Are You in the Know About Construction & Renovation within Your Facility?
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1 Are You in the Know About Construction & Renovation within Your Facility? Hajira Hafeez, BSc. Infection Control Practitioner Toronto East General Hospital Date: June 5, 2015
2 Conflicts There has been no financial support for this research project
3 How do you know about Construction work in your facility?? How many of you are missing or are not invited to the pre-planning stages of Construction work in your facility? Who feels they are usually involved when the Construction work has already started? Who feels that they find Construction work on their way to the cafeteria?
4 My Journey Read up on the CSA and CHICA/IPAC resources Made site visits and talked to other ICPs from other facilities Researched how other hospitals involved Infection Prevention and Control (IPAC) in pre-renovation work One Common theme: Most ICPs are not involved in the crucial stages!!!
5 My Journey What I realized was: Every hospital has it s problems A structure in how to bridge those gaps was lacking
6 So What Do You Do When You Need Help??
7 Solution: CAA Customize Awareness Accountability
8 Customize Lets make the contractors life easier and hardwire a structured system: Pre-determine each area of the hospitals group level Incorporated IPAC tool in the Hospitals Contractor Manual An IPAC one-on-one pre-renovation session with the Project Manager was mandated 1. Infection Control During Construction, Renovation, and Maintenance of Health Care Facilities. Canadian Standards Association (2007). Tables 1-3
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11 Area X Area X Area X Area X Area X A6 (Group 2) C6 (Group 2) E2 (Group 1) G7 (Group 3) J7 (Group 3) A5 (Group 3) C5 (Group 2) E1 (Group 3) G6 (Group 3) J6 (Group 4) A4 (Group 1) C4 (Group 2) EB (Group 1) G5 (Group 3) J5 (Group 3) A3 (Group 3) C3 (Group 2) G4 (Group 3) J4 (Group 1) A2 (Group 1) C2 (Group 3) F5 (Group 1) G2 Rehab (Group 2) J4 Catering (Group 3) A1 (Group 1) C1 (Group 1) F4 (Group 1) G2 Pacemaker clinic (Group 4) J2 (Group 4) AB (Group 1) CB (Group 1) F3 (Group 3) G1 Pediatrics (Group 3) J1 (Group 3) F2 Endoscopy(Group 3) G1 (Group 2) JB (Group 1) B6 (Group 4) D6 (Group 1) F2 Pre-op (Group 2) GB Pharmacy, CPD (Group 4) B5 (Group 3) D5 (Group 1) F1 minor surgery (Group 3) K 3 & 4 (Group 1) B4 (Group 2) D4 (Group 3) F1 (Group 1) H7 (Group 3) K2 (Group 4) B3 (Group 3) D3 (Group 1) FB (Group 1) H6 (Group 2) K1 (Group 3) B2 (Group 4) D2 (Group 3) H5 (Group 2) KB (Group 4) B1 (Group 1) D1 (Group 2) H4 (Group 3) BB (Group 1) DB (Group 1) H2 (Group 3) H1 (Group 3) HB clean linen area (Group 3) HB (Group 1)
12 Awareness Getting everyone else in the know Post the permit on the construction site IPAC contact information on permit Finally a weekly meeting with the Maintenance Supervisor/Manager
13 Accountability Let s get key players involved and create accountability Construction Education training day IPAC Construction Permit must be held by any Contractor doing work within our facility Our tool required the Contactor/Project Manager to acknowledge and sign off on required class of Construction Activity A check list of what is required for that class of Construction Activity 2. Construction & Maintenance Infection Control in Healthcare Facilities. Pinchin Environmental (April 2013)
