Category: Ideation

Join HH Angus’ Nick Stark and The Ottawa Hospital’s Jessica Fullerton as they discuss “ Considerations for Planning & Design of Isolation Rooms to Improve Safety in Healthcare Environments. ”

Date: March 18 @ 1PM – 2 PM EDT

45 minute Panel Discussion followed by live Q&A
Webinar Registration Fee: $65 (including taxes and fees)
www.cchf.net

Isolation Rooms help to separate patients and residents in healthcare settings as needed to protect patients and staff. Typically, acute care hospitals allocate isolation rooms in hospitals, with some being simply private rooms, and others having specialized engineering depending on the clinical needs of the patient and the safety requirements presented.  Given COVID, hospitals, long-term care homes and other healthcare facilities are looking at increasing and potentially upgrading the design of their isolation rooms, and reconsidering engineering design to enhance safety in the facility.

This webinar covers:

  1. Differentiating between the different types of isolation rooms to meet specific needs and corresponding design criteria.
  2. Identifying infection prevention and control risks related to the design of building HVAC systems in ‘pressure’ (positive / negative pressure) critical spaces.
  3. Reviewing the role of HVAC systems in the context of Pandemic Planning and Catastrophic Event Management

Speakers:

Nick Stark's headshot

Nick Stark P. Eng., CED, LEED AP, ICD.D
Vice President, HH Angus and Associates Limited Consulting Engineers

In 40+ years at HH Angus, Nick has pioneered many innovative and sustainable initiatives as solutions to difficult challenges faced by clients. His technical expertise also benefits staff as he directs HH Angus’ Knowledge Management initiatives, ensuring the firm’s skillsets continue to lead the industry. In 2017, Nick was awarded the PEO/OSPE Medal for Engineering Excellence for his outstanding contributions to the profession. He spearheads the design and management of HH Angus’ P3 hospital projects, and served as the firm’s Principal-in-Charge for the massive $2 billion+ CHUM P3 project in Montreal. The team’s work on the project was honoured with the 2018 Schreyer Award, Canada’s highest honor for engineering.  Nick chair’s the CSA Subcommittee on Special Requirements for HVAC Systems in Health care Facilities, is Vice Chair of the CSA Subcommittee on Z8000 Canadian Health Care Facilities, and is a former member of the CSA Subcommittee on Infection Control during Construction or Renovation of Health Care Facilities.

Jessica Fullerton's headshot

Jessica Fullerton, M.Sc. CIC
Construction Lead – Infection Prevention and Control, The Ottawa Hospital

As a member of the Infection Prevention and Control team at The Ottawa Hospital, Jessica specializes in health care facility design and construction, focusing on design elements to help prevent the spread of infection. She has provided Infection Prevention and Control expertise on a wide range of acute care, rehabilitation, ambulatory care, community health, and long-term care projects. Jessica’s passion lies in bridging the gap between health care design and how it can positively or negatively influence the care and safety of patients. She currently sits as a member of the Canadian Standards Association (CSA) Health Care Facilities Technical Committee providing expert content for several standards related to health care design and construction. Jessica is the Chair and member of CSA training faculty for the Z317.13 Standard, Infection Control During Construction, Renovation and Maintenance of Health Care Facilities.  

Doctor smiling at child and parent

Infrastructure Ontario (IO) and Grandview Kids have announced a shortlist of three bid teams to design, build and finance the Grandview Children’s Treatment Centre Redevelopment P3 project in Ajax ON. We’re delighted to be part of the Children’s First Consortium which was named as one of the three teams moving on to the RFP stage for this 100,000+ ft2 greenfield project. The Grandview Children’s Treatment Centre will offer family-centred care for children and youth with physical, communication and developmental needs, and their families, in the Durham Region.

According to IO and Grandview, teams were shortlisted based on design and construction capability, experience, qualified personnel and financial capacity to undertake a project of this size and scope. The Children’s First Consortium prime team members are: Amico Design Build Inc. and Sacyr Construction S.A (Applicant Lead); Parkin Architects and HH Angus (Design Team); Amico and Sacyr ( Construction team); and Stonebridge Financial Corporation (Financial Advisor). 

Source Link: https://www.infrastructureontario.ca/Short-Listed-Proponents-Named-Children%E2%80%99s-Centre-Redevelopment/

Interior of the St. Joseph’s Health Centre, Mental Health Emergency Services Unit

The Mental Health Emergency Services Unit at St. Joseph’s Health Centre is the recipient of a 2020 Toronto IES Illumination Section Award. Congratulations to St. Joseph’s and the entire design team! HH Angus’ Lighting Design group was proud to have been involved with this project.

