AUBMC’s Renovation Projects Supported by ASHA

USAID/ASHA Annual Partners ConferenceOctober 2017

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Outline

I. Brief introduction on AUB Medical Center (AUBMC)

II. USAID/ASHA funded renovation projects at AUBMC

A. Operating rooms

B. Core lab facility

a. Brief intro on the projects (purpose, timeline,

population served)

b. Challenges faced

c. Lessons learned

AUBMC at a GlanceAUBMC at a Glance

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TODAY

AUBMC is considered the main tertiary/quaternary referral medical center in Lebanon and the region.

AUBMC operates 382 beds, serving 40,521 inpatients annually. The outpatient facilities receive 431,380 outpatient visits annually (including ER).

AUBMC is the first medical institution in the Middle East to have earned five international accreditations of Joint Commission International (JCI), Magnet, College of American Pathologists (CAP), Joint Accreditation Committee for EBMT and ISCT Europe (JACIE), and ACGME-I.

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AUBMC Mission Statement

AUBMC is an academic medical center dedicated tothe passionate pursuit of improving the health of thecommunity in Lebanon and the region through thedelivery of exceptional and comprehensive qualitycare to our patients, excellence in education andtraining, and leadership in innovative research.

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AUBMC 2020 Vision

To be the leading academic medical center inLebanon and the region by delivering excellence inpatient-centered care, outstanding education andinnovative research.

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Our Core Values

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Providing patients with the highest standards of patient-centered care

Recruitment of top-caliber, highly specialized, and accomplished faculty

Academic innovation through the creation of clinical and research centers of excellence, and the provision of outstanding medical education

Establishment of strategic partnerships and collaborations locally, regionally, and internationally

Investing in and expanding our facilities to meet the needs of the people of Lebanon and the region

Supporting the health of local and regional patients in need by ensuring their access to care

The Paths to our Vision

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Path 5

Investing in and expanding our facilities to meet the needs of the people of Lebanon and the region

Renovation of the Operating Rooms

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Renovation of the Operating Rooms (OR) 10 OR were renovated in phases under 3 periodic ASHA projects:

– ASHA no. 1336-987

– ASHA no. 1336-1024

– ASHA no. 1336-1055

OR were old and outdated Renovation included all aspects of the room:

Ceiling Walls Flooring

Infrastructure of each room was adjusted and updated to accommodate newand advanced technologies

Pendants were installed to prevent staff injuries and falls and to have aninfrastructure for hi-tech audiovisual systems

The induction rooms were prepared in the best way possible in terms ofinfrastructure to decrease the turnover time between cases

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OR Renovation – Benefits

Old floor tiles were unsafe and had to be repaired frequently almost on weekly basis. The floor, walls and ceilings were completely renovated and replaced with seamless ones

Floors and walls can now be cleaned easily and comply with infection control principles

Medical gas outlets were changed and fixed in the wall

Anesthesia and surgeon’s pendants with ample medical gas outlets and power outlets were included in the works

Environment was improved in terms of safety and infection to comply with JCI standards

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OR Renovation – Benefits (cont’d)

Surgeons of Lebanese origin coming from US have been recruited and are utilizing the renovated facilities

Intranet and Internet access and capacity were drastically improved

Installed screens in all OR Theaters. We were able to connect to the Picture Archiving Computerized System (PACS) which improved OR time and the output of surgical procedures

Professional staff such as medical students and surgeons coming from the Middle East and other countries were able to better view the surgical procedures from the surgical library which improved the teaching and consequently the qualification of the attendees

INTRODUCTION TO EVENTSTotal OR Cases per Year

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OR Renovation - Challenges

We had to order samples for the flooring and then place the final order and the delivery of the materials took 4 – 6 months

Access to the OR theaters was very difficult, as we had to comply with JCI standards in terms of safety, infection, and sounds

Construction time started slow to better understand needs then was accelerated

Since we were using the OR theaters, we weren’t able to close more than one OR theater at a time and had to perform the civil works during evening and night shifts

Ceiling height was an issue that necessitated revision of the ceiling work

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OR Renovation – Timeline

Construction time started with an average of 4 – 5 months for the first two OR theaters

Once materials were standardized, we were able to accelerate works by using two tactics:

1. Repeat buys of all the materials without going through decision making

2. Thorough planning to ensure all criteria are available just in time

This resulted in finishing the rest of the 8 OR theaters at a rate of one OR per six weeks

INTRODUCTION TO EVENTSTimeline

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OR Renovation – Minimizing Effects to Operations

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During

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After

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Robotic Surgery

OR in action

Renovation of theCore Lab Facility

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Renovation of the Core Lab Facility

Department of Pathology and Laboratory Medicine (PLM) performs more than 1,800,000 billable tests per year. These tests are referred to PLM from:

The 382-bed medical center

Outpatient’s services

Other referring centers in Lebanon

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Renovation of the Core Lab Facility PLM department needs to include a new servicing

section – Core Facility that will accommodate most of the routine laboratory tests. The primary drivers for performing the project are:

Workload is expected to double as AUBMC is working to accomplish its 2020 Vision

Laboratory lacks adequate space for expansion of workload and the addition of new technology

Redesign the lab space to maximize efficiency and effectiveness

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Renovation of the Core Lab Facility (cont’d)

Determine optimal layout, including instrument location and workflow patterns

Reduce hazardous waste Ensure a safe work environment that meets JCI

and CAP accreditation standards Consolidate laboratory administration into

contiguous space

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Renovation of the Core Lab Facility

6 phases of the renovation project:Phase I: Core lab facility

Phase II: Pathology & Biochemical Genetics

Phase III: Molecular Diagnostics & Cytogenetics

Phase IV: Flow Cytometry & Bone Marrow

Phase V: Stem Cell & Administration Area

Phase VI: Microbiology & Neuromuscular

ASHA has so far contributed to funding the renovation and equipment of the first 2 phases

Phase I works are complete and Phase II works will start towards the end of 2017

Master Plan

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Challenges

Having a core lab facility that fits within a work frame of lab specialty interactions:

An exhaustive exercise was done to design the whole lab area taking into consideration the current technologies and best practices as well as keeping enough flexibility for future changes

Flexibility dimension: The solution had to be looked at holistically to come up with a lab space

that accepts change

The solution was having fully modular lab benches that can be totally removed or modified

Electromechanical services all came above false ceiling to allow for this maximum flexibility

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Challenges (cont’d)

The matter of transporting lab samples from remote points to the lab was thought through and thus the modification of the existing pneumatic system to allow for future connections to upcoming facilities.

The internal transportation of lab samples within the subsections of the lab was also another challenge where the sample is less stable. Thus came the solution of the conveyor belts with its elevators and lowerators.

The automation of the transportation has a direct impact on human resources since no more manual transport is needed. The other benefit was that traceability of the sample becomes higher.

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Core Lab Facility Works

The works were done in a format to minimize any effect to the ongoing operations around the site in the different sections of the lab.

The modular lab benches were equipped with all the services available.

During execution, many technological changes happened. Having the modular benches allowed the change to be smooth.

The receiving area serving the core lab facility and which will serve later on the rest of the sections was equipped with the pneumatic system and soon the conveyor belt system will also be introduced.

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During

After

Spectral CT(newly funded ASHA project)

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Diagnostic Radiology – Spectral CT

Recently, ASHA approved a project to have a new CT that would provide enhanced imaging for cardiac, pulmonary, pediatric, trauma, neuro, spectral, perfusion, and general.

The introduction of this CT will also enhance the workflow efficiency by dedicating one CT machine for ED patients.

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Diagnostic Radiology – Spectral CT

Thank you