Construction Management - Construction Management and Contracting, Cranbury, NJ

ICRA Requirements on A Hospital Construction Project

Posted by admin in Commercial construction | Health Care | health care construction - (0 Comments)

New Infection Control Risk Assessment (ICRA) codes were put in place last January to address the 5000 American deaths due to infections that occur during hospital construction, renovation, and maintenance. Most ICRA requirements are aimed at reducing the spread of infection during construction itself; however, some rules include those who tread through the hospital corridors prior to construction – architects, engineers, design professionals, and consultants as well as anyone who enters a space that may harbor bacteria, fungi, or contaminants.

Proper classification of the space to be disrupted is essential. Different regulations apply to building protection for airborne, biologic, chemical, and radiologic situations. It is also essential to categorize patients according to their inherent susceptibility to infection. Those at the greatest risk include patients who with immuniosuppression, such as bone marrow allograft, chemotherapy, or radiation patients. Healthy patients undergoing surgery are at a risk if the sterile equipment or the environment is exposed to unsanitary conditions.

One of the first lines of defense against contamination control in NJ healthcare construction is a negative pressure system. Often available with HEPA filtration and UV-C germicidal radiation, these systems prevent the escape and dispersion of infectious agents, such as viruses, airborne bacteria, and mold spores, from demolition areas, actually sucking pathogens into the device, rather than allowing them to spread.

It is essential for construction personnel to ensure that the construction area is sealed off completely. ICRA requirements account for noise pollution as well as the spread of infection. Dust control in surrounding areas and daily cleaning are all pieces of the puzzle. Keep contractors informed – all of them. With any construction project, there is a wide range of workers in and out of the area. It doesn’t take but one to open a vent, lift a ceiling tile, or leave open a door for the whole area to become contaminated.

Train all staff members and ensure that contractors understand the extent and importance of ICRA requirements, particularly if they work with other clients and are not accustomed to working in the healthcare industry with its strict controls.

Resources:

http://www.djc.com/news/ae/11139447.html

http://www.mist-dust-collection.com/Cleanroom-Filtration/negative-pressure-systems.html

http://www.premierinc.com/quality-safety/tools-services/safety/topics/construction/icra.jsp

http://olao.od.nih.gov/NR/rdonlyres/53F3B38F-7572-4FAD-A59D-99D60FCD1DA7/5631/NIHPWSFinal.pdf

Health care construction, Hospital construction, ICRA Requirements

Building Patient Satisfaction into Hospital Design

Posted by admin in hospital design | nursing home design | Patient care | Uncategorized - (0 Comments)

While short-term costs may rise, it is prudent to take patient satisfaction into account during hospital construction. Acting on these considerations should be a financially sound move that provides satisfaction to administrators, patients and staff alike.

Happy patients heal more quickly. They are more likely to follow instructions for care and respond better to medicine and other treatments. An added, obvious benefit is that satisfied patients do not lodge complaints or sue for malpractice. Also, they are connected to a happy staff. A staff that is at ease makes fewer mistakes, is more efficient, and supports a better bottom line.

New programs penalize hospitals with high readmission percentages in an effort to cut spending and improve care. Approximately $17 billion per year is being spent on patients required to return for the same illness or injury. At least half of these patients do not see a doctor between visits, suggesting that a lack of follow-up is costing money. The “care transitions” initiative at Scott and White Healthcare in Temple, Texas, is one of the new projects that work to decrease readmission and increase patient satisfaction.

Patient satisfaction saves money, but the discussion soon turns to how exactly healthcare systems can please patients. Value Based Purchasing (or VBP), or models like it, appear to be moving the process along by providing incentives for better care, communication and outcomes. So, some hospitals are increasing room size – as much as 200 square feet per room. Hospitals are bringing the family closer, providing more seating and allowing sleepover guests. Design and renovations include single rooms, aiding in infection control and allow patients more privacy. More amenities – from in-room temperature control to wireless technology to entertainment and educational systems for at-home care. More natural light and soothing finishes to make anyone’s time spent in a hospital more pleasing.

