Infection Prevention and Control's Role in the Design and Construction of a new Ambulatory Care Center. Lessons Learned

Abstract

BACKGROUND An urban, teaching medical center started designing a new 740,000 sq. foot ambulatory care center in 2013 with the Center scheduled to open in April 2018. Infection Prevention and Control (IPC) was included in the Planning and Design team, attending numerous meetings over the next 3?years. METHODS At project design meetings, IPC input was incorporated into all areas of the center including Infusion Services, Intervention Radiology, Endoscopy, Ambulatory Surgery, Central Sterile Processing, and Diagnostic Imaging. Input included, the number of Isolation Rooms, number and location of handwashing stations and hand sanitizers, construction materials and finishes, and work flow. IPC signoff of the final design was required for all areas of the Center. At the start of construction, because dust control measures were not needed, IPC was not included in the construction meetings. RESULTS Towards the end of construction, IPC joined in multidisciplinary weekly walkthrough of the various areas in the Center. Modifications and changes had been made to the design plans without input from IPC. Some of changes the included: Medication room counter use which encroached on the handwashing sink, locations of hand sanitizers, hot water circulating temperature and the addition of a second visual pressure monitor which in some instances was in conflict with the electronic monitor. To fix some of the changes required modification of the already built space. However, others could not be changed and resulted in a space that, from an Infection Prevention and Control perspective was not optmal. CONCLUSIONS Had IPC continued to attend project meeting during construction, many of the modifications that were made could have been prevented, or a better solution could have been designed. This experience has taught us that IPC should be part of all construction projects for the entire project.