HIROSHI YASUHARA – PRESIDENT, HEALTHCARE ENGINEERING ASSOCIATION OF JAPAN (HEAJ), JAPAN FACILITY UPGRADES
Aerosol transmission prevention in pandemic
The coronavirus pandemic affected hospitals’ clinical activities in various ways. Accordingly, besides standard isolation precautions, many infrastructural adaptations have been reported in the literature. These structural/operational anti-pandemic measures included introducing medical equipment to prevent infection clusters, converting general wards to isolation wards to mitigate airborne transmission, recruiting healthcare staff to provide sufficient medical services for infected patients, and simple operational changes in general wards. Above all, improved ventilation of whole
existing wards adhering to the current guidelines for airborne infection was considered to be key for providing medical services for infected patients and preventing infection with the least difficulty. Our previous study reported that the
appropriate assignment of healthcare staff in proportion to clinical demand was a prerequisite to maintaining hospital activities. There was a need to focus not only on infrastructural adaptation and the care of infected patients but also on the workload of healthcare staff. Their workload appeared to increase even more through the structural/operational anti- pandemic measures. In this context, some of the above-mentioned anti-pandemic measures may have been beneficial and others not.
Hiroshi Yasuhara, president of the Healthcare Engineering Association of Japan (HEAJ), discusses the findings of a survey of Japanese hospitals with over 100 beds on the preventative measures they implemented during the pandemic. In addition, it is known that there were
several phases of the coronavirus pandemic. Each phase required relevant measures to deal with each situation according to the phase of the pandemic. In particular, we experienced an abrupt increase in demand for patient admissions between December 2019 and December 2020. Thus, controlling a large influx of infected patients to hospitals was a top priority during the surge phase of the pandemic. In this study, we focused on the surge phase of the coronavirus pandemic, when hospitals needed to respond to an abrupt increase in infected patients and attempted to establish a comprehensive strategy against the pandemic.
Material and methods We conducted a survey on the measures implemented to deal with the coronavirus pandemic. We sent a questionnaire to the directors of 3,935 hospitals with over 100 beds. In the questionnaire, we asked them what anti-pandemic measures they implemented to mitigate the influences of coronavirus infection between December 2019 and December 2020. We also asked whether they experienced difficulties in clinical practice during the period. The answers were received on the web using the Google Forms application.
Improved ventilation of whole existing wards was considered to be key
Hiroshi Yasuhara
Hiroshi Yasuhara is the 12th president of the Healthcare Engineering Association of Japan (HEAJ), which takes a wide view of the whole healthcare system. Before starting a career as a healthcare professional, he spent over 25 years as a surgeon and a professor in Teikyo University and the University of Tokyo in Japan. As an OR medical director, he also managed the department of OR in
the University of Tokyo Hospital. After a successful career treating many surgical patients, he worked as a director of Tokyo Teishin (Telecommunications) Hospital from 2019 to 2022.
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Clinical practice In this study, we classified clinical practices into two categories – therapeutic practice including surgery or invasive procedures, and clinical practice without therapeutic procedures. These included diagnostic procedures, providing care, and drug prescriptions.
Infrastructural adaptations In this study, infrastructural adaptations included the following structural/ operational anti-pandemic measures implemented during the pandemic: l 2-1 Structurally remodelling a general ward to an isolation ward specifically to improve ventilation of the whole existing ward against airborne transmission.
l 2-2 Introduction of various medical devices including portable negative pressure systems and air cleaners equipped with HEPA filters. These medical devices were mainly used to prevent aerosol transmission in the ward.
l 2-3 Operational changes in inpatient beds. These include converting general beds to infection beds and mandatorily securing beds for COVID-19 patients. This was sometimes carried out upon administrative request and was associated with closure of part of the general ward.
l 2-4 Changes in nursing shifts in general wards. This was necessary because some nurses were transferred to the infection ward and some developed coronavirus infection. The staff number was frequently reduced in general wards.
Accommodation capacity for COVID-19 patients For the present study, we focused on the surge phase of the pandemic and determined how various anti-pandemic measures influenced the accommodation capacity for coronavirus patients. The total number of patients does not necessarily represent the accommodation capacity of a hospital because this may
IFHE DIGEST 2025
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