Spending a more on hospital construction and design can go a long way towards increasing patient success and a return on investment.

References:

http://www.hcrealty.com/medicalrealestatedevelopment/healthcare-real-estate-developer-3-reasons-hospitals-must-focus-on-patient-satisfaction/

http://health.usnews.com/health-news/best-hospitals/articles/2010/07/21/health-reform-takes-aim-at-hospital-readmission-rates

http://www.uberlumen.com/2011/01/30/vital-signs-of-healing/patient-satisfaction-linked-to-healthcare-satisfaction/

healthcare construction, Hospital construction, Hospital Design

Sustainable Design in Healthcare Construction

Posted by admin in hospital construction | sustainable hospitals - (0 Comments)

Merwick Lobby

We as a race are facing our responsibilities to the planet and future generations. Car manufacturers are addressing issues of greenhouse gas emissions and gasoline usage, while homeowners are diligently collecting recyclables. Those involved in building, particularly healthcare construction, are also working towards improving the quality of life while sustaining a clean, healthy environment.

Healthcare facilities seem to be working from behind, with waste – medical waste, Styrofoam cups, and surgical gowns – to the 24-hour per day usage of lights, air conditioning, and high-powered medical equipment. The Department of Energy reports that hospitals account for 2.5 times more carbon dioxide emissions compared with other commercial buildings. Plus, they generate over four billion pounds of garbage every year.

Healthcare facilities are responsible for making people in the community healthy, and are beginning to feel obligated to take into account the health of the planet. Yet, it takes more than just recycling the cans from the soda machine and turning off lights in empty rooms. In many cases, it requires sustainability considerations from the ground floor up – beginning with the planning stages of healthcare facility construction.

Renewable energy is growing increasingly popular in healthcare construction, as facilities move toward natural, renewable energy – sun, wind, and geo-thermal – to meet their objectives rather than relying on traditional power sources. Solar power, for instance, is becoming a necessity, rather than an embellishment, particularly in New Jersey, which boasts the second most solar power usage next to California.

Energy efficiency is important in hospital construction, particularly as hospitals look for new ways to reduce their budget while maintaining high quality care. According to a study by the Rutgers Center for Energy, solar power “costs less than one percent of a ratepayer’s utility bill” for retail rates of electricity. Additionally, it opens a new stream of cash flow. Not only does solar power produce “free” energy for the building, it also comes with Solar Renewable Energy Credit (or SREC) income.

If renewable energy cannot be factored into the project plan, HVAC systems with high efficiency units should be considered. Either way, sustainable design in healthcare construction reduces energy costs, aids the environment, and ultimately enhances healthcare effectiveness.

http://www.healthleadersmedia.com/content/MAG-255118/Hospital-Sustainability-Gets-Executives-Attention.html

http://en.wikipedia.org/wiki/Sustainability

http://www.njand.com/news/magazine.php/2011/01/21/p6094#more6094

http://www.newjerseynewsroom.com/science-updates/new-jersey-solar-power-hitting-new-heights

healthcare construction, Hospital construction, Sustainable Design

Hospital Design for Better Patient Care

Posted by admin in health care construction | hospital design | Hospitals | nursing home design - (1 Comments)

As hospitals vie to serve patients, providing high-quality care is only one of the issues they face. Hospital and long term care construction aims to reveal at first glance a place of respect, compassion, comfort, safety, and expert treatment. These facilities are including amenities once only thought to exist in first-class hotels. Such designs include automatic lights in the bathroom, flat-screen televisions, private rooms, fold-out couches, stylish wallpaper and tile, beauty salons and a beautiful view.

daycare

Yet the idea of style isn’t just to sway upscale patients. Research shows that focusing on design, to include more natural light, soothing finishes and accessibility can provide patient – and staff – benefits, including faster recovery times, happier and more efficient employees, fewer accidents and falls, lower medication errors, and decreased spread of infections. Thus, it can save the healthcare facility money.

