Hospitals present a host of distinct and sensitive situations for the construction crews tasked to work within or around their walls. Patients inside these facilities are susceptible to infection and may not be able to evacuate on their own; emergency situations arise, demanding resources and functioning systems; and operations never stop, eliminating any “convenient” time for construction crews to shut down certain systems.
Mike Strickland of Turner Construction focused his session, “Construction Safety Management at Health Care Facilities,” on some of the key areas of concern for both construction crews and hospitals during this type of work. According to Strickland, construction crews at Turner go into the job with the following attitude: “When you work in a hospital, your kid’s the one upstairs in surgery.”
Strickland stressed the following topics to OSU-OSHA attendees:
Water. As Strickland pointed out, there is no convenient time to shut down the water supply at a hospital. “Water is a big deal – hospitals are 24/7 facilities,” he said. An emergency operation, for example, could occur in the middle of one of the construction’s water shut downs. But sometimes, it may be necessary to shut down supply to a pump, meaning a portion of the hospital will be without water. When placed in this position during a job, Turner Construction notified a fire department and walked firefighters through the building, showing them water sources and ways to enter or exit the hospital in case of emergency. Fire crews waited behind the building by a live fire hydrant to be prepared if a fire occurred while the water was off.
Infection control. “This is one of biggest things we deal with when working inside of a hospital,” Turner said. Patients are at the risk of suffering infections – sometimes fatal – from construction or maintenance-related activities inside the hospital. Construction-related causes of nosocomial infections are dust-borne, waterborne or caused by inhalation of fungal spores. “The first thing we do is set up a HEPA filter that will re-circulate air inside that area,” Strickland said, adding that conducting a weekly Infection Control Risk Assessment also is necessary.
Interim Life Safety Measures. When working in a hospital, construction crews may need to change or disable fire alarm systems, sprinkler systems, evacuation routes or other systems. But without working systems in active areas of the hospital, an emergency can have devastating effects. Contractors therefore must work on implementing, inspecting, training and monitoring interim systems. If the job requires regular fire alarms to be disabled and temporary alarms used, for example, take the steps to ensure everyone’s safety. “Set up monthly inspection of any temporary fire alarm you may have in the building, and train the hospital as well as your own people,” Strickland advised.
Ambulance traffic. “You cannot shut down one of their main ambulance routes,” Strickland said, “so quite a bit of pre-planning needs to go along with staying out of the way of their procedures there.” As is required with much of the work completed in hospitals, crews and hospital personnel must work together to determine best alternate routes or solutions.
Electrical and medical gas. “They’re probably the two biggest items that the hospital needs for patient care,” Strickland said of electrical and medical gas. Crews must understand how they are affecting gas systems and what they need from the hospital, he added. And when it comes to medical gas, Strickland suggested to “just say away from it – make sure you plan your work around it.”
Communication. When interrupting any life-safety monitoring system, from fire alarms to sprinkler systems to evacuation routes, the appropriate hospital staff and management must be kept apprised of the situation to create a clear plan and minimize risks. The contractor also must remain up-to-date with hospital and emergency procedures and be sure to coordinate any changes or procedures with the facility.
“You have to remember that when we design and build hospitals, there are areas where people basically are going to be in a 2-hour enclosure waiting out the storm for someone to come rescue them because they can’t get up and out of the building,” Strickland said of emergency situations in health care settings. “You have to keep that in your mind when dealing with interim life safety.”The 2009 OSU-OSHA Safety Day was held Jan. 27 on the campus of the Ohio State University (OSU) in Columbus, Ohio, and was hosted both by OSU and the Columbus, Ohio-area OSHA office.