READINESS: Practice makes perfect for response to chemical spill
Between natural disasters and its biannual mock emergency drills, the Charleston (W.Va.) Area Medical Center Health System (CAMC) has had plenty of practice lately in responding to disasters.
All of that experience was put to the test in January when thousands of gallons of 4-methylcyclohexane, a highly toxic chemical used for cleaning coal, spilled from storage tanks into the Elk River, the area's primary water source. More than 30 people were admitted to area hospitals with nausea and vomiting.
When state authorities declared that the chemical posed a potentially serious health risk that rendered the water undrinkable and unusable for medical procedures, CAMC sprang into emergency-response mode, says Glenn Crotty, M.D., chief operating officer. Emergency challenges are nothing new to CAMC.
A derecho — a violent storm with severe winds and heavy rain — knocked out power at CAMC in June 2012. While Hurricane Sandy hammered the Northeast in October that same year, CAMC experienced another power outage accompanied by several inches of snow.
Although dealing with the recent chemical spill was a new test, responding to each of the prior emergencies and the mock drills has served CAMC well.
Like clockwork, administrators immediately set up a command center at General Hospital, the largest of the system’s three facilities, and secondary command posts at Memorial Hospital and Women and Children’s Hospital.
Staff utilized every communications tool available to keep information flowing among patients, staff, vendors, county and state officials, other area hospitals and anyone who could help to ease the burden during the five-day water ban.
The priorities were to find water to replace the average 7,200 gallons CAMC uses each weekend to care for patients and to determine which clinical services they could still perform. Elective surgeries were canceled for that weekend and trauma cases were diverted to other hospitals, Crotty says.
Within a few hours of contacting the county emergency services department, a 7,000-gallon water tanker was stationed outside General Hospital, says Joe Tucker, system director, housekeeping and logistics. A 1,200-gallon drum filled with water was delivered to one hospital and a 400-gallon drum to another facility, Tucker says.
Local vendors delivered water coolers and ice coolers to the hospitals to ensure that each nursing unit had sufficient water for patients. CAMC also had stored about 24,000 bottles of water on-site for an emergency, Tucker adds.
Eight dialysis stations kept working because another tanker truck was brought in for that unit along with a makeshift piping system that supplied water to the unit from the truck, Crotty says.
Endoscope cleaning continued thanks to a system devised by one of the facilities' staff members. Water was hand-carried from a storage tanker to a 450-gallon drum moved inside the hospital. Water then was pumped to the scope washers using a rigged-up piping system, says Wyatt Roderick, vice president of facilities management, Jones Lang LaSalle, a vendor management partner.
CAMC Teays Valley Hospital, which was not affected by the chemical spill, helped by sterilizing 450 sets of medical instruments before CAMC was cleared to start using its autoclaves again, Crotty says. Another nearby hospital cleaned thousands of pounds of linen.
The bill for purchasing water and other services and equipment plus revenue lost from cancelled surgeries ultimately could total up to $1 million, Crotty says. He praised the staff’s dedication and hard work in getting the health care system through a highly sensitive few days.
Most importantly, of course, no patients were harmed during that time.
By Jeff Ferenc, senior editor.
The geothermal HVAC system that heats and cools Advocate Sherman Hospital, Elgin, Ill., is on track to pay for itself from the energy saved.
The system has saved from $600,000 to $1 million annually — depending on utility prices — by using 80 percent less natural gas and 72 percent less water compared with the old hospital’s traditional mechanical system, says Ray Diehl, facilities manager, Sherman Hospital.
The system is expected to hit the break-even point in summer 2015, about five and a half years after the new hospital opened in December 2009. Sherman is the second hospital in the nation to install the system.
The system uses a closed loop of plastic piping through which a mixture of water and methanol either extract heat from the adjacent 15-acre, 18-foot-deep lake the hospital built or deposit heat there from the hospital.
The pipes are linked to 761 water-to-air heat pumps used for each of the 255 patient rooms, office areas, nurse stations and more. Another 132 water-to-water heat pumps are used to generate hot water for reheat for critical care areas.
The geothermal system cost about $6 million more than a traditional heating and cooling system, he says.
There have been challenges. Diehl calls it a “high-maintenance” system that involves continuous preventive maintenance of the hundreds of heat pumps. Plus, there are occasional leaks in the pipes.
In one incident, a leaking pipe caused the system’s fluid to be dumped into a medical records office, which caused extensive damage. None of the 17 leaks over four-plus years of operation has harmed patients, he says.
Diehl recommends the system to others but with a few words of caution. "Stick with the design parameters and avoid too much value engineering,” he says.