Energy-efficient LED lighting, complete with remotely located dimming controls, replaced the old, inefficient fluorescent fixtures. Remote control of lights in patient rooms provides increased staff security and convenience, and minimizes disturbance to patients. The design team consulted with hospital clinical staff, the architect and best practices in Mental Health design in order to provide tamper-proof and anti-ligature versions of lighting fixtures, M&E devices, and services. 

Click here to read more about the full scope of this project and some of its interesting design challenges.

Hospital entrance in Africa

Earlier this month, HH Angus teamed up with Parkin Architects as part of a global group of volunteer healthcare designers organized through a partnership between the World Health Organization (WHO) and the International Federation of Healthcare Engineering (IFHE). 

These volunteers respond to requests from the WHO to quickly create design documents for emergency facilities to help hospitals and nations respond to the COVID-19 pandemic.

We were honoured to have the opportunity to contribute in the global efforts to battle the spread of COVID-19 with our most recent endeavour in Doba, Chad – nearly 10,000 km away from Toronto. Our mandate was to provide design guidance for the repurposing of three existing medical buildings into a facility with one building to handle suspected COVID-19 patients (those awaiting test results), and two buildings for inpatient treatment of COVID-19 positive patients. Our team followed WHO guidelines and provided the optimal design solution for patient care and the safety of staff and visitors, while balancing speed of constructability and simplicity of operation. We proposed several alterations to the existing buildings to address improved patient, staff and visitor circulation in order to mitigate spread of COVID-19, as well as changes to washroom facilities, expansion of the exterior open air arcade (covered walkways), additional doors, partitions and ante rooms.

A hybrid ventilation system was proposed where supply air for all rooms is provided using natural ventilation through building windows, and exhaust fans draw air from the patient rooms using an overhead duct system. The design of critical and severe patient rooms included an anteroom to provide a physical barrier to mitigate the risk of air transferring from the patient room into the corridor.

Despite the uncertainty that COVID has created for many industries, we’re appreciative that we can contribute our knowledge and expertise in healthcare design to help construct facilities to combat this pandemic in regions that may not have access to the same level of resources as we have in Canada.

Our HH Angus team, comprised of Michael Botros, Jessica Generoso, Laura Sisson, Kim Spencer and Tim Zhu, collaborating with Parkin Architects, put together a thoughtful design solution and report for the client, working to their key considerations on a short timeline (7 business days from beginning to end). It was a rewarding experience for our team and we’re looking forward to the next assignment!

Exterior view of the COVID-19 outbreak Response Facility
Exterior view of the COVID-19 outbreak Response Facility

Images credits: Daga/ Google

As the economy slowly re-opens, businesses need to plan for restarting operations. Those who require their staff to work in a common location will need to ensure their employees, customers and partners feel safe and can trust that they will be returning to a healthy and clean work environment, both for the near future and for potential second or third waves of infection.

The spread of COVID-19 is generally understood to be through close proximity – by respiratory droplets and aerosols created when an infected person coughs, sneezes, sings, shouts, or talks,  and surface transmission. Transmission through HVAC systems is not adequately tested or documented, and available resources (such as ASHRAE) appear to favour an abundance of caution in making any recommendations due to this lack of testing. Our engineers and technology strategists have been exploring the impact of COVID-19 on building design. Here are some considerations for building owners and tenants.

Improving Air Quality In a typical office building, indoor air is comprised of roughly 25% outdoor air. The rest is recirculated and filtered. It will be important to understand what upgrades may be necessary for the building’s HVAC and Building Automation System (BAS), as well as current and emerging technologies to enhance these systems. Simple building operation and system adjustments A first stage of re-entry can include the following, relatively simple adjustments to normal building operation:

  • Assess the amount of additional outdoor air for occupied and unoccupied modes of operation to permit increased air exchange in the tenant areas and disable demand-controlled ventilation schemes.
  • Review the volume of additional outdoor air that could be added to the system based on current system capacity and further open outdoor dampers to eliminate or reduce recirculation. In milder weather, this does not necessarily affect thermal comfort or humidity, but will become more difficult in extreme weather.
  • Assess the site for possible addition of energy recovery units to offset some of the operational costs associated with an increase in outdoor air.
  • Make necessary adjustments to building control sequences and changes to set points, such as humidity, to allow for temporary flushing or extended operation of systems.

