ASHRAE – Working to Ensure Healthcare Facilities …2003 ASHRAE handbook, HVAC Applications. It...
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Ronald Vallort is President of the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE) and is President of Ron Vallort and Associates Ltd. As ASHRAE’s president, Mr Vallort directs the Board of Directors and oversees the Executive Committee. During his term, Mr Vallort is emphasising the widespread benefits of refrigeration as the technology for survival, and ASHRAE as the strongest link in the cold chain. He served on the Board of Directors as President-elect in 2003–2004, Treasurer in 2002–2003, Vice President in 1998–2000 and Director-at-large in 1992–1996. He is a member of the Presidential Ad Hoc Committee for Building Health and Safety Under Extraordinary Incidents. He has served as Chair of Regions Council, the Finance Committee, the Refrigeration Committee, the ASHRAE Learning Institute, Technology Council, the ASHRAE Planning Committee and the Research and Technology Committee. Mr Vallort held all leadership positions in the Chicago Chapter and has been active in the Illinois Chapter. He has received the Exceptional Service Award, the Distinguished Service Award and a Regional Award of Merit. Mr Vallort is past Chair of the International Association of Cold Storage Constructors and the International Institute of Ammonia Refrigeration. He was awarded a BSc in 1964 and an MSc in mechanical engineering in 1965 from the University of Illinois. a report by Ronald Vallort President, American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. An operating room (OR) requires a minimum of 25 total air changes per hour. A storage room in the same facility requires only four. The challenge for engineers is to design a heating, ventilation and air- conditioning (HVAC) system that accommodates the ventilation requirements of both. The role of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) is to provide information to make that design easier. ASHRAE recently formed a new technical committee (TC 9.6) on healthcare facilities, which replaces an existing subcommittee that was active in developing programmes for ASHRAE’s semi- annual meetings and chapters for the ASHRAE handbook and other publications. The committee will hold its first meeting at ASHRAE’s 2005 winter meeting in Orlando, from 5 to 9 February. It has already submitted a research proposal to ASHRAE regarding the experimental investigation of hospital OR air distribution. While surgical methods have improved since modern antiseptic surgery began in the 1860s, each year some 700,000 patients in the US suffer from surgical site infections (SSIs). Data shows that the direct cost of additional healthcare for these SSI cases is at least US$3.5 billion annually. These are only the costs seen by the hospital. The full cost including time away from work, degraded life style, suffering and death is surely much higher and demands the attention of every profession involved. Many of these cases are caused by airborne exogenous organisms. Contributions from HVAC engineers have helped impede this pathway of infection, including a significant advance in OR air distribution design included in ASHRAE’s Design Manual for Hospitals and Clinics. The research proposed by TC 9.6 would enhance the modelling of OR air distribution and infectious particle transport. The findings would hopefully support recommendations in the design manual and ASHRAE’s proposed standard 170P, ‘Ventilation of Health Care Facilities’. The title of the proposed project is ‘Experimental Investigation of Hospital Operating Room Air Distribution’. Another of TC 9.6’s first charges will be to discuss a recommendation that the society conduct research and develop standards and guidelines for HVAC system design in order to minimise the transmission of severe acute respiratory syndrome (SARS). Another way that ASHRAE offers guidance is through its publications, such as the HVAC Design Manual for Hospitals and Clinics published last year. HVAC systems in hospitals and other healthcare facilities must do more than simply provide for a comfortable working environment. Their design must also provide ventilation that minimises exposure hazards for patients, workers and visitors. Well-designed HVAC systems enhance the other facets of the built environment to offer a ‘healing environment’. This includes minimising the airborne transmission of viruses, bacteria, fungal spores and other bioaerosols and minimising the impact of the building and its processes on the environment. Guidance on how to address the special requirements of hospitals and healthcare facilities can be found in the design guide, which is intended to provide a comprehensive source for the design, installation and commissioning of HVAC systems for hospitals and clinics. This includes environmental comfort, infection control, energy conservation, life safety and operation and maintenance. Building-related illnesses, especially those associated with airborne infectious agents, continue to be a challenge for healthcare organisations that treat infectious patients and those that are susceptible to environmental microbes, such as Legionella. This manual provides design and maintenance practices to optimise the safety of occupants. The manual fills a gap left by existing resources related to HVAC design for healthcare facilities. The guide includes: • chapters on facility descriptions; • an overview of healthcare HVAC; • HVAC systems; • existing facility design consideration; ASHRAE – Working to Ensure Healthcare Facilities Remain Healthy 30 HVAC & Air Quality BUSINESS BRIEFING: HOSPITAL ENGINEERING & FACILITIES MANAGEMENT 2005
Transcript of ASHRAE – Working to Ensure Healthcare Facilities …2003 ASHRAE handbook, HVAC Applications. It...
