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What is special in maintaining a Modern Hospital?

Mohammad Akhtar
Comparing maintenance activities of a Modern Hospital with other public facilities such as Hotels, Motels, Restaurants, Clubs  and other similar places can be a lot different since these  provide services to mostly healthy recipients. Where as the recipients in a Hospital are patients with various levels of physical conditions. Some can walk at their own into the Hospital for treatment and some are brought with the help of Medical professionals in an ambulance. The patients are vulnerable in respect to receiving disease from other patients suffering from communicable disease if not adequately managed by engineering controls  as well as by infection control measures. The Hospitals are meant to retrieve good health of their patients within an appropriate time frame and with highest possible level of comfort. This can only be achieved if the facility is fully equipped and managed under strict rules, regulations, codes & standards set by reputed organizations of the leading countries.

Today, ‘Hospital Engineering’ in general is an important branch of hospital management. 

Clinical Engineering and Equipment & Building Engineering have a vital role in ensuring the prevention and treatment of diseases by maximum equipment utilization with minimum downtime and by:- 

  • Adequately constructing, face lifting, renovating and reorientation of spaces according to contemporary needs.
  • Accommodating growing technology into running medical facilities.
  • Maintaining high levels of different atmospheric conditions according to different diseases to be treated and diagnostic and treatment facilities available.
  • Implementing and enhancing engineering controls for interim life safety measures, infection controls and safety & security measures to the highest level possible for the patients, visitors, staff and properties.

Infection Control (internal & external) is a major challenge to the Hospital Engineering professionals in any of the Modern Hospital. There are several issues that need to be looked upon in this regard such as:- 

·         Intake and expel of air of the Air Conditioning System.

·         Internal distribution and circulation of air of the Air Conditioning System according to the disease of the in-patients and their treatments.

·         Adequately expel of air in the hazardous locations.

·         Hospital waste management.

·         Housekeeping.

·         Interim life safety measures

·         Maintenance of various piped systems such as Medical gases distribution, Water distribution, Sewerage distribution and Steam distribution etc.

·         Interior finishes.

·         Food management. 

The above mentioned may be more in contributing to infection if not satisfactorily managed from their design stage, construction and maintenance. One can imagine if air intake of the air conditioning system is close by the exhaust outlet of a hazardous location and exhaust of air from T.B. patient is not filtered according to the set standard before releasing into the atmosphere. The negative air pressure with 100% exhaust from a T.B. patient’s room can not be overlooked for a moment if you significantly want to control infection. The expel of air from soiled side of sterilization area, exhaust of Ethylene Oxide Sterilizer, smoke of incinerator and release of other similar hazardous locations will pose negative health threat to the patients, hospital staff, visitors and community living in the close vicinity of the hospital boundary, if the releases are not controlled under strict codes and standards. The competent collection, the transportation within and out of hospital and final disposal of the Hospital waste (Radioactive, Biological, Chemical and General) can become the biggest life threatening issue if not managed according to established rules regulations. Managing House Keeping in a hospital is another important area that needs to be administered for satisfactory results. Implementing Interim Life Safety measures especially at internal construction site pays back with dividends in relation to health of patient, staff and visitors. Materials of pipes, joints and their construction and maintenance methodology of various piped distribution systems can not be ignored in relation to infection control. Interior finishes play double role in Medical facilities, esthetic look and infection control. Engineering controls also play an important role for internal food preparation in hospital kitchen and its distribution to individual patients in the Medical Facility.                                            
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