protecting the facilities we work in
The importance of planning
When working in Healthcare and Life Science Facilities we have a moral and human obligation to protect the patients and science within that facility. A properly developed PCRA (preconstruction risk assessment) and then subsequent ICRA are not only critical to protecting patients and science but, as builders within these facilities, its our most valuable way to show our level of care and compassion. As builders and construction professional we must all make it our top priority to protect the execution and maintenance of the ICRA plan.
According to ASHE approximately 90,000 people will die from infections contracted while in healthcare facilities. While the same statistic doesn’t translate to Life Science facilities, it is a clear indication that contamination and cross barrier exposures are very real and will absolutely impact the very science that finds cures that will save lives. As building professionals our contribution to reducing impacts on these facilities is centralized around our development and adherence to a strict ICRA plan. We must never find ourselves too comfortable in these facilities- we must always hold ourselves to an urgent standard of care.
Communication
As a community of builders and construction professionals we must work together as a team with all facility stakeholders and effected parties to ensure we develop and execute in a robust way the ICRA mitigation plan. Putting in place up front a system of checks and balances and daily inspections ensure compliance is our best and most effective way to protect the facilities we all work in.
Communication is the most important first step in developing the PCRA and therefore we must ensure we identify all appropriate parties to partake in the process. This will ensure we receive input and expertise to identify all items in the PCRA and ICRA.
Proper Containment
As the ICRA team we must fully define all scopes of work being performed and the surrounding area types abutting these work zones. This is vital to developing a proper mitigation plan. Communication with all stakeholders helps to ensure that the ICRA developed is robust enough.
What's the harm?
Dust can carry with it germs, viruses and other contaminants that can impact patient health, lab testing, quality control standards and in severe cases can cause death, severe reactions and disqualification of stringent testing criteria. We can never underestimate a little dust on our project sites and as such proper control and mitigation methods are paramount. Mitigation methods range widely but are defined in the ICRA document. They may range from a simply poly wall with stick pads all the way up to full gowning, air showers, HEPA filtration with negative pressure monitoring services. The mantra with dust is to Trap It, Block it, Keep it out.
The "why"
In Healthcare and Life Science facilities we must be ever mindful of the extreme sensitivity of patients and science. In healthcare facilities we as construction professionals must understand the fragility of immunocompromised individuals as an example. Simple environmental exposures that we can easily manage when healthy (i.e. naturally occurring mold around us, dust, viruses etc) can be fatal to many patients (think newborns, burn victims, cancer treatment, surgery recovery). Science can be contaminated just as easily and weeks, months or even years of research can be impacted if contaminated with something as simple and benign seeming as dust. We must protect the integrity and quality of Healthcare and Science facilities by implementing stringent and well articulated ICRA protocols.
High Standard of contaminate control
In critical facilities the best method to reduce and outright eliminate the risk of spreading contaminates is to design your construction zone to be NEGATIVE (generally -.01 to -.02” H20) pressure relative to all surrounding spaces. This ensures that contaminates from your space can not migrate to adjacent areas. This is generally accomplished by creating tight barrier (the tighter to the better to control where makeup air is pulled from) and then installing a HEPA exhaust system. Depending on project and facility specific requirements exhaust and makeup to construction sites will be exhausted locally back into the facility so long as using HEPA filtration or exhausted directly to the outdoors (although this can come with risks of creating pressure problems in the facility so this should be reviewed in detail and integrated with a makeup air solution via the building BMS system.
We are ASHE ICRA 2.0 certified
We maintain a high level of care and constantly improving our lessons learned and construction methods. We participate in ASHE, AAALAC and are member of ASHE and a member of the Boston chapter of AMFP (Assoc of Medical Facility Professionals).