Healthcare

Features expected
A number of Ideation sessions to capture from an invited panel of sector experts the most relevant and current issues in Health care buildings. The output of these sessions was a series of 6 problem statements and for each statement, the implications of the problem, a solution proposal and the benefits of our proposed solutions were considered. The results are set out below and informs of some current high-level issues that could form part of any discussion and the solutions available.

Patient Enviroment
What is the problem: Rising need for social distancing and space segregation; reduced recovery times and higher bed capacity; Lack of resources to invest in high-quality care provision in state-financed projects; Incidents in medical facilities due to medical staff inefficiency (e.g., manual set up of environment).
Proposed solution: Human centric lighting; Improved air quality and ventilation; Remote monitoring and management of patient's environment by medical staff.
Implications of the problem: Negative impact on healing process; Lack of exposure to the sun's spectrum disturbs the Human Circadian System which is fundamental to our physiology and controls much of our behavior; Negative impact on medical center reputation and financials.
Benefits of Solution: Optimised conditions for improved healing process (experience); Efficient performance (automated functions) and improved cost profile; Improved intervention time from medical staff in case of unforeseen urgency.

Maintenance and system monitoring
What is the problem: The cost of downtime for not delivering healthcare; business continuity; Cybersecurity (IT and OT layers); Overloaded existing electrical system; Connectivity and interoperability with other systems.
Proposed solution: Data driven real-time monitoring and proactive intervention; Condition-based maintenance vs time-based maintenance, predictive maintenance; Electrical system resilience, redundancy, monitoring; Remote monitoring capabilities; M&T, FDD.
Implications of the problem: Overloaded exiting electrical system resultant safety issue; Unscheduled system failure where no redundancy is provided.
Benefits of Solution: Reduced intervention time to ensure minimum downtime and first-time fix; Asset life-cycle management; Proactive and predictive maintenance.

HVAC management
What is the problem: Most medical areas will require environmental conditions to be maintained 24/7 requiring dual systems, continuous monitoring and alarm activation; HVAC set values such as air pressure, temperature, air quality and airflow need to be maintained to maintain patient comfort and infection control, requiring continuous monitoring and adjustment.
Proposed solution: Advanced DDC control of HVAC plant.
Implications of the problem: Spread of airbourne infections; Patients put at risk while in healthcare environment; Hospital reputation and financials at risk; Hospital unable to reconfigure spaces in case of emergency and unforeseen crisis
Benefits of Solution: Rapid changes in system configuration; Continuous monitoring, control and recording; Alarm handling and prioritisation; Asset life-cycle management; Proof of meeting statory requirements.
    General HVAC Considerations: Hospitals include different purpose areas, some with specific air treatment requirements.  COVID-19 trends include hospital need for clear zoning – separation of “clean” and “dirty” areas, also with the help of HVAC. HVAC play an important role not only by maintaining comfort, but also creating a clean, germ-free environment for patient well-being and prevention if decease spread. General fresh air treatment occurs for common areas like lobbies or corridors; Increased filtering is applied for operating theaters. Surgery rooms can also use ultraviolet light to disinfect the air; Often operating theaters are kept at positive pressure to prevent the leaks of contaminant air from outside; Hospital units for patients with infectious-contagious diseases are usually kept at negative pressure to prevent the spread of contagious air from inside out; Hospital infection units also require the filtering of outgoing air before it leaves the building.

CO2 emissions and Cost Efficiency
What is the problem: Being able to demonstrate achievements of statutory requirements and local governance; Budgetary pressure to reduce OpEx; Governmental programs around carbon neutrality.
Proposed solution: Provision of renewables; EVCI; Energy and Asset manager.
Implications of the problem: Penalty costs; Extra running costs; Local environmental pollution; Reputational impact; Long term health. 
Benefits of Solution: Long-term sustainability; Corporate accountability.

Space Utilisation
What is the problem: Need for optimising space utilisation (extensions and brownfield development); Flexibility in space usage, accommodate space requirement changes; More equipment and infrastructure required in hospitals, but space availability hasn't grown to accommodate.
Proposed solution: Optimise space utilisation through modular equipment and retrofit packages.
Implications of the problem: Rising trend for extensions to accomodate new technology and digital equipment; Increased use of temporary hospitals, for instance modular operating theaters, specialised units etc.
Benefits of Solution: Flexibility to allow adds moves and changes Resilience; Holistic system management; Minimal footprint of equipment; Flexibility at no extra costs.

Telemedicine
What is the problem: Day-surgery helps to reduce the need for long-term bed capacity and to optimise recovery times; Caring for patients' recovery and other vulnerable people living in the community.
Proposed solution: Home/room automation to provide real-time data and control; Environmental monitoring (water flow, electrical loads allowing Al and ML).
Implications of the problem: Lack of appropriate and monitored environment outside hospital for convalescence, recovery and long-term care; Increased hospital bed requirement where home could be an option.
Benefits of Solution: Patient recovery outside of hospital environment; Reduced costs and freed up beds Noncritical long-term care at home could be provided.

Collaborative Robotics
What is the problem: Shortage of skilled workers; Rising costs, affordability of care; ageing population; Rising patient expectations.
Proposed solution: Laboratory and pharmacy automation; Logistics and intra-logistics management; Robotic-assisted surgery or recovery.
Implications of the problem: Cost of hiring, turnover, training needs; Just in time management; m2 optimisation.
Benefits of Solution: Quality and security; Productivity; Efficiency.

Circulations spaces
Areas: Lobby, stairs, corridors.
Building applications: Lighting control system, shading control system, diming control system, HVAC Control system, emergency lighting/central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: Optimised use of energy, space occupancy efficiency, optimise use external brightness, reduced carbon emission, reduced fan motor noise, more comfortable air quality & temperature environment.

Critical care areas
Areas: Operating theatres, specialist therapy, diagnostic centre (X-ray, MRI’s, endoscopy etc.), pre & post operation wards, high dependency units, birthing Unit, cardiac Unit (Angiography), coronary Care Unit (Epidemic Room), ITU intensive care unit, high dependency Care.
Building applications: In room controls, HVAC Control & alarm monitoring, isolation room integration, emergency lighting /central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: More comfortable air quality & temperature environment, critical equipment monitoring & predective maintanence, fireman’s override feature making ventilation applications ignore faults and warnings during emergency and run until destruction ensuring smoke extraction and evaluation route maintenance if possible for the hospital occupants’ highest safety, clean air circulation throughout critical hospital areas, tighter control over temperature changes.

Treatment units
Areas: Minor treatment rooms, A&E suite, mobile health unit, audiology, orthodontics, opthalmy, diabetics unit, ENT ear/ nose & throat, EMU, fracture clinic, hematology, orthopedics, podiatry, urology, hand and wrist unit.
Building applications: Lighting & diming control, HVAC control & alarm monitoring, emergency lighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: More comfortable air quality & temperature environment, simple & user friendly controls (touch screens, scene controls, etc..), critical equipment monitoring & predictive maintanance, fireman’s override feature making ventilation applications ignore faults and warnings during emergency and run until destruction ensuring smoke extraction and evaluation route maintenance if possible for the hospital occupants’ highest safety, optimised use of energy & Space occupancy efficiency.

Medical rooms
Areas: Counselling, consultation, examination, diagnosis, pain management, physiotherapy.
Building applications: Lighting & diming control, HVAC control & alarm monitoring, emergency lighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: More comfortable air quality & temperature environment, simple & user-friendly controls (touch screens, scene controls, etc..), critical equipment monitoring & predictive maintenance, fireman’s override feature making ventilation applications ignore faults and warnings during emergency and run until destruction ensuring smoke extraction and evaluation route maintenance, if possible, for the hospital occupants’ highest safety, optimised use of energy & Space occupancy efficiency.

Ward areas
Areas: Ward areas general, ward areas premium single room.
Building applications: In room controls & electrical accessories, HVAC control & alarm monitoring, isolation room integration, emergency lighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: More comfortable air quality & temperature environment, simple & user friendly controls (touch screens, scene controls, etc..), critical equipment monitoring & predective maintanence, fireman’s override feature making ventilation applications ignore faults and warnings during emergency and run until destruction ensuring smoke extraction and evaluation route maintenance if possible for the hospital occupants’ highest safety, clean air circulation throughout critical hospital areas, tighter control over temperature changes.

Specialist support
Areas: Pharmacy, CSSD sterilisation, pathology, laboratories (microbiology, Phlebotomy), mortuary, medical equipment, occupational therapy.
Building applications: Lighting & diming control, HVAC Control & alarm monitoring, emergency lighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management, isolation room integration.
Benefits: Critical equipment monitoring & predective maintanence, clean air circulation throughout critical hospital areas, tighter control over temperature changes, real time motinoring & alarm, conditional monitoring & Predictive mainatance.

Services areas
Areas: Medical gases, electrical switch rooms, generator rooms, incinerators and disposal, laundry (medical), patient kitchens.
Building applications: Power protection, UPS, lighting & diming control, HVAC control & alarm monitoring, emergency lighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management, isolation room integration.
Benefits: Critical equipment monitoring & predective maintanence, clean air circulation throughout critical hospital areas, tighter control over temperature changes, real time motinoring & alarm, conditional monitoring & predective mainatance, optimised use of energy, reduced carbon emission, reduced fan motor noise, seamless intergation with healthcare equipements, ospital areas, tighter control over temperature changes. 

M&E services
General M&E Areas: Waiting areas, libraries, education, offices, crèches, retail pharmacies, cafés.
Specific M&E Areas: Swimming pools, gyms, kitchens, restaurants, car parks.
Building applications: Lighting control System, shading control System, diming control System, HVAC control system, emergency ighting/ central battery system, variable speed drives & motors, central monitoring & control, energy management.
Benefits: Optimised use of energy, space occupancy efficiency, optimise use external brightness, reduced carbon emission, reduced fan motor noise, more comfortable air quality & temperature environment.