Tracking the sterility journey
Posted on 2 July 2019
At Mediclinic, we put our patients first from day one – new Mediclinic hospitals are designed with infection prevention and control in mind, long before construction begins. Amy Blaine, Architectural Design Team Manager: Mediclinic SA, explains.
Mediclinic’s measures to prevent and reduce the spread of microbial infections are built into the very foundations of our hospitals.
“Any new infrastructure project is an enormous undertaking,” says Amy Blaine, Architectural Design Team Manager: Mediclinic SA, “and there is just no point in us constructing a fixture that is not fit for purpose. Not many people know this, but infection prevention and control (IPC) strategies form a major part of a hospital’s core function.”
In fact, preventing and controlling the risk of infections is up there with other critical priorities such as public safety and patient experience, she says.
“We bring Mediclinic’s clinical committee into our design process, including the group’s IPC Control Officer Briette du Toit, each step of the way,” she explains. “If they advise, for example, that we should no longer use a specific material as it compromises our ability to control the spread of infection, then our project committee will approve those changes so they are implemented in all projects moving forward. If that means we need to reverse course on an existing build and start over in a certain section, so be it.”
Those guidelines usually involve design elements, including the natural flow of staff, the movement of waste into and out of the hospital, or the placement of alcohol rub dispensers. In this way, innovations to contain and control in-hospital infections evolve from one infrastructure project to the next.
Mediclinic’s infrastructure team conceptualises each new project with constant innovation in mind. Each new building must improve on the last, in both clinical standards and efficiency. The recently completed Mediclinic Stellenbosch, on the R44 outside Cape Town, is a perfect example.
The new hospital’s cutting-edge Day Clinic draws on designs from renowned hospitals in the US to cut down on the time it takes patients to be admitted, treated and accommodated for recovery.
Kobus Jonck, General Manager: Infrastructure Mediclinic SA, explains that he and his team identified critical points of delay in the Day Clinic’s typical patient journey and set about building new efficiencies into the system. “We have admission, surgery in theatre, recovery and discharge,” he says. “Usually we have staggered these stages: our patients wait at the pre-theatre stage before moving back to recovery, then going back to the ward. These delays and disruptions are wasteful. They waste the patient’s time, they waste the hospital’s space and they waste precious resources.”
They also lead to an increased risk of exposure to infection.
Mediclinic Stellenbosch is the first hospital to make use of this new “pod design” in its day clinic rooms – in which traditional six-bed units are divided into individual patient-private cubicles. The pod design ensures the transition between patients being admitted and those being discharged is as smooth as possible. The design divides each unit into on-stage zones, accessed by patients and the public, and off-stage areas, occupied by clinical staff.
The surgical theatre complex is another high-risk area for infection, says Blaine, and is designed and demarcated into on- and off-stage zones accordingly. “We have to be very careful in how we design these areas. The aim is that items used in surgery will flow naturally from sterile to non-sterile, and never backwards: out of theatre, into a processing area to be separated into waste and cleaning, then disinfected and moved into a central sterile storage space, which is the cleanest part of the hospital. It is a perfect circle.”
Operating rooms themselves have sterile and non-sterile zones. “The anaesthesiologist sits in a non-sterile space, marked on the floor in red, as they work with liquids and directly with the patient. This is a ‘dead corner’: it’s designed so no one needs to move past or behind him or her, or cross their path – so they’re not at risk of being contaminated.”
The success of these innovative measures is monitored by the hospital’s clinical teams, and their feedback is directed back to the infrastructure team.
“Infection prevention and control is a major focus for the infrastructure department,” says Blaine. “In every new build, we look for opportunities to improve on our efficiencies. We do that so that it is easier and quicker for staff to save time and reduce the spread of infections – and every step of the way, we aim to enhance the safety and experience of our patients.”