U.S. Infection Control Could Learn From Europe

Posted on November 7, 2012

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Many architects dismiss vendors who want to come to their firm and pitch their wares. Not me. I find vendor presentations an easy and rewarding way to keep up with industry products—and not just because of the CEUs and free lunches. I especially like to attend lunch-and-learns on products that are not healthcare related, to make sure healthcare is benefiting from the same innovation in other industries.

Last month Corro-Shield International, a company specializing in floor and wall resinous coatings primarily for industrial applications, came to Haskell. What I derived from the presentation was eye-opening.

Right now, healthcare in the United States is at war with hospital acquired infections (HAIs), which cost the industry $35 billion a year from nefarious organisms like MRSA and C.diff.  This is important because HAIs are not supposed to happen and are uncompensated care (i.e. not paid for) for hospitals, yet a handful of strains continue to plague hospitals and raise insurance claims for HAIs each year.  It is a growing and expensive problem with everyone from the custodial staff to doctors to construction teams verifying they are following the most sterile protocol they can in doing their jobs in a hospital. And still HAIs develop.

Outside of healthcare, Haskell does a significant amount of work for food and beverage clients in the U.S., names you would recognize on the snack and drink shelves in your local supermarket. The level of design detailing in food preparation areas is very important to a company that trades on its name as a reliable purveyor of edible products. Reports of contaminated meat or E.coli in the news can wreck the company associated with the quality lapse.

Interestingly, infections acquired at a hospital, the equivalent of a Salmonella outbreak at a dairy farm, have been kept largely out of the public eye. One of the reasons is because, unfortunately, it is not that rare an occurrence.

Food processing environments can be very strict in regard to cleanliness. Anyone who has ever designed food preparation areas knows how stringent an inspector can be, like with the welds on the kitchen hoods. What Corro-Shield mentioned in their presentation was that Europe is leading the way in requirements for thwarting contaminants in food processing and pharmaceuticals.  In my opinion, those two industries are especially relevant to U.S. healthcare when it comes to learning how to prevent unfavorable outcomes from lack of cleanliness.  

Based on upcoming standards to be instituted, European food service and pharmaceutical companies will need to more carefully consider floor, wall and ceiling systems in certain areas to promote easy cleaning and decontamination. For instance, cove (rounded, non-90 degree) corners at floor, wall and ceiling intersections, and the use of naturally, anti-microbial materials are soon to be required. Surfaces with any irregularities that could promote dirt accumulation would be verboten. Clean rooms, which are often used in other industries including pharmaceuticals, are another good place to borrow ideas for healthcare.

Based on Corro-Shield’s presentation, it was clear to me hospitals are laggards on the design and maintenance of interior environments to control infections. Sterility aside, there is no reason an operating room should not be more like a clean room. If a company that makes pills feels a clean room is worth the investment, then an institution whose job is to ‘first do no harm’, and also provide care to heal patients, should surely feel at least a handful of spaces within are worth a similarly rigorous approach to contaminant containment.

The healthcare industry would do well to borrow more from other industries, particularly if it will affect healthcare code regulations. This notion of industry cross-pollination has come up previously in regard to system redundancy design for hospitals versus how other industries design and build to prevent disruption to their operations. 

Hospitals must make smart investments in every aspect of their business to succeed. Having an industry-leading record on HAIs no matter where the best practices come from, would be an excellent outcome. Choosing a company that knows both industries to properly design and construct your next project would be a great start.

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Posted in: Interior Design