construction work is undertaken in hospitals to keep buildings and equipment up to date for our patients’ care. The most important issues to be addressed are infection risks, arising from dust and water. We approach this by determining the

Electricity plant and below, installation.

Data and voice All essential technical installations and equipment are integrated with a digital information system. A variety of parameters are analysed, and an alarm will alert the nursing team of any patient issues. Other technical and fire alarms are also sent to the technical services department. Staff are available 24 hours a day, 7 days a week to respond to these alarms. There is a highly skilled technician based on site, 24/7, to implement the first necessary actions, then technicians from all disciplines can be contacted at home, via alarms, to call them into the hospital to provide onsite support.

Managing serious incidents A hospital incident management system (HIMS) ensures we are fully equipped to deal with any potential incident. We have analysed a wide variety of risks – not only technical risks, but also a shortage of nurses or pharmaceutical products, as well as severe weather events etc. Firstly, we establish preventive

measures to avoid incidents from occurring. This includes preventive maintenance on all equipment, and ensuring we stock the most essential spare parts in our own technical store located at the hospital. If an incident does occur, it is vital to

have procedures to instruct people on what they need to do in an emergency situation. We have developed

risk index, before commencing with a study of the work or the search for a contractor. The contractor must demonstrate full knowledge of the methods required to minimise any inconvenience for the patients during the works, especially noise, vibration and circulation of dust etc. The risk index from 1 to 4 is based on a decision table that primarily rates the risk for infection of the patient. The second parameter is the type of work to be performed, ranging from simply opening a ceiling for inspection, to the demolition of a concrete wall. Based on the index, we have to take measures to ensure there is no dust in the patient environment. We close doors, make temporary walls in wood (not plastic) and consider how to transport the materials from and to the construction site. We have a strict system of signage on

comprehensive emergency procedures and store them in a digital system called ‘MUZLIDOC’. This system offers the ability to have the procedures approved by several stakeholders. After a designated period, all of these stakeholders are required to review the procedures. We also believe that it is not enough to simply have these in place – it is important to continue to train staff on these procedures, as such events occur rarely. If an incident escalates, there is an

option to switch to the state of “disaster management”. This may include the evacuation, isolation or relocation of patients to other locations within our hospital. This is an option of last resort and we hope that we never have to utilise these plans.

Building risks We have, so far, addressed the technical risks, but there are also special risks associated with the building process of hospitals. As we all know, considerable

every entrance door of the construction site, listing the point of contact for information and action. All contractors must have a badge with the name of their organisation. But, most important, is that all installations must be fully checked by the contractor, the engineering bureau if necessary, the official inspection agency, and the engineer from the hospital’s technical services department. If all of these stakeholders have given their approval, a hospital engineer will give the go-ahead for patients to be treated in this area. We have a culture of reporting near-

accidents (however small they might be). By analysing all of these reports, we succeed in preventing real accidents. The hospital recently started a ‘Last Minute Risk Analysis’ (LMRA) to enable and encourage our staff to think ahead and be optimally prepared for any safety concern related to a task.

Critical hospital and Mother & Child unit. 76

Conclusion In this article, I have provided an overview of how the technical service in the University Hospital of Leuven (Belgium) deals with risks from technical installations and buildings. While it is a challenging task to completely eradicate accidents, it is important that those who are responsible can rest in the knowledge that they have done everything possible to prevent incidents from occurring. All those working in the technical service department at UZ Leuven are committed to ensuring there are no negative consequences arising from our operations and to safeguarding the wellbeing of patients at all times.


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