BY: David O’Riley, Marketing Director, Snag & Inspect, Dubai, UAE
Patient care, hygiene, cleanliness and a safe environment are at the very centre of a hospital’s core objectives so naturally every effort is made to achieve excellence in all three endeavours. Management teams work tirelessly to give their customers a high-quality patient experience but rather like the swan on a river that appears to move serenely along, under the surface there is a significant amount of activity.
Keeping the whole environment within a hospital safe is indeed a major challenge for all concerned, but the job is made much more difficult as a result of the indifferent quality with which the building(s) were and are still being constructed and commissioned.
In many parts of the world, governments have taken the initiative when it comes to construction standards by not only mandating standards but more importantly taking steps to ensure that those standards are enforced, after-all what use are standards if they can be ignored without major penalties.
From our experience of inspecting a wide variety of building across the region, including hospitals, there are a number of areas that gives us cause for concern and we know that they will be a cause of concern for the hospital management and maintenance teams and they are:
- Waterproofing both underground and on roofs
- Water tanks and water leaks
- Leaking sewer and waste-water lines
- Condensation problems
- AC systems
- Potentially dangerous electrical wiring
- Facades systems
- Fire alarm systems
- Active fire suppression systems
- Passive fire protection systems
Each of the above creates additional health and safety problems that increase the financial and resource burden upon a hospital’s management team in trying to achieve the very high standards of hygiene, cleanliness and safety that are required.
Inadequate waterproofing in a basement for instance will allow water into the fabric of the building’s structure creating corrosion and movement which in turn will cause pipes to fracture, plaster to fall from the walls, paint to peel from wall and eventually to a foreshortening of the life of the building.
Poor quality waterproofing on a roof will allow water under the roof seal, which will then leech down into the building fabric to damage walls and provide a beneficial environment for mould growth.
Similar problems occur when a water leak goes undetected, posing the added danger of mould developing and often in places that are not usually inspected, so running the risk of spores getting into the airways; the problem gets much worse if the leak is from a waste or sewer line.
Condensation is an ever-present problem because of the climate and the need for air conditioning. Poor quality materials and installations mean that moisture enters the building and condenses on cold pipe-work and so a cycle of degradation begins with the inevitable result that infrastructure deteriorates and mould develops. This problem is usually made worse by the fact that the AC system has not been installed correctly and/or has not been commissioned correctly.
We have yet to inspect a building where the electrical wirings meets the governing body’s published code of practice. In every case the contractor insist on using non-code compliance connector blocks and in many cases no connectors at all, just twisted wires and insulation tape. This is a major fire risk.
Many buildings we have inspected have non-compliant façade installations. Not only does this present a risk for anyone passing the building it also damages the sustainability of the building because air permeability standards can not be met and building insulation material are compromised. Additionally, passive fire protection in respect of the perimeter edge fire seals will not meet code and the lack of inadequate seals will create a micro-climate which in turn further promotes condensation and mould.
Fire safety within a hospital is crucial since a large portion of the people the hospital are likely to have some restriction regarding their mobility. It is essential therefore that fire alarm systems work correctly. Sadly the state of the majority of fire alarm systems installed across the region fall short of the standards achieved elsewhere in the world with the inevitable consequence that they are troubles with false alarms and inaccurate reporting. For our experience we know that it is usually the wiring of the alarm circuits that cause most problems because contractors do not follow the codes and do not commission the systems correctly.
In the unfortunate circumstance that a fire does occur the primary line of defence for the occupants and the building is the active fire suppression system, so ensuring that these systems are ’fit for purpose’ in an absolute must. It is with regret that I have to report that we are still looking for a building that has code-compliant installations throughout. Typically we find that systems are not installed correctly and very rarely maintained to any recognized standard despite a Civil Defence requirement to do so.
According to NFPA25 which is preferred UAE Fire Code maintenance code, fire pumps are supposed to be run every week, 10 minutes for electric pumps and 30 minutes for diesel pumps, in left image above we see a ‘run meter’ which has recorded just 4 ½ hours in a building that has been occupied for over three years. On the right (above) we can see the fire pump is switched off and yet the BMS shows that it is fully operational.
Given all of these problem areas it is not difficult to appreciate that prevention is much better than cure and that if new hospitals were built and commissioned correctly many of the issues that face the management and maintenance teams would all but disappear.
Governments will of course in the longer term get to grips with the issues that face the construction industry, but in the short-term the only sensibly way for the hospital to ensure that their new building is truly fit-for-purpose is to engage the services of a company that actually knows about buildings, their systems and the standards that should be adhered to during and after their construction.
For existing buildings, although the problems are the same, the approach needs to be different as the objective should be one of damage limitation. To achieve that it is necessary to tackle each problem area head-on