kevin moon proposed doh maintenance standards ppt

8/8/2019 Kevin Moon Proposed DoH Maintenance Standards Ppt

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Proposed DoH Maintenance StandardsProposed DoH Maintenance Standards

A brief overview Kevin Moon A brief overview Kevin Moon



MaintenanceMaintenance

l What are the minimum maintenancerequirements for Vic. public hospitals?

l Who is responsible?l What evidence is there that it is carried

out?

l Where is it documented, reported?

l Where are reports tabled?

l What reports should user departments& Infection Control receive?

l What are the minimum maintenancerequirements for Vic. public hospitals?

l Who is responsible?l What evidence is there that it is carried

out?

l Where is it documented, reported?

l Where are reports tabled?

l What reports should user departments& Infection Control receive?



Maintenance shouldMaintenance should

support clinical outcomessupport clinical outcomeswith a focus on betterwith a focus on better

infection prevention andinfection prevention andcontrolcontrol

Maintenance shouldMaintenance should

support