In on the Ground Floor: Involving IP in New Hospital Design and Development

Abstract

Background Infection Prevention is a critical element underlying every aspect of the healthcare environment, but it is often overlooked during the design of a new facility, leading to decisions being made in a vacuum without proper expertise. By reversing this paradigm and involving Infection Prevention as a key stakeholder from the outset, far-reaching decisions can be made holistically, influencing everything from flow of clean and dirty equipment to placement of airborne infection isolation rooms and beyond. Methods To develop two new facilities for a major hospital system, leadership established a multidisciplinary team to shape a bottoms-up approach. Maturing from space allocation to department-specific requirements to operational logistics and the day-to-day user experience, this team is working to optimize design from a staff and patient perspective. Crucially, while this team incorporates representation on a unit-by-unit basis, it is founded upon a core group of system leaders, architects, and infection prevention and regulatory subject matter experts, ensuring a high standard of quality across the enterprise. Results Halfway through the initial design phase, this approach has yielded a number of pivotal decisions. For example, the team designated separate clean and dirty elevators while mapping a travel path to minimize cross-contamination. They provisioned for a breakdown room in departments with voluminous deliveries to segregate packaging material from clean supplies. They ensured that sanitization stations were logically allocated throughout each unit, removing barriers from the hand hygiene process. These and other choices would not have been possible without Infection Prevention being a foundational stakeholder. Conclusions The unique contributions enabled by this bottoms-up, multidisciplinary approach demonstrate that this paradigm for facility design presents distinct strengths. Establishing a core leadership group that prioritizes subject matter experts as key stakeholders inherently drives higher quality standards for facility development, and key lessons learned should be extracted and implemented for other large-scale construction projects. Infection Prevention is a critical element underlying every aspect of the healthcare environment, but it is often overlooked during the design of a new facility, leading to decisions being made in a vacuum without proper expertise. By reversing this paradigm and involving Infection Prevention as a key stakeholder from the outset, far-reaching decisions can be made holistically, influencing everything from flow of clean and dirty equipment to placement of airborne infection isolation rooms and beyond. To develop two new facilities for a major hospital system, leadership established a multidisciplinary team to shape a bottoms-up approach. Maturing from space allocation to department-specific requirements to operational logistics and the day-to-day user experience, this team is working to optimize design from a staff and patient perspective. Crucially, while this team incorporates representation on a unit-by-unit basis, it is founded upon a core group of system leaders, architects, and infection prevention and regulatory subject matter experts, ensuring a high standard of quality across the enterprise. Halfway through the initial design phase, this approach has yielded a number of pivotal decisions. For example, the team designated separate clean and dirty elevators while mapping a travel path to minimize cross-contamination. They provisioned for a breakdown room in departments with voluminous deliveries to segregate packaging material from clean supplies. They ensured that sanitization stations were logically allocated throughout each unit, removing barriers from the hand hygiene process. These and other choices would not have been possible without Infection Prevention being a foundational stakeholder. The unique contributions enabled by this bottoms-up, multidisciplinary approach demonstrate that this paradigm for facility design presents distinct strengths. Establishing a core leadership group that prioritizes subject matter experts as key stakeholders inherently drives higher quality standards for facility development, and key lessons learned should be extracted and implemented for other large-scale construction projects.