Managing Healthcare Operations During Renovations

If your healthcare facility is aging, was damaged from an emergency such as a water pipe failure, fire, or storm, or you simply need to upgrade, one thing is clear: closing down your healthcare facility to make necessary renovations isn’t an option.

Unlike a restaurant or retail shop, patients can’t wait until construction is done to receive the healthcare they need, especially if there are few alternatives in their area.

There is also the added responsibility to ensure that patients stay safe, are comfortable and are protected from infection and the dust and debris associated with a renovation. This is particularly true when those patients have to stay in the building overnight.

So, when renovations have to be done, your team needs to appoint a project manager to determine the risks, identify the disruption, and ensure your team is following the proper protocols for both infection control and construction management.

Determining Risks
One of the first things the leadership at a healthcare facility should do when it becomes necessary to renovate is to pull together a project management team that includes representatives from the facility and the construction crew.

A project manager, an infection control nurse, a risk manager, the construction foreman, subcontractors and any others who are directly affected by the renovation need to be on this team. This group needs to meet regularly before, during and even after construction to ensure that everyone is on the same page and to make recommendations.

One of the most important decisions you’ll make is to determine the risk factors and plan how you’ll mitigate them.

A nurse who understands the Infection Control Risk Assessment (ICRA) protocol is specifically important because this establishes how you’ll move forward with renovations and how you will work to protect patients from the dust and debris of construction. From this, the project or risk manager will begin a four-step process designed to reduce health risks to patients. This includes:

1. Identifying the type of construction.
2. Identifying the patients and staff risk groups that will be the most affected.
3. Determining the level of infection control classification under the ICRA matrix.
4. Assigning the appropriate controls that will be needed to reduce or eliminate risks to the patients and staff.

These steps, along with the infection controls, will have to be documented on the ICRA permit.

Identifying the Disruptions
Most people consider loud noises or having to move from one space to another the biggest disruptions they will face during renovations.

But in a hospital or healthcare facility, it’s not always the biggest change that disrupts patients the most. In many cases, it’s small things like dust that can carry germs and infections that can harm those who are trying to recover from other sicknesses.

The construction may be confined to one area, but without the proper containment, the entire hospital or care facility runs the risk of cross-contamination.

As part of your ongoing remediation, your team should consider how it confines your renovation to the construction arena. Using modular containment walls is a practical way to create dedicated space. For example, the walls used by Temporary Wall Systems exceeds the ICRA Class IV infection control standards to help minimize patient exposure to dangerous pathogens, air pollution and renovation debris.

These types of modular walls are scalable and can also be customized to completely block off an area so that it further limits noise issues. And, in a nod to safety, these walls come with lockpad enabled doors so that patients or visitors cannot mistakenly wander into dangerous areas.

Following ICRA guidelines also allows your team to determine the risk level based on location and exposure. Risk levels include:

• Low risk: These areas include office or administrative spaces that are only occupied by staff.
• Medium risk: These areas include spaces where patients are coming and going but aren’t staying for long periods of time. Waiting rooms and departments where patients go for tests are included.
• High risk: These areas include rooms where patients with critical and vulnerable conditions are treated. It can include nurseries, critical care units and surgical theaters.
• Highest risk: These are spaces where patients need the most protection and includes locations with immunocompromised patients, burn units, intensive care units and oncology departments.

By determining what types of patients you’re treating and what risks they face, you can design a plan to keep areas contained and patients safe during reconstruction.

Following Protocol
If you’ve taken the time to follow the ICRA guidelines, have regular meetings with your project management team and determined risk factors, then the final step is to ensure everyone is following the right protocol.

The ICRA classifies project levels into four classes from the lowest risk patients in lower risk areas to the highest-risk patients that need the best protection and care. Project management teams make the class determination based on patient risk levels and project types.

Most renovations are static endeavors. Your team will need to meet regularly to adjust your classification and risk levels as construction moves throughout the building.

Knowing your classification level will help you offer the most practical solutions that will allow you to continue to see patients without disruption during your renovations.

While most healthcare facilities will follow ICRA guidelines during renovations, it’s interesting to note that there are no state laws governing construction at healthcare facilities that have to be met. But, if you don’t follow the ICRA guidelines, it will affect your ability to properly treat your patients and keep them safe.

Renovations are disruptive but necessary. And since it’s difficult for most hospitals and healthcare facilities to shut down completely during construction, making sure you follow the proper protocol is imperative. You need to keep patients, staff and visitors safe from airborne pathogens, dust, falling debris and other construction hazards so you can continue to see patients while you improve your building.

As president of Temporary Wall Systems, Patrick Kiessling has led the company during a critical time for growth. Kiessling has worked with several emerging and established brands in the construction, property management and home service industries over the course of his working life. Prior to his appointment at TWS, he worked with redbox+ Dumpsters, going from a franchise owner to a brand president in less than five years.