More environmental services (ES) teams will have a chance to shine in 2014. But first, you’ll need to enter the 2014 ES Department of the Year competition, sponsored jointly by Health Facilities Management and the Association for the Healthcare Environment (AHE).
Currently in its eighth year, this program recognizes top-performing U.S. hospital ES teams. All applications must be for a single hospital, although health systems may create separate applications for more than one of their facilities. A panel of judges selected by AHE and HFM will score the applications.
There have been several important modifications in the program this year that will give more hospitals a chance to earn recognition. Awards are given to the highest-scoring teams based on performance in 13 critical areas.
There will be three eligible awards based on bed size of the individual hospital, and judges will decide whether there is an appropriate winner in each of the following categories: fewer than 150 beds, 150–450 beds and more than 450 beds. Certificates of merit also may be awarded in each category, depending on applicants' scores.
Visit www.hfmmagazine.com/2014ESDepartment to access the online application form. While on the site, you can view previous winning entries. The deadline to submit entries is May 23.
The winners of this year’s awards will be profiled in the September issue of HFM and recognized at the AHE conference Sept. 21–24 in Tampa, Fla. For more information on the conference or to register, visit www.ahe.org.
Actions speak louder than words, so they say. But sometimes a kind word to staff for a job well done — no matter how routine it may seem — can be just as powerful.
That and the importance of collaboration among departments and staff are at the core of OneTogether: The Power of Small Actions, a program established by 3M’s infection prevention division, one year ago this month.
Founded with nine health care associations, including the Association for the Healthcare Environment (AHE), OneTogether is a free resource offering help and guidance to environmental services (ES) departments and all health care staff needing assistance in the fight against health care-associated infections (HAIs).
The findings in a white paper called “Educate, Empower, Engage: A Collaborative Interdisciplinary Call to Action for Reducing Surgical-Site Infections” presented at the 3M Infection Prevention Leadership Summit in 2011 served as the foundation for OneTogether.
The paper’s conclusion? “Although scientific knowledge is important, it will not solve the problem of HAIs by itself,” says Silvia M. Perez, global business vice president, 3M infection prevention division. “More attention to behavioral science and leadership behavior as well as engagement of hospital leaders and staff at all levels are needed to make a difference.”
Because the front-line ES workers are a critical part of the effort, the program came up with a simple way for departmental leaders to acknowledge them for doing a good job with a series of thank-you cards. It’s all about changing the culture to one of positive reinforcement and engaging the staff to do the right thing, Perez says.
“Preventing HAIs is a complex issue that takes a coordinated, multidisciplinary effort,” says Patti Costello, executive director, AHE, one of the program's original supporting organizations.
“The value of the OneTogether movement is the demonstration of how small actions can have a broad impact on HAI challenges as a whole from hand hygiene to best practices that foster prevention,” she says.
Kevin Bussiere, infection preventionist, Sentara Leigh Hospital, Norfolk, Va., points to his experience using OneTogether’s goal of culture change as proof it can make a difference in taking steps to stop HAIs. Sentara tried to teach ES staff how to follow the same five steps each time they cleaned patient rooms, a process that had only 20 percent compliance when a checklist and managerial threats were utilized.
Taking a page from OneTogether, the department tried to make learning the correct regimen more fun by incorporating a slogan for a well-known fast food chain that promotes its $5 sandwiches as a healthy bargain.
The result? The department increased compliance to 75 percent almost immediately and to 100 percent in a few months, Bussiere says.
“We instituted this culture change and we are having fun with it. They not only know the correct cleaning steps and can recite them, they are cleaning the rooms the right way as well,” he says.
For more information on the program, ES professionals can log on to www.joinonetogether.org.
The Centers for Disease Control and Prevention recently launched a website to help prevent infections in long-term care (LTC) facilities such as nursing homes and skilled nursing and assisted living facilities.
“Over 3 million Americans receive care in U.S. nursing homes and skilled nursing facilities each year and nearly 1 million persons reside in assisted living facilities,” the website states. “Data about infections in LTCFs are limited, but it has been estimated in the medical literature that 1 million to 3 million serious infections occur every year in these facilities.”
For more, go to www.cdc.gov/longtermcare
The Joint Commission clarified its medical gas storage requirements in the Jan. 29 edition of its Joint Commission Online newsletter.
The newsletter provided advice on segregating and emptying medical gas cylinders as well as on minimizing fire risk. “Improper storage of medical gas cylinders poses a number of hazards to patients and staff,” the newsletter stated. “The Joint Commission requires compliance with the NFPA requirements under Environment of Care standards EC.02.06.01, EP 1 and EC.02.03.01, EP 1.”