14 Construction Activity Date Location Description of Project Signed PM Contact Permit Approved Hording Contractor Notes 13-May 15-May-13 J6- Resp. Storage / Office Space Replace re-heat valves x Faye Baisley ext Y 3&4 May-13 A1- Tim Hortons Kiosk New Tim Hortons Kiosk x Doug Brown Y 3&4 Select Cowst 15-May-13 J6 Corridor- Doctors Lounge Receptable Installation x Faye Baisley ext Y 3&4 15-May-13 H2 Lab Investigation Work x Faye Baisley ext Y 1 16-May-13 H7- All Patient Washrooms Vent/ Grill Cleaning x Faye Baisley ext Y 3&4 13-Jul 12-Jul J2 - CCU Floor Removal x Rene Ellinas ext Y 3&4 Maystar Hording needs improvements 18-Jul-13 West Foyer West Foyer Gut + Reno x C. Heesters Y 2 Hady Issues with compliance with hording - Concrete cutting incident 13-Sep 17-Sep-13 Dialysis ISO Rooms Mould Abatement x Faye Baisley ext Y 4 Coast to Coast 27-Sep-13 K1 Corridor,Mamo, Lounge Electrical- new installation x Faye Baisley ext.3199 Y 3&4 TEGH 27-Sep-13 A3 Soiled Utility Mould Abatement x Faye Baisley ext.3199 Y 3&4 Capital Constructors 27-Sep-13 H526 Ducto work investigation x Faye Baisley ext.3199 Y 3 TEGH 27-Sept-13 A3 Clean Utility Mould Abatement x Tony Martine ext.6497 Y 3&4 Capital Constructors 13-Oct 03-Oct-13 A3 Clean Utility Finishing Work x Faye Baisley ext.3199 Y 3&4 Maystar 13-Nov 12-Nov-13 D619-D618-D617 Demoing walls(opening walls for a door) x Carmen Mariano Y 2 Embassy Works well with IC 12-Nov-13 D600 Painting x Carmen Mariano Y 1 Embassy No Sanding 12-Nov-13 Basement F004 Remove tiles x Carmen Mariano Y 2 Embassy RemovetToilets.sinks,putting up 12-Nov-13 C4 Building Walls x Carmen Mariano Y 3 Embassy 13-Dec 04-Dec-13 F1 Demo,Closing up Doors x Carmen Mariano Y 3&4 Embassy 14-Jan 13-Jan-14 G1 Corridor Electrical work x Tony Martino Y Duplex 14-Jan-13 H4 Electrical work x Tony Martino Y Duplex 16-Jan-13 J2 Corridor Electrical work x Tony Martino Y 3 Duplex 29-Jan-13 G5 Floor Removal x Mike Hayne Y 3&4 Duplex Remove and Install carpet
15 Quality Improvement SURVEY In January 2014, a survey of all hired Contractors revealed From May 2013-January 2014 our hospital hired 5 different Construction Companies Question 1: Have you ever done Construction or Renovation work in a hospital before?
16 Results 4 out of 5 Contractors were NEW to Construction & Renovation in Hospitals
17 Quality Improvement SURVEY Question 2: On a scale from 1 to 5 (1 being the lowest and 5 being the highest) How would you rate the overall method of using a Permit? Results: Out of a total possible score of 25, our hospital scored 23
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19 Quality Improvement SURVEY Question 3: On a scale from 1 to 5 (1 being the lowest and 5 being the highest) How would you rate the function and personalization of the IPAC Surveillance tool?
20 Results Out of a total possible score of 25, our hospital scored 25
21 Lessons Learned Misconception that contractors are experienced in IPAC guidelines Lack of structure and consistency between hospitals A team approach is best
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23 In Conclusion When you use CAA: The ICP is able to achieve a sense of transparency which was found valuable in creating a system in where the ICPs no longer needed to look for Construction Projects it came to them!
24 Special Thanks!!! Hospital s Referred to: Catherine Harlton-Strezov Mackenzie Health Paula Raggiunti & Jayshree Somani - Rouge Valley Hospital Kasey Gambeta - St. Michael s Hospital Toronto East General Hospital: Faye Baisley, Maintenance Supervisor Tony Martino, Facility Services Manager Janice Ward, RN, Manager, Organizational Quality & Safety James Downey, PhD, MD, FRCPC Infection Control Officer Consultant in Infectious Disease
25 Questions???
26 References 1. Infection Control During Construction, Renovation, and Maintenance of Health Care Facilities. Canadian Standards Association (2007). Tables Construction & Maintenance Infection Control in Healthcare Facilities. Pinchin Environmental (April 2013)
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