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HVAC monitoring systems help engineers contain infectious diseases, save money


May 1, 2019

Hospital engineers don’t have much time on their hands these days. So much information about their facility’s operation crosses their paths on a daily basis that it’s hard to stop and think about how that information can be used to save money and make the facility safer. Frankly, unless a facility has a complex computer system that alerts personnel to the things they should be changing, a hospital engineer’s job is mainly reactive.

Many healthcare facilities periodically check HVAC systems and air quality. However, these checks are often still done manually, which gives bacteria more time to spread. Manual checks are also a reactive approach. To help identify potential contamination issues before area shutdowns are necessary, some hospitals implement continuous monitoring systems that provide real-time updates on air quality and ventilation operations throughout the entire facility.

Continuous monitoring keeps watch over life safety systems such as fire suppression and HVAC systems, which control the physical environment in crucial places such as operating rooms (OR) and patient treatment areas. If there are issues in these systems, results can be deadly.

According to a World Health Organization (WHO) study, over 1.4 million people suffer from hospital-acquired infectious complications. Given the right airflow, humidity, and pressure, airborne bacteria can spread quickly throughout a hospital, contaminating far more than the initial exposure area, so hospitals must be able to quickly change the environment if necessary.

Surprisingly, though, many hospitals in today’s high-tech environment have outdated HVAC solutions that are controlled by siloed monitoring systems. These systems cannot communicate with each other about problems, so they cannot proactively help control environmental conditions.

“Healthcare facilities are usually a number of different building automation systems,” says Rhonda Landis, vice president of operations for Plymouth, Massachusetts–based FacilityConneX, a company that specializes in real-time facility data monitoring solutions and a service provider for increased operational efficiency, equipment optimization, and energy savings. “Hospitals merging together don’t have nice, pretty control systems. They all act differently and require different people who need to monitor them. Most engineers cannot keep up with more demands. They feel totally overwhelmed, and they are chasing problems because someone called in a problem.”

If the humidity level in an OR is too high, people call the engineer to change that immediate problem. But engineers aren’t continuously monitoring equipment such as cooling units to figure out how to efficiently keep conditions at ideal levels.

The regulatory standards that govern hospitals aren’t as strict as they could be either. Many patient safety standards covering the environment of care require temperature, humidity, and pressure to be monitored; however, in some cases, this monitoring is only required an hour before surgery is scheduled to start.

“If the operating room hasn’t been used for a day, no one has been paying attention to the things that cause bacteria to grow,” Landis says. “Bacteria could still be growing and be airborne, and if you aren’t monitoring, you can’t fix it. You want to make sure those conditions in critical areas stay level all the time. You have to know what HVAC systems should be doing instead of what they are doing.”

Landis’ company provides the computer software and remote system surveillance for a trend known as continuous HVAC monitoring.

“Let the computers tell you what the issues are,” she says. “That computer can see everything; it can see boilers and chillers and knows the outside temperature and history.”

FacilityConneX is not the only company to offer this kind of technology; there is a trend in the industry to make it easier for engineers to keep tabs on a hospital’s many HVAC needs.

As spaces within a hospital range from offices to areas with critical requirements, many hospitals, especially older ones, tend to improve their HVAC systems in several areas simultaneously. North Carolina–based Trane has a system called the Tracer®, which allows facility managers to monitor and optimize environmental requirements for individual spaces.

The company’s HVAC infrastructure upgrades at Laughlin Memorial Hospital in Greenville, Tennessee have significantly lowered energy and service costs, with an estimated first-year savings of more than $778,800, according to a case study Trane published on its website. Hospital CEO Chuck Whitfield told the company that energy efficiency was the main objective. “It translates into cost savings and offers environmental benefits as an added bonus. To solve our challenges, we wanted to upgrade our infrastructure and ensure that all of our systems were working together.”

Trane also installed necessary upgrades to the facility’s sensors, boilers, and air handlers. A new building management system called the Tracer Ensemble™ now allows the hospital to monitor and control building systems throughout the complex, establish set points for critical areas such as ORs, implement scheduling to turn off systems in areas not in use, and receive alarm notifications.

Richard Banks, maintenance supervisor at Laughlin Memorial Hospital, told Trane that hospital “technicians have a laptop on their toolbox and can access the building management system from wherever they are,” adding that the technicians can use Tracer to “control HVAC and lighting systems, diagnose problems, and make adjustments.”

Milwaukee-based Johnson Controls offers similar systems. Its Health Environment Optimization system integrates the building’s current automation system with surgery scheduling to safely lower air exchange rates when ORs are not in use while maintaining and validating differential pressures. When the ORs are in use, air exchange rates ramp up and in-room displays confirm that environmental conditions are optimal for care. The company’s user interface, known as Metasys 7.0, allows monitoring and remote management anywhere from any device.

By installing sensors as well as using equipment already installed in a facility’s systems and controlling it through a cloud-based computer platform, the systems provide real-time monitoring, commissioning, and fault detection, as well as diagnostics for HVAC and air quality optimization.

Southcoast Health, a Massachusetts healthcare system, installed the FacilityConneX system at two of its hospitals, according to the company's news blog. Christopher LeBlanc, executive director of engineering/facilities and EVS at Southcoast Health, told the company that air quality is "of the utmost importance to our facilities as it not only supports patient comfort but also helps to control and mitigate the spread of infectious disease(s) throughout hospitals.”

“Using the FacilityConneX platform, we’ve been able to bring a much more proactive approach to maintenance and energy savings, reducing these costs by approximately 15%,” LeBlanc said. “We’re looking to bring this same approach to our HVAC systems to provide our patients and staff with the best air quality possible, and the FacilityConneX solution and team has proven to be the right choice for this effort.”

The HVAC and air quality optimization project is happening within specialized areas of two of Southcoast Health’s facilities: Charlton Memorial Hospital in Fall River and St. Luke’s Hospital in New Bedford. Areas involved include ORs, sterilization areas, and recovery areas. Through FacilityConneX’s monitoring platform, Southcoast’s facility management staff receive real-time alerts to potential issues with airflow, air changes, temperature, pressure, and humidity, all of which can boost energy savings, enhance safety, and provide infectious disease detection related to the facility equipment. Currently, the company is monitoring 1,600 pieces of equipment and 13,000 analytics across four of its facilities to better support energy savings and meet environmental, health, and safety requirements.

“You aren’t replacing engineers, but helping them get to the fix quicker,” says Landis, adding that the system allows the engineer’s job to switch from reactive to proactive. “Now instead of looking at reams of data, the issue is found by the computer, analyzed, and tells the maintenance guy what to do.”

Landis says that the Southcoast installation, which includes a three-year commitment and focuses on air optimization in the system’s ORs, has more than 1,500 pieces of equipment providing 10,000–15,000 analytics every 15 minutes. That information is then sent to the system dashboard so engineers can track it from smartphones and tablets if needed.

“A human is a human and cannot analyze like that,” she says. “The computers can look at air currents across all your ORs and show which ones are optimal and which ones are lower than optimal. It’s about prioritizing the issues. We don’t hand you a 50-page paper and say, ‘Those are your issues, go get them.’ ”

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