VENTILATION
design, commissioning, and subsequent performance of ventilation systems as well as recommended maintenance routines (Building Regulations. 2010, Part 8, Paragraph 39).3 One of the key obligations under HTM
03-01 Part a 13.15 is for the provision of a logbook for each system which evidences the full operational history. If established correctly, such a logbook can be a rich source of data for all the designated staff.
Asset life-cycle management Under HTM 03-01, the Air Handling Unit (AHU) in a ventilation system is expected to have an operational life of 20 years. Currently, it is estimated that a large proportion of NHS theatre ventilation systems are in the latter stages of their life cycle – in some cases, AHUs may already be operating beyond their expected life. Also, it is worth noting that as PFI
contracts come to an end, even more ventilation systems will be passed back to the NHS and it is inevitable that some of them will continue to be used. Wherever assets are reaching or have
passed the end of their useful life, it is vitally important to maintain full data on these ‘higher-risk’ assets, even though they might be about to be replaced.
Damaged cooling coil.
Verification and scrutiny Annual verifications provide a vital source of information about the operation of ventilation systems. Carried out by independent engineers, these annual checks provide essential evidence regarding both condition and performance. Appendices 1 and 2 of HTM 03-01 Part b identify a minimum set of data to be collected annually, or more frequently if required to reflect any inherent risk associated with older equipment. The checks specified to assemble the minimum dataset relate to specific assets, sub-assets, and rooms, which are characterised by their position in the cleanliness hierarchy. However, that underlying structure is not entirely obvious from the sequencing of the checklists and those checks are not weighted for risk, so analysis by simple scoring may not represent the operational situation accurately. Also, each verifying engineer has their own individual style of reporting; generally, their reports are extensive (often 20 pages or more) and the underlying unstructured data can be difficult to understand, evaluate, and benchmark. The Seeker Ventilation logbook
structures verification data so it can be analysed easily and presented effectively for users, thus providing a holistic view of a hospital’s theatre suites and critical systems, along with the historic performance trends. With consistent and well-structured data, the full potential of
IFHE DIGEST 2023 Poor quality maintenance or end of life?
technology can be exploited and the annual verification used to confirm system compliance and provide maintenance alerts.
Analytics and presentation By applying analytical rules consistently, the extensive data from a series of annual verifications can then be presented clearly, so that users have meaningful information. Smart logbooks will aid analysis and presentation; rankings and comparisons will allow trends and context to be established easily and promptly. Considerable efficiencies and time savings will be achieved from having better information.
It is important to note that annual
ventilation verification information and data is not used exclusively by engineers and estates teams – it is also relevant to infection prevention teams and theatre managers. Therefore, it is concerning to note that a leading surgeon with considerable experience of ventilation issues - Hilary Humphreys - recently said: “Infection prevention and control team members (IPCTM) are often intimidated by aspects of ventilation as they relate to healthcare, because they consider them technical and outside their area of comfort and expertise. However, engineers, estates departments and planners need IPCTM input to ensure appropriate design and use.”4
With effective presentation of
information derived from verifications, estates can provide safe systems, infection control can minimise risk, and theatre managers can optimise revenue flows.
Smart logbooks, VSGs, and quality improvements Traditionally, paper logs were available for every critical system and the associated recording processes were routine, so the logs contained only a limited amount of information. Technology enables a wealth of data to be aggregated easily but, to date, it could be argued that technology has both improved and worsened the traditional situation. It may have improved the collection of, and access to, some data, but masses of incomplete data does not necessarily improve the quality of the information available to support the associated management processes. However, a smart log book can provide a golden source of verification data which informs the designated staff and other users, who may have different lines of reporting and individual goals. Whether simple rules-based AI or more sophisticated technologies, a smart logbook can aid analysis and presentation of that information. By identifying data gaps and missed deadlines, the logbook improves the efficiency of data management, which enables a Trust’s
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Dirty plenum with failed vermin screens.
Rusty louvre.
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