While treating the coronavirus is still a primary focus for healthcare facilities, one thing is becoming clear–-We are shifting away from Covid-19 being considered a global emergency. The World Health Organization (WHO), the agency responsible for international public health, has stated the pandemic is at a “transition point.” On April 11th, the U.S. government signed a resolution to end the national emergency.
Even though significant progress has been made in treating Covid-19, the World Healthcare Organization urges healthcare organizations to be cautious, stating:
“There is little doubt that this virus will remain a permanently established pathogen in humans and animals for the foreseeable future. As such, long-term public health action is critically needed.”(source)
During the pandemic, the team at CHT worked with many healthcare facilities experiencing sudden surges in patients and medical gas usage. To help create more resilient healthcare systems, we have compiled a list of 5 lessons learned from the pandemic.
5 Lessons Learned from the Covid-19 Pandemic
During the pandemic, the influx of patients, some of which required oxygen therapy, placed an immense strain on healthcare facilities and their medical gas systems. Many facility managers are still concerned about whether their systems are sufficient enough to handle another surge in usage.
Listening to these concerns has allowed us to identify how healthcare facilities successfully adapted to handle the pandemic and where facilities have room for improvement. The 5 lessons learned from the Covid-19 pandemic are:
Let's begin with the most overarching lesson learned throughout the pandemic.
Healthcare Flexibility is Vital
Healthcare managers, administrators, providers, and supporting staff saw how being flexible allowed them to adapt to the demands of the pandemic. Being flexible allowed them to meet staffing needs, manage patient care, and adjust available resources and support distribution.
As healthcare facilities handled constantly changing protocols and regulations regarding the handling of Covid-19, managers were forced to be flexible. This flexibility allowed them to implement changes quickly, which led to better patient outcomes.
But how do healthcare architects and engineers perceive flexibility?
They look at facility spaces, layouts, and medical gas systems and evaluate their ability to adjust. Researchers, breaking down flexibility in healthcare design even further, have identified three key aspects. These aspects and how you can use them to identify areas for improvement are as follows:
- Adaptability: Evaluate your healthcare facility's ability to accommodate increases in different treatment modalities without changing the surrounding environment. Confirm you have at least 2 times the estimated amount of gas to back feed your system and that your back feed system meets all NFPA99 requirements.
- Convertibility: Look into your facility's ability to create temporary isolation rooms. Does the potential location of temporary rooms allow healthcare workers to provide care effectively? Are there better areas for future temporary rooms that may reduce staff travel time to supplies or the risks of contamination with surrounding, possibly high-risk populations?
- Expandability: Can your facility's medical gas systems expand to meet potential surges? Assessing your medical gas system can reveal cost-effective ways to make your system more cost-efficient.
Future healthcare facilities are being designed to maximize the building's ability to meet these aspects of flexibility. However, flexibility can still be optimized in existing facilities. Looking back at areas where your facility struggled and why that was can seem overwhelming but doing so can allow you to produce better patient outcomes.
Related Content: Managing patient flow should be flexible. Many facilities have implemented new strategies to do so, like working with surrounding hospitals to help patients get care in a timely fashion. Read more in 17 Tips to Improve Patient Flow.
How To Reduce Medical Oxygen System Failure
The importance of having a scalable medical oxygen system and a sufficient supply of medical oxygen during the pandemic cannot be overstated.
The application of a high flow nasal cannula (HFNC) was used to treat severe cases of Covid. HFNC requires 5–10 times the amount of oxygen of more traditional oxygen delivery systems and can push the oxygen supply and delivery systems to their limit.
To understand how medical oxygen systems fail, we must look at how they transform liquid oxygen into a gaseous state.
To conserve space, medical oxygen is often stored in a liquid form, requiring it to maintain a temperature of around negative 300 degrees Fahrenheit. At the beginning of the delivery process, liquid gas is transformed into gas. This process is performed by a vaporizer, a device that heats liquid oxygen to the appropriate temperature.
Vaporizers can cause issues when oxygen flow increases to meet high demands. If oxygen demands exceed vaporizer capabilities, the low temperature of liquid oxygen can cause ice buildup on a facility's vaporizers, halting the flow of oxygen.
Hospitals that experience a decrease in oxygen flow often believe that their supply has been depleted. Now, understanding the weak link in the oxygen delivery chain, you can reasonably deduct that the vaporizers may just be experiencing excess ice accumulation.
Preventing ice buildup can allow you to avoid resorting to drastic measures, such as calling your local fire department to remove the ice.
Methods to prevent ice buildup include:
Monitor your vaporizers: During increased use, being aware of any ice can allow you to remove it by spraying it with water before decreased oxygen flow affects your patients.
Switch between vaporizers more often: Most hospitals have multiple vaporizers that rotate in and out of use. Switching more frequently, such as every 6 hours instead of twelve, prevents buildup.
Increase airflow around vaporizers: Promoting airflow, often with fans, around vaporizers keeps the surrounding air temperature more consistent, reducing the possibility of freezing.
Install electric or steam vaporizers: These vaporizers are much more resistant to ice build-up when compared to the ambient finned tube vaporizer, the most common type used in hospitals.
Related Content: While vaporizers are often the choke point in oxygen delivery systems, the pandemic highlighted other ways oxygen system failure could occur. CHT goes in-depth on vaporizer management and strategies for preventing treatment stoppages in Medical Oxygen System: Extraordinary Use and Strategies to Avert Failure
Be Prepared To Create Temporary Isolation Rooms
Negative pressure rooms, commonly called isolation rooms, are meant for single or double-patient occupancy and are designed to prevent the transmission of pathogens.
A room classifies as a negative pressure room when the air pressure inside a room is lower than the air pressure in the surrounding areas. By creating a low-pressure area, airflow becomes regulated, preventing the movement of airborne particles into high-pressure areas. When a door opens to a low-pressure room, air flows into the room but not out. Instead, the air is drawn out through filtered ventilation.
Many hospitals, needing to prevent the transmission of Covid-19, quickly surpassed the number of available isolation rooms and areas in their facility. As a result of pushing facilities past their limits, areas of improvement were brought to light.
Hospitals must be prepared to create temporary isolation rooms when the need for existing negative pressure rooms exceeds the amount available. Temporary isolation rooms present a practical and cost-efficient solution. Barriers allow for quick installation, are easily disinfected, and are great at preventing the spread of noise and dust.
The greatest benefit of temporary builds is the extra space they provide for patients.
When paired with a hospital ventilation system, temporary builds increase the number of isolation rooms in a hospital.
Identifying areas in your hospital that allow for the construction of temporary isolation rooms creates environment flexibility, namely convertibility, that will enable hospitals to succeed in treating future outbreaks.
Solve Problems With Technology
With the pandemic constantly creating obstacles for healthcare systems, technology did what it was meant to do. It solved problems.
Telehealth
The pandemic saw a rise in the use of telehealth, allowing providers to care for patients without an in-person visit. Telehealth regulations in the US, established during the pandemic, have been extended. The Consolidated Appropriations Act (CAA) of 2023 extends the temporary telehealth regulations until the end of 2024, but many experts believe telehealth is here to stay.
Integrated Data Sharing
Healthcare facilities made great strides toward creating a more connected healthcare system. In response to the stress placed upon individual facilities, they connected with surrounding healthcare systems to coordinate the treatment of patients. This allowed patients seeking care to be directed to available providers and increased the rate at which patients received treatment.
Sharing information also became critical for helping agencies track the spread of Covid and allowed these agencies to identify what practices hospitals are using to prevent it.
Additional Technological Advancements
The pandemic acted as a catalyst for medical technology advances.
Wearable medical monitoring devices saw increased use due to their ability to provide real-time insights into a patient's condition. Researchers from Stanford Medicine partnered with medical centers to create programs to use this data to detect early signs of infection.
In addition, a shortage of PPE and equipment components lead facility managers to implement creative solutions. Massachusetts General Hospital used 3D printing to produce much-needed face shields. Northwell Health was able to design a 3D printable adapter, able to convert a BiPap machine into a ventilator.
The Importance Of Ongoing Inspection, Testing, and Maintenance
Identifying weak points in your medical gas system can be complex. Without ongoing inspection, testing, and maintenance, components that held up during the pandemic may fail during normal use or a resurgence.
Facility managers often face financial obstacles, like high fixed expenditures or waiting for funds to become available. Deferring inspection, testing, or maintenance as a short-term solution can have dangerous and costly consequences.
Postponing routine servicing for your medical gas system can allow a minor problem to escalate into a much larger issue, potentially causing complete system failure. It also opens up your facility to the possibility of fines from regulatory agencies, such as the CMS.
Above all, deferring routine inspection, testing, and maintenance poses a potential safety hazard to all occupants.
CHT's certified technicians conduct medical gas inspections and testing to help you meet NFPA 99 regulations, pass the Joint Commission and CMS requirements, and help prepare you for any situation.
Inspection, testing, and maintenance of your gas system must be conducted by a professional certified by the American Society of Sanitary Engineers (ASSE), per NFPA 99-2018, 5.1.12.11, which requires inspection and testing on all new piped gas systems, additions, renovations, temporary installations, or repaired systems.
Conclusion
While national and international agencies are moving towards considering the pandemic over, healthcare facilities must remain vigilant.
Covid-19 has prompted new facilities to be designed with flexibility in mind. Existing facilities can still benefit from assessing how they handled the pandemic and addressing their shortcomings.
While this can require thinking outside the box or reconsidering different aspects of your medical gas system, it can also be a time to evaluate your existing system and determine how to be better prepared moving forward. Working with certified professionals can open up avenues for improvement.
CHT's certified technicians conduct medical gas inspections and testing to help you meet NFPA 99 regulations, pass the Joint Commission and CMS, and help prepare you for any situation.
CHT offers medical gas services to help you reach your compliance goals. To help you navigate through these challenges, we offer a free 30-minute discovery call.