Design and selection of various filter options for your air handling systems

  • Investigate solutions to retrofit or add enhanced filter technologies in existing air handling systems such as higher MERV-rated filters, High Efficiency Particulate Air (HEPA) filters, Active Particle Control filters, UVGI, and Bipolar Ionization.
  • Consider portable room air cleaners with HEPA filters.
  • Active Particle Control technology filters are claimed by their manufacturers to create collisions on a sub-micron level. This causes smaller particles to collide and stay together becoming larger, and providing the ability to collect the larger particles within normal MERV 13 or higher filters.
  • Consider ultraviolet germicidal irradiation to safely and effectively reduce bacteria, viruses and allergens, particularly in high-traffic areas such as lobbies, elevators, and cafeterias/kitchens.
  • Bipolar Ionization may also be a beneficial solution to improving air quality. Manufacturer literature states that it inactivates viruses and creates positively and negatively charged ions that attract to other particles and become bigger and heavier. These bigger heavier particles can now be better trapped by MERV 13 or higher-rated filters. Also, many small particles that are generated within a space will drop to the floor quickly, taking them away from where we breathe. It is imperative to understand that the above changes to system operations and addition of certain filter technology will have an associated impact to energy use and cost.

Cleaning of systems

  • Consider probiotic cleaning of existing coils and other components in contact with air streams.
  • Consider swabs of air handling unit interiors after cleaning and instantly test for presence of Covid-19.
  • Consider use of mobile and local air-cleaning solutions in congested areas.
  • Re-start and re-establish safe drinking water supply.
  • Establish process, protocols, and testing requirements for domestic water systems that have been stagnant during the COVID pandemic.

Technologies for Infection Control in Buildings  There are various technologies currently in use or emerging in the healthcare sector that could benefit and be applied to commercial real estate buildings. Real-time locating and monitoring systems

  • Hand hygiene compliance–technology such as infrared can be used to better monitor hand hygiene. Can be deployed at hand-washing stations and bathrooms.
  • Contact tracing apps can create a contact history log, based on location. They can allow you to accurately track the interactions between people, the facility and equipment. Knowing this information can help to slow the spread of the infection. However, there are privacy implications involved with contact tracing apps which should be carefully considered.
  • Occupancy sensors provide real-time information on occupancy and location to indicate whether social distancing or occupancy limits are being respected.
  • Building owners and tenants can also send instant communications and alerts through a mobile app to occupants, and provide information to first responders in case of emergencies, including specifying the exact location of the emergency.

Cleaning

  • UV lighting technology has improved to the degree that it can sanitize an unoccupied room in a few hours.
  • Cleaning robots (currently used in some hospitals) may become normal procedure to clean office buildings or hotels in off-peak hours.
  • Occupancy sensors can notify cleaning crews (or the aforementioned robots) that a particular area is vacant and can be sanitized before next use.

Touchless (Hands-free) control

  • To minimize potential infection from contaminated surfaces, occupants could utilize mobile apps (through their smartphones) to control security access/opening doors and elevator call. This could be rolled in with existing space management apps used for boardroom booking and office hoteling – which also play a role in effective social distancing.
  • Automated or proximity sensor door opening technology.

Social distancing

  • To better practice social distancing in the office environment, occupants may prefer to access amenities such as ordering food, dry cleaning notification, building gym occupancy, transit alerts and ride sharing services through an app – possibly one provided by the building owner that integrates in-building amenities and other local services.
  • Automated social distancing alerts through wearable technologies or smartphone apps.
How HH Angus Can Help Whether you are a building owner or tenant, we can help you plan your operational restart strategy. Specifically, we can:
  • Assess your HVAC systems and explore ways to minimize the impact of virus aerosols.
  • Work with the Facilities team to appropriately optimize building systems and controls.
  • Investigate and recommend technologies that can help mitigate the spread of infectious disease through sanitization, monitoring, social distancing and other means.
HH Angus has been involved in the design of healthcare facilities (both new construction, renovation/retrofits, expansions and maintenance) for over 75 years. We are a leader and innovator in all aspects of healthcare design. Our knowledge of hospital design and how to address challenges such as infectious disease control can be effectively leveraged into other sectors such as office buildings, retail, hospitality, educational facilities, airports, transit stations, entertainment centres and more. As well, many of HH Angus’ technical staff are actively involved in committees and associations that are continually developing industry standards for construction and renovation, including the CSA’s HVAC Standard, and the Catastrophic Events section of CSA Z8000 – Canadian Healthcare Facilities. On the technology front, our Angus Connect division is focused technology, including smart buildings technology, and is a leader in providing technology strategy and implementation in healthcare facilities. To learn more contact:

Kevin O’Neill, P.Eng., LEED® AP
Commercial Director
kevin.oneill@hhangus.com