Hospitals are incorporating design in an effort to improve patient care and efficiency. Single, private rooms are one enhancement that hospitals are implementing to reduce infection between patients. Two-way cabinets are being used by the door to prevent repeated intrusion on patients. Additionally, the single rooms have shown in studies to improve communication between the patient and medical staff.

While new hospital construction designs typically increase costs by five percent, they reduce expenses of the day to day operation, quickly recouping any extra building costs.

According to Roger Ulrich, an environmental psychologist, a room with a view can not only help a patient feel better, it can reduce cost. His study of forty-six patients recovering from gallbladder surgery showed that half the patients with a view of nature from their room “complained less, used less pain medicine… had shorter hospital stays” and cost $500 less than the half of the patients whose rooms overlooked a brick wall.

Focusing on health care design using approaches such as Evidence-based Design or the Eden Alternative principles, can ensure that a hospital not only provides better care for patients, but reducing their operating costs in the process.

http://online.wsj.com/articl/SB10001424052748703890904575296633680660708.html?mod=rss_Health

http://www.cleveland.com/healthfit/index.ssf/2010/09/blueprint_for_healing_–_hospi.html

healthcare construction, Hospital construction, Long term care design

Health Care Construction Post Health Care Reform

Posted by admin in Commercial construction | Health Care | Hospitals - (0 Comments)

In 2010, President Obama’s Healthcare Reform Bill was passed into law amid much controversy. Yet rather than providing answers, the move merely added more questions in the minds of everyone involved in the healthcare industry. Budgeting for the construction of healthcare facilities in the wake of this reform is just one of the issues that has arisen.

The main focus of the reform is allowing more Americans access to healthcare. The industry should expect an increase in patients at hospitals and testing facilities, as well as at outpatient clinics, doctors’ offices, and inpatient care.

All of the changes that will result from the healthcare bill will not be fully seen until 2017, Jocelyn Frederick points out in her article, “Reform Means Rethinking Planning, Design.” Another example is that the reimburse amount for Medicare and Medicaid patients which “For Profit” facilities receive has decreased. Yet organizations must consider and proactively respond to the changes in order to remain competitive as well as efficient in the new healthcare atmosphere.

With more patients utilizing health care and reimbursement costs decreasing, facilities must think in terms of efficiency and costs when planning new health care construction. Perkins Eastman, an architectural firm that deals in hospital construction, believes that many organizations will focus on planning as they sort through exactly what the new reform bill means. Even with the increase in potential patients, “the long-term focus will be on more efficiency and better use of facilities or updating of outdated facilities more than on expanded capacity.”

The healthcare industry – from hospitals to nursing homes to clinics – will have to consider how to handle the almost certain patient increase. Those that do not properly meet the needs of patients may find themselves without any, as individuals are able to choose which facility they prefer. Healthcare is becoming more of a customer-centric, performance-driven environment.

Frederick believes that those involved in the planning of a new health care facility should take into consideration several adaptations which will fit with the new reform bill. She recommends the following:

1) Increased focus on preventative care. As the number of patients grows, prevention will become key to avoiding over-crowding, long waits, and unhappy individuals.

2) Taking advantage of government incentives for electronic record-keeping. Not only is this a step into the future, enabling medical professionals to easily read and share information, it also frees up valuable space, which can be used for something else.Yet, keep in mind that while there is a net reduction, there will a need for larger IT areas and nurse work stations to accommodate record access and updates.

3) Making essential services more accessible with added funding, and eliminating services due to the taxing of policies and treatments being streamlined.

So what does all this mean for medical facility and hospital budgets? The optimal formula should include combining productivity, efficiency and quality, according to Jason Sussman, partner with Kaufman Hall, which provides Financial Strategies for Healthcare.

http://www.modernhealthcare.com/article/20100823/NEWS/100829999/

http://www.healthcarefinancenews.com/news/challenges-are-everywhere-budget-planning

http://www.healthcaredesignmagazine.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications::Article& mid=8F3A7027421841978F18BE895F87F791&tier=4&id=AC1DA64A4F8948E49B83AF21A4556B7D

Health care construction, Hospital construction