libraries. Caroline Finlay
before – these were models that were perfectly good, but not well known in the UK. The clinical engineering teams had to be extremely vigilant around electrical and safety testing. Most of the equipment came with European electrical connections, but in some instances, we had to change the power supplies,” Finlay reported.
The volume of consumables required also presented some challenges and was initially underestimated – these consumables needed to be matched to a wide variety of models and devices: “The lack of standardisation in terms of the design of these accessories is an industry-wide issue – they are all bespoke to the equipment. Ventilators require tubing and
filters, for example, and there needs to be an understanding of the typical usage, as well as the different models and manufacturers. “In addition, the cables are not always supplied with the equipment. If the person procuring the devices hasn’t had the right technical engineering input, they may not purchase everything required to make the equipment functional. This is where the clinical engineering teams had to really step up to the plate,” continued Finlay. “Clinical engineers do not normally get involved with these types of procurement issues. It pushed them outside of their comfort zone – they had to understand what the clinical pathway was, what the patients required, and worked closely with the clinicians to ensure they had everything they needed at the bedside. It was a massive learning curve.” MTS and Avensys also worked on the Manchester Nightingale Hospital. Finlay explains that the Manchester Nightingale hospital required a different approach to the London Excel: “While London had a designated EBME facility on site, Manchester had an equipment library. This meant there were duplicates of everything required. If there were any issues with a piece of equipment, they could simply replace it with an item from the library, although there was also a core project team on site to deal with any problems.
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