For more, go to www.jointcommission.org/assets/1/23/jconline_January_29_14.pdf
Significantly higher levels of infectious pathogens were found in water from faucet taps with aerators compared with water from deeper in the plumbing system in a study published in the February issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
Researchers from the University of Genoa in Italy and collaborating universities studied cold and hot water samples at two tertiary care hospitals for a year from faucets used by health care professionals for hand washing, surgical washing and washing of medical equipment.
"Aerators are a potential reservoir for drug-resistant bacteria and a source of infection for patients at risk,” said Maria Luisa Cristina, a lead author of the study.
For more, go to www.jstor.org/doi/story/10.2307/PR.2014.02.07.22685453
The Occupational Safety & Health Administration recently launched a new educational Web resource to help hospitals prevent worker injuries, assess workplace safety needs, enhance safe patient-handling programs, and implement safety and health management systems. The materials include fact books, self-assessments and best-practice guides.
“These new materials can help prevent hospital worker injuries and improve patient safety, while reducing costs,” says David Michaels, assistant secretary of labor for occupational safety and health. “At the heart of these materials are the lessons from high-performing hospitals that have implemented best practices.”
For more, go to www.osha.gov/hospitals
»'Construction Quarterly' finds California leading the nation
Our building activity data page finds California leading the nation in new hospital and clinic construction underway, followed by Texas, Ohio, New York, North Carolina, Arkansas, Missouri, Iowa, Illinois and Maryland while major activity includes a billion-dollar-plus project in Nevada.
For more, click on the graphic below:
Madonna Rehabilitation Hospital Purchases Land, Selects DLR Group to Lead Architectural Design in First Steps Towards Construction for World-Class Facility in Omaha, Nebraska
Madonna Rehabilitation Hospital has purchased 20.8 acres of land in Omaha, Neb., from the University of Nebraska Physicians Group as the first step in Madonna's long-term project to build a world-class rehabilitation hospital in Omaha.
The 110-bed, state-of-the-art facility, with a full continuum of inpatient rehabilitation care, will cover 250,000 square feet and will include a pediatric rehabilitation unit. The $93 million project will begin construction this year with a target completion date of 2016.
DLR Group, Omaha, in association with Michael Graves and Associates, as well as Page, will provide architectural and engineering services and lead the design team.Paul Dongilli, Jr., executive vice president and COO at Madonna, is leading the planning for the Omaha Campus. "This is a rare opportunity to build a world-class facility that specifically meets the needs of rehabilitation patients from the ground up and at every touch point of the hospital," he says.
Texas Children's Hospital kicked off its 60th birthday with the official groundbreaking ceremony of its new pediatric community hospital in The Woodlands.
Slated to open in 2017, the 548,000-square-foot, state-of-the-art facility designed especially to serve children and families, will offer inpatient and outpatient specialty pediatric care.
"Today, on Texas Children's 60th birthday, we stand at the forefront of an exciting new time in pediatric health care as we continue to grow, save more lives and create better futures for children everywhere," says Texas Children's President and CEO Mark A. Wallace. "Our next 60 years start today—here in The Woodlands—with a Texas Children's community hospital built right on this spot."
Texas Children's Hospital The Woodlands will offer specialty pediatric care in areas that include cancer, cardiology, neurology, orthopedics, diabetes and endocrinology, urology, sports medicine, gastroenterology and nutrition, plastic surgery, otolaryngology, allergy and immunology, dermatology, adolescent medicine and physician rehabilitation.Hospital facilities will include 24 emergency center rooms, 74 outpatient rooms, five radiology rooms, four operating rooms and 30 acute care beds at opening with plans of up to 200 beds. Ample free parking will be available with 1,000 spaces planned.
General contractor Brasfield & Gorrie recently celebrated a construction milestone for the new Emory Proton Therapy Center, Winship Cancer Institute in Atlanta.
A ceremony was held on Feb. 7, 2014, to celebrate the completion of a concrete structure that will house the proton beam system used for this cutting-edge cancer treatment. Construction on this 100-foot-wide, 280-foot-long and 48-foot-tall structure was completed in seven months and involved 26,000 cubic yards of concrete.
The center, developed by Advanced Particle Therapy (APT), will be operated by Emory Healthcare and is located in midtown Atlanta. Upon completion in 2016, the 107,000-square-foot proton therapy center will feature the world’s most advanced radiation treatment for cancer and will be the first proton therapy treatment facility in the state.
The center will feature five treatment rooms, including four rotational gantries and one fixed-beam room.
Brasfield & Gorrie was engaged by San Diego-based APT to be the general contractor for the Emory Proton Therapy Center. They have teamed with architect VOA Associates Inc. on the project, which began in March 2013. The center is anticipated to begin treating patients in 2016.