Ronald Vallort is President of theAmerican Society of Heating,
Refrigerating and Air-ConditioningEngineers, Inc. (ASHRAE) and is
President of Ron Vallort andAssociates Ltd. As ASHRAE’s
president, Mr Vallort directs theBoard of Directors and oversees the
Executive Committee. During histerm, Mr Vallort is emphasising thewidespread benefits of refrigerationas the technology for survival, and
ASHRAE as the strongest link in thecold chain. He served on the Board
of Directors as President-elect in2003–2004, Treasurer in
2002–2003, Vice President in1998–2000 and Director-at-large in
1992–1996. He is a member ofthe Presidential Ad Hoc Committee
for Building Health and SafetyUnder Extraordinary Incidents.
He has served as Chair of RegionsCouncil, the Finance Committee, the
Refrigeration Committee, theASHRAE Learning Institute,
Technology Council, the ASHRAEPlanning Committee and
the Research and TechnologyCommittee. Mr Vallort held all
leadership positions in the ChicagoChapter and has been active in theIllinois Chapter. He has received the
Exceptional Service Award, theDistinguished Service Award and a
Regional Award of Merit. Mr Vallort is past Chair of the
International Association of ColdStorage Constructors and the
International Institute of AmmoniaRefrigeration. He was awarded a
BSc in 1964 and an MSc inmechanical engineering in 1965from the University of Illinois.
a report by
Ron a l d V a l l o r t
President, American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc.
An operating room (OR) requires a minimum of 25total air changes per hour. A storage room in thesame facility requires only four. The challenge forengineers is to design a heating, ventilation and air-conditioning (HVAC) system that accommodates theventilation requirements of both.
The role of the American Society of Heating,Refrigerating and Air-Conditioning Engineers(ASHRAE) is to provide information to make thatdesign easier. ASHRAE recently formed a newtechnical committee (TC 9.6) on healthcare facilities,which replaces an existing subcommittee that wasactive in developing programmes for ASHRAE’s semi-annual meetings and chapters for the ASHRAEhandbook and other publications. The committee willhold its first meeting at ASHRAE’s 2005 wintermeeting in Orlando, from 5 to 9 February. It hasalready submitted a research proposal to ASHRAEregarding the experimental investigation of hospitalOR air distribution. While surgical methods haveimproved since modern antiseptic surgery began in the1860s, each year some 700,000 patients in the USsuffer from surgical site infections (SSIs).
Data shows that the direct cost of additionalhealthcare for these SSI cases is at least US$3.5billion annually. These are only the costs seen bythe hospital. The full cost including time awayfrom work, degraded life style, suffering and deathis surely much higher and demands the attention ofevery profession involved. Many of these cases arecaused by airborne exogenous organisms.Contributions from HVAC engineers have helpedimpede this pathway of infection, including asignificant advance in OR air distribution designincluded in ASHRAE’s Design Manual for Hospitalsand Clinics.
The research proposed by TC 9.6 would enhancethe modelling of OR air distribution and infectiousparticle transport. The findings would hopefullysupport recommendations in the design manual andASHRAE’s proposed standard 170P, ‘Ventilation ofHealth Care Facilities’. The title of the proposedproject is ‘Experimental Investigation of HospitalOperating Room Air Distribution’.
Another of TC 9.6’s first charges will be to discuss arecommendation that the society conduct researchand develop standards and guidelines for HVACsystem design in order to minimise the transmissionof severe acute respiratory syndrome (SARS).
Another way that ASHRAE offers guidance isthrough its publications, such as the HVAC DesignManual for Hospitals and Clinics published last year.HVAC systems in hospitals and other healthcarefacilities must do more than simply provide for acomfortable working environment. Their designmust also provide ventilation that minimisesexposure hazards for patients, workers and visitors.Well-designed HVAC systems enhance the otherfacets of the built environment to offer a ‘healingenvironment’. This includes minimising the airbornetransmission of viruses, bacteria, fungal spores andother bioaerosols and minimising the impact of thebuilding and its processes on the environment.
Guidance on how to address the special requirementsof hospitals and healthcare facilities can be found inthe design guide, which is intended to provide acomprehensive source for the design, installation andcommissioning of HVAC systems for hospitals andclinics. This includes environmental comfort,infection control, energy conservation, life safety andoperation and maintenance.
Building-related illnesses, especially those associatedwith airborne infectious agents, continue to be achallenge for healthcare organisations that treatinfectious patients and those that are susceptible toenvironmental microbes, such as Legionella. Thismanual provides design and maintenance practices tooptimise the safety of occupants.
The manual fills a gap left by existing resourcesrelated to HVAC design for healthcare facilities.
The guide includes:
• chapters on facility descriptions; • an overview of healthcare HVAC; • HVAC systems; • existing facility design consideration;
ASHRAE – Work ing to Ensure Hea l thcare Fac i l i t i e s Remain Hea l thy
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• cooling plants; • space and process heating systems; • air handling and distribution systems; • controls and instrumentation; • life safety and fire protection; • room design; • clinics and other healthcare facilities; • operation and maintenance; • commissioning for hospitals; and • energy-efficient design and conservation of
energy resources.
In addition, appendices are included on managingconstruction and renovation:
• reducing risk in healthcare facilities; • ensuring disaster readiness; • load calculations and equipment heat gains;• infection control issues; • life-cycle cost analysis; • ventilation trends; • power quality issues; • sample control strategies; and • OR air distribution.
A chapter on healthcare facilities was updated in the2003 ASHRAE handbook, HVAC Applications. Itcontains a revised table that provides at-a-glancedesign criteria for a range of hospital departments. Inprevious volumes, this information was scatteredaround in the text of the chapter. Putting theinformation into the table makes it easier to find andmore like other healthcare design data tables.
ASHRAE and the American Society for HealthcareEngineering (ASHE) are also working on a proposedstandard – 170P ventilation of healthcare facilities.The standard will define requirements for ventilationsystem design intended to provide environmentalcontrol for comfort, as well as infection and odourcontrol in healthcare facilities.
Currently, conflicting design codes, guides andmethods for ventilation in healthcare facilities exist.The proposed standard would recommend a singlerate, drawing from different rates by differentgroups, such as the ASHRAE handbook, AmericanInstitute of Architects (AIA) guidelines and others.There is a need for guidance about types ofventilation systems and their application, operationand maintenance procedures.
The requirements will apply to patient care areas andrelated support areas within healthcare facilitiesincluding hospitals, nursing facilities and out-patientfacilities. The proposed standard considers chemical,physical and biological airborne contaminants thatcan affect the delivery of medical care to patients, theconvalescence of patients and the safety of healthcare
workers and visitors. The committee writing thestandard is hoping that it will be available for publicreview in 2005.
ASHRAE are working with ASHE in a number ofother areas. ASHRAE technical committees arehelping to formulate portions of the trainingprogramme for both ASHE’s 2005 “Planning,Design and Construction” conference and its 2005annual meeting. The material will focus on energyconservation, indoor air quality and sustainabilityapplications for healthcare facilities for facilitymanagers, architects, engineers and contractors.
ASHE and ASHRAE recently held a healthcaresummit with the US Green Building Council andthe Environmental Protection Agency (EPA). Aspart of those discussions, ASHRAE’s energyconservation standard, “ANSI/ASHRAE/IESNAStandard 90.1, Energy Standard for Buildings ExceptLow-rise Residential Buildings”, was established asthe design tool for healthcare facilities. The standardprovides the minimum requirements for the designof energy-efficient buildings. In addition, ASHRAEand ASHE will be the lead organisations in researchto develop a protocol of reporting performance datafor equipment used in healthcare facilities. ASHRAEwill take the lead in monitoring and developing ausable format of ‘plug and process’ loads for at least10 areas in these facilities, such as ORs andcatheterisation laboratories.
These research programmes are likely to be fundedby outside agencies who have expressed interest infunding such types of endeavours.
ASHRAE also provide information through thetechnical session presented at the winter and annualmeetings. Among the sessions of interest at the 2005winter meeting is a seminar on air filtration onhospitals. The Centers for Disease Control andPrevention (CDC) estimates that more than 90,000people die each year from hospital-acquiredinfections. Many of these occur through the airborneroute. Proper application of air filters and air filtrationsystems can help eliminate the spread of airborneinfections, helping protect the lives of patients,hospitals and healthcare workers and visitors. Theseminar will highlight these applications.
This year, one of the challenges to ASHRAE membersis that ASHRAE committees must examine the impactof their work on humanity. When discussing research,programmes or information for the handbook,members should ask how this will impact the industryand the public. Nowhere is that question moreimportant than in ASHRAE’s work in healthcare, aswork is undertaken to ensure that indoor environ-ments in healthcare facilities remain healthy. ■
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