flexiblefullpage
billboard
interstitial1
catfish1
Currently Reading

TLC’s Michael Sheerin offers guidance on ventilation in COVID-19 healthcare settings

Coronavirus

TLC’s Michael Sheerin offers guidance on ventilation in COVID-19 healthcare settings

Guidance document offers technical advice on room ventilation for coronavirus patients.


By ROBERT CASSIDY, EXECUTIVE EDITOR | April 1, 2020
TLC Engineering Consultants' guidance on ventilation in COVID-19 patient rooms

TLC Engineering Consultants' guidance on ventilation in COVID-19 patient rooms.

Michael Sheerin, PE, CEO of TLC Engineering Solutions, chairs the ASHRAE Standard 170 committee, which covers the ventilation of healthcare facilities. A 25-plus-year veteran of designing mechanical systems for healthcare, Sheerin and colleagues at ASHRAE, ASHE, and TLC have created a PDF document (updated almost daily) to advise design, engineering, and construction professionals as to the nuances of ventilation for facilities where COVID-19 patients are being treated.

NOTE: The guidance referenced here is based on input from ASHE, the ASHRAE Technical Committee for Healthcare, and the ASHRAE/ASHE Standard 170 Committee. The guidance represents the personal opinions of TLC Senior Healthcare Engineering staff. ASHRAE and ASHE are not responsible for the use or application of this information. For further information, contact: Michael.sheerin@tlc-eng.com.

 

Use of hospital auditorium for post-acute careUse of hospital auditorium for post-acute care.

 

 

Here are key highlights of the TLC document.

SETTING UP AND IMPLEMENTING THE ACTION PLAN

Health facility operators should first verify the performance of any existing airborne infectious isolation (AII) rooms in their facilities, as well as the performance of the emergency department HVAC system. All HEPA units should be secured, and plans for a patient surge and temporary patient segregation should be readied for deployment.

The primary function and expertise of healthcare engineers in preparing healthcare facilities for COVID-19 is advising on HVAC systems, configurations, and modifications to support the safe segregation of suspected and confirmed patients within controlled-air environments, whether true isolation or modified alternative arrangements.

Basic advice: Keep it simple. In terms of resource management, recognize that you have limited time, so focus your efforts. Don’t waste time or dollars if you don’t have clear goals and a plan. Work with clinicians in the facility to establish minimum standards, define key spatial areas and designated rooms or suites for airborne infectious isolation. Maintain all life safety precautions. Draw a floor plan or map, and make sure everyone involved understands it.

 

THE BASICS OF PASSIVE ISOLATION

As prescribed in CDC Guidance, the most basic approach is “one patient per room, close the door.” Healthcare engineers should implement related CDC safety protocols and work with clinicians to anticipate patient load and establish a layered approach as needed.

In implementing a layered approach, hospital facilities and their engineering consultants should be aware of the various clinical modes:

  • “Normal Mode” - Follow CDC guidelines. The clinical plan may limit airborne infection isolation rooms to patients receiving aerosol-generating procedures.
  • “Small-scale Surge Capacity Mode” – The project team may be asked to create additional dedicated AII or temporary patient observation/segregation rooms with HEPA and negative pressure.
  • “Large-scale Surge Capacity Mode” – The team may be asked to establish dedicated wards or suites and establish protocols with clinical and environmental action plans.

 

Small-surge COVID-19 patient roomFloor plan for a small-surge COVID-19 patient room with optimal ventilation.

 

The report recommends informing clinicians that temporary patient observation or segregation areas are not true AII rooms.

The document also provides guidance on patient rooms and ICUs and ORs (for use with COVID patients and as alternative ICU space).

The document also provides information on personal protection equipment (PPE) and ventilators.

 

CREATING ALTERNATE CARE SITES

In developing alternate care sites, project teams should be clear about the clinical goals, as they will dictate the infrastructure needed. Are the alternate case sites to be used to provide care to COVID-suspected patients or non-COVID patients? At what acuity level? Don’t forget to consider liability issues if diverging from FGI or State Guidelines.

 

Triage area near emergency department in parking garage at Vanderbilt Medical Center, Nashville.

 

ASHE Note: During emergencies, it is important that activities be coordinated through the organization’s incident command system. Activities outside of an organization’s command structure should be coordinated with the local, county, and state incident command systems. This enables effective and efficient incident management within common organizational structures. See ASHE Resources.

Additional items to plan for and address in creating alternate care sites include the adequacy of skilled care providers and support staff; supplies: PPE, beds, equipment, and infrastructure, including HVAC, power, Wi-fi;  space considerations; and site evaluation and proximity to the hospital and areas of demand.

 

AII airborne infection control roomDesign options for AII airborne infection control room for COVID-19 patients.

 

Do not ignore access to toilets and handwashing. This can be a problem at large-scale facilities like convention centers, such as the Javits Center in New York.

Javits Center, New York - post-acute care configuration

Javits Center, New York - post-acute care configuration.

 

CODE COMPLIANCE CONCERNS

The design team should coordinate with state and local authorities for help and take appropriate action based on circumstances and develop Interim Life Safety Measures as applicable.

Important reminder: Document the Action Plan and Alterations in Place.

 

 

Related Stories

Coronavirus | Oct 2, 2020

With revenues drying up, colleges reexamine their student housing projects

Shifts to online learning raise questions about the value of campus residence life.

Coronavirus | Oct 1, 2020

The Weekly show: Decarbonizing Chicago, re-evaluating delayed projects, and the future of the jobsite

The October 1 episode of BD+C's "The Weekly" is available for viewing on demand.

Coronavirus | Sep 28, 2020

Cities to boost spending on green initiatives after the pandemic

More bikeways, car restrictions, mass transit, climate resilience are on tap.

Coronavirus | Sep 28, 2020

Evaluating and investing resources to navigate past the COVID-19 pandemic

As AEC firm leaders consider worst-case scenarios and explore possible solutions to surmount them, they learn to become nimble, quick, and ready to pivot as circumstances demand.

Coronavirus | Sep 24, 2020

The Weekly show: Building optimization tech, the future of smart cities, and storm shelter design

The September 24 episode of BD+C's "The Weekly" is available for viewing on demand.

Coronavirus | Sep 10, 2020

Mobile ordering is a centerpiece of Burger King’s new design

Its reimagined restaurants are 60% smaller, with several pickup options.

Coronavirus | Sep 9, 2020

Prefab: Construction’s secret weapon against COVID-19

How to know if offsite production is right for your project.

Coronavirus | Sep 3, 2020

The Weekly show: JLL's construction outlook for 2020, and COVID-19's impact on sustainability

The September 3 episode of BD+C's "The Weekly" is available for viewing on demand. 

Coronavirus | Sep 1, 2020

6 must reads for the AEC industry today: September 1, 2020

Co-working developers pivot to survive the pandemic, and the rise of inquiry-based learning in K-12 communities.

Coronavirus | Aug 28, 2020

7 must reads for the AEC industry today: August 28, 2020

Hotel occupancy likely to dip by 29%, and pandemic helps cannabis industry gain firmer footing.

boombox1
boombox2
native1

More In Category


MFPRO+ Special Reports

Top 10 trends in affordable housing

Among affordable housing developers today, there’s one commonality tying projects together: uncertainty. AEC firms share their latest insights and philosophies on the future of affordable housing in BD+C's 2023 Multifamily Annual Report.



halfpage1

Most Popular Content

  1. 2021 Giants 400 Report
  2. Top 150 Architecture Firms for 2019
  3. 13 projects that represent the future of affordable housing
  4. Sagrada Familia completion date pushed back due to coronavirus
  5. Top 160 Architecture Firms 2021