By David B. Bishop / Special to Healthcare Facilities Today

 With every available resource devoted to fighting the COVID-19 pandemic, hospitals are being challenged to increase safety and efficiency in their operations wherever possible and to lower their costs. By streamlining facility management processes, more resources can be devoted to fighting the current crisis. For many, the change in direction has included embracing remote management, staff augmentation and altering maintenance schedules as effective tools to make that happen.

Optimum building performance is critical to enable healthcare workers to effectively do their jobs

Buildings are the foundation of the work that goes on inside its walls. To support healthcare workers and limit the spread of the virus in care facilities, the impact of identifying critical areas that need support such as HVAC, fire systems, security, and building automation systems is underestimated.  

HVAC in particular has a huge role to play in the battle against this virus. In a best-case scenario, patients are placed in airborne isolation infection rooms (AIIRs), which have negative pressure with a minimum of six air changes per hour. These AIIRs constantly provide clean air to patients and help protect staff from infection by containing, diluting and exhausting contaminated air through a high-efficiency particulate air (HEPA) filter, eventually sending those air particles outdoors rather than recycling the air. They also prevent contamination from traveling to other areas of the hospital when the doors are open. As we move past this initial pandemic response, new regulations and expectations are developing around ensuring the environment conditions in the facility are being monitored and reported. The Joint Commission, for one, recently issued a mandate to measure and maintain negative pressure in isolation rooms. Going forward, the healthcare market must measure the negative pressure relationship and be able to prove it is within acceptable limits.  

In addition to actively battling COVID-19, facilities must maintain at least baseline levels of operations and safety. For example, while the NFPA has been working to provide guidelines to help healthcare facilities navigate this new environment, building safety measures such as fire inspections are still required. Once priority operational systems and their needs are identified, implementing strategies to maintain them safely and efficiently is the next step.

So, how do facilities work safely and efficiently to keep up with these needs?

There are several tools that were available before the pandemic that have gained traction as they’ve become useful in healthcare facilities’ response, namely staff augmentation, remote management, and condition-based maintenance. When certain individuals are concentrating on keeping the facility as clean as possible or focused on just one system, such as HVAC, other components of building management seem like less of a priority and can take away from those efforts. Staff augmentation can be a good solution. By supplementing with trained staff, people can come in, check equipment, make sure things are working properly and service as needed to fill any gaps created by keeping non-essential workers home while ensuring proper precautions are being taken for the safety of all.

Remote management is another piece of this puzzle, minimizing non-critical on-site staff and enabling them to participate in social distancing measures, which can help decrease the spread of infection in healthcare facilities. It also means having the capability to receive and triage alarms, reset or restart alarms or a piece of equipment remotely.

Consider the use case of a not-for-profit healthcare system whose resources are limited in the best of times. Remote monitoring was implemented in response to COVID-19 and a full-time, on-site team began a condition-based maintenance program. Staff can be notified of alarm and equipment issues and be provided with troubleshooting to reduce their workload. This strategy includes the capability to monitor the facility during second or third shifts and engage them only when needed. Some technological capability is required to implement such practices, such as a connected chiller program, but it can be a time and resource saving tool, especially now. This provides the comfort of knowing critical systems are being monitored around the clock by building experts and the utilization of technology to keep costs low.

COVID-19 has seen the healthcare industry rise to previously unimaginable challenges. Like every other aspect of the field, facility management priorities and strategies have shifted to slow the spread of the virus as much as possible within facilities, maintain critical operations, and accommodate the shift to remote work for non-essential employees. Moving from a reactive to a need-based maintenance model on building systems like HVAC or building automation means that those services are provided safely and efficiently. As we move forward, many of the lessons learned promise to influence facility management practices during and after this pandemic.  

David B. Bishop is the Director, Service Operations, Building Solutions North America, for Johnson Controls.