This May will mark the two-year anniversary of when Chester County Hospital broke ground on an expansion and renovation project spanning more than 300,000 square feet that will enlarge the existing Emergency Department and add state-of-the art operating rooms, interventional hybrid/procedure rooms and a 99-bed patient tower. Construction is expected to be completed by 2020.
A project of this magnitude under ordinary circumstances, like building and renovating office complexes or retail malls, is loaded with logistical challenges. That it’s unfolding on an operating hospital campus complicates even the most straightforward details.
“Things that are somewhat easy in typical construction projects, like taking the trash out and minimizing dust, become more difficult,” says Charlee Faucette, MT, director of Infection Prevention at Chester County Hospital. “Just like in a home, dust can be problematic in hospitals, so we’re taking extra precautions like covering carts, creating trash chutes and anterooms, and wiping everything down to ensure nothing is brought from the work areas into the hospital. Any measure we can take to keep the dust inside (the construction area), we do.”
The anterooms are negative pressure barriers between the hospital and the construction area. Shoe booties and spray materials are used to prevent dust or debris from sticking to the wheels of carts or boxes that come in and out of the work area. Sticky walk-off mats that remove dust or debris from the shoes of people entering and exiting are also placed at all transition points between the site and the hospital.
Experience and Commitment to Patient Safety
“Chester County Hospital has always prioritized its patient-centered culture with a diligent focus on quality, and safety,” said Kathy Gorman, senior vice president of Strategic Planning and Marketing for Chester County Hospital. “Many of our routine processes were modified before construction even started.”
Chester County Hospital is working in partnership with contractor LF Driscoll to combat these known risks and put patient care at the forefront of the expansion. This is nothing new to either organization, though. Just four years ago the hospital worked with Driscoll to complete the addition of the Lasko Tower, a four-story addition that houses the Mother Baby Pavilion, an Orthopaedic Unit, Radiation Therapy Suite and a Telemetry Unit.
“When we were building Lasko Tower in 2014, there were times when we stopped construction to accommodate patient needs,” Faucette said. “During a project we will continually work with the construction firm to know what to expect and minimize any disruption to care, either by halting construction or moving patients to areas that are away from the work being done.”
Faucette serves as the hospital’s infection control liaison throughout construction. She conducts periodic site checks of the project to ensure the work and maintenance remain in compliance with the standards that were established at the start.
LF Driscoll also trains its own infection control specialists with a curriculum that closely follows the topics covered in the American Society of Healthcare Engineers (ASHE) Certified Healthcare Constructors exam.
The heavy lifting before and during the construction
During initial meetings to plan the huge construction project, a multidisciplinary group established a Pre-Construction Risk Assessment (PCRA), which described in detail every aspect of the project so the team could create a comprehensive strategy that addressed how the work would be done and the safety measures that would be necessary. The immediate construction site is not all that’s accounted for in the plan, either. Each corridor that borders it above, below, and on all sides were also evaluated.
“That’s where we really got into discussions with the hospital to understand who our neighbors would be during this project and what processes we could implement to eliminate any risk,” said Colin Burke, project manager at LF Driscoll.
Faucette said the key to a successful construction plan is the multidisciplinary coordination. All partnering organizations need to have a strong understanding of the other’s expertise. Faucette and other hospital staff involved in the project need to know a great deal about the processes that will take place in each step of the construction plan in order to assess and minimize risk.
“We all bring different knowledge to the table and collectively, we pretty much think of everything,” Faucette said.
The hospital is also mindful of the importance of ensuring continued operations during construction. “We focus on all aspects of the hospital when any type of construction, or even a minor update to the facility, is proposed,” Faucette added. The hospital ensured interim safety measures were in place prior to the start of the project, including fire safety, updating signage, running drills for traffic pattern changes, and educating staff on how to redirect people to safety in the event of an emergency.
From the PCRA, individual Infection Control Risk Assessments were created for each location and phase of the project.
“By identifying and addressing the various levels of risk related to the patient and visitor areas impacted by the construction,” said Gorman, “we are proactively providing our community of employees, patients and visitors with a safe environment.”