High care needs more care
With the spotlight on minimising contamination and reducing Healthcare Acquired Infections (HAIs) in recent years, the demand for specialist construction companies with the necessary infrastructure, skill-sets, knowledge and experience to serve these types of high-care environments has grown rapidly. Cleanroom Technology caught up with Adam Bell, Managing Director of Building Projects Group, who has established an enviable reputation for delivering challenging high care construction projects over the past 12 years, to ask how they approach their projects.
We’ve definitely seen a rise in demand for our skills and experience working in high care environments. While construction is a necessity, it is not always possible or practical to close down areas or halt production in a high care environment; it has to be business as usual for our clients. Whether public or private sector we have to understand their objectives and identify what the impact of the work could be for their users and stakeholders. There are often additional risks or implications on high care environments, particularly from the healthcare sector. One of their major concerns is minimising the potential risk of HAIs and protecting patients and staff during a construction project. Construction can be a major contributor to HAIs and the same strict controls used within cross-contamination environments, such as the pharmaceutical industry, are transferable to this sector. And with changes in NHS directives resulting in stricter control procedures being undertaken within health centres, the same protection and risk management needs to be transferred to these types of environment as well.
To provide best practice I feel it is key that providers have experience in working across different types of high care environments so that skills and techniques developed to increase effectiveness and minimise contamination potential in comparable sectors can be shared.
I believe the due care and attention demanded in cleanroom facilities should be applied to all high care environments, including hospitals, GP surgeries, care homes, food processing and packaging plants, as well as research and development laboratories. At Building Projects Group we’ve been working in the pharmaceutical industry for many years. We design, build, convert and refurbish high specification, unidirectional and non-unidirectional cleanroom facilities. We are often brought in by the main contractor because of our specialist skills and knowledge of working in an aseptic controlled environment. Advancing technologies, new materials and shifting health and safety regulations all contribute towards any building project in a high care environment being a challenge, but the principles remain the same.
Nursing and care homes are mere extensions of the healthcare system and the people in their care are just as at risk and vulnerable as patients in a hospital. Measures should always be put in place to reduce risk and infection contamination during a construction project in these environments too. Those working in the food processing and packaging industry have always had concerns regarding the potential for cross-contamination. And in this industry there is the potential to damage a brand, with disastrous financial consequences.
All high care contracts we work on have guidelines and state the procedures that are required in terms of construction control. However our experience, built up over the last 12 years, often means that our own internal practices are of a higher standard than being asked of us. To demonstrate this we recently published a company charter which displays our commitment to our clients and their stakeholders.
Major Control Charter
Our Major Control Charter sets out the methods we adopt to prevent cross-contamination and the construction controls and procedures we use. It includes detailed project specific risk assessments, creation of working zones using robust, dust-proof barriers capable of maintaining the necessary air pressures, construction of temporary airlocks with zipped double doors for access and egress of materials and personnel and the use of ‘tacky-matting’ as dust traps in all access points of the working area. Daily inspections by our own staff ensure the integrity of the working zones and certification of the working area, including a contamination inspection is carried out prior to handover
Our Charter is in addition to the standard health and safety regulations adhered to on a construction site and our quality management systems in line with ISO 9001, ISO 14001 and OHSAS 18001. We also use careful planning to minimise disruption to daily activities. The consequences are far too great for any company to ignore, but good planning and open communication goes a long way towards a project being delivered on time and to budget.
Expanding Hereford Hospital
The Major Control Charter was used to great effect to create additional bedrooms at Hereford Hospital, part of the Wye Valley NHS Trust. It had been well documented that there was a shortage of hospital beds in the area and in 2010 they were tasked with creating additional bedrooms whilst ensuring the surrounding wards remained fully operational. In addition to our own Major Control Charter, we adhered to Hereford Hospital’s own strict infection control requirements. This included installing temporary partitions, made from flame retardant Antinox sheets, which incorporated double zip doors, to segregate the building works from the main functioning areas of the hospital. Hereford Hospital was so impressed with the standard of our works, that they showcased it to other contractors to demonstrate best practice.
To maintain a sense of normality our operatives wore regular clothing in the hospital corridors, and then changed into high visibility jackets, safety helmets and work boots once behind the partitioned areas and out of sight of patients. Even waste materials from the works were covered so they were not recognisable, to further minimise the impact of the building works on staff and patients.
This project created an additional challenge when we had to work around an isolated area being used to control an outbreak of the stomach bug, Norovirus. Only our team’s implementation of enhanced management controls and procedures allowed the hospital to work to its safest maximum capacity. Our attention to detail didn’t go unrecognised, we were awarded a ‘Going the Extra Mile Award’ for Health and Safety procedures by Wye Valley NHS Trust.
Photograph below shows Hereford Hospital and the dustproof acoustic segregation within working hospital wards over 3 floors to create 15 much needed extra beds.
New inspection area for Teva Pharmaceuticals
Teva UK Limited is one of the biggest pharmaceutical companies in the UK. Here the photograph shows how we created a new inspection area within a live pharmaceutical production facility. Behind our dust proof screens, heavy demolition was taking place and a temporary dust extraction system was used. Our screens also allowed for temporary fire escapes.
The photo shows the nearly completed sterilisation machinery for Synergy Healthcare, Knowsley, with just the dust proof segregation still in place.
Building Projects Group continues to invest heavily in research and development to make sure we understand the latest cleanroom technologies and to keep us at the forefront of our industry. For example, we’ve recently started using harmonised dust removal systems, which are integrated into the usual building machines for drilling, chiselling and sawing. It’s a much more efficient system and helps prevent dust entering the working environment. Dust is a constant problem for a construction project in a high care environment – simply slitting cable trays into concrete can produce 15kg of dust in just one hour, which can create a lot of potential contamination. So the new harmonised dust removal system will help remove a lot of that risk.
I’m a member of a national health technology business support organisation, Medilink, which is dedicated to the growth and development of health, technology and related life science industries. I am also an active board member of a special interest group responsible for infection control, to help me keep abreast of industry issues and to help us to respond effectively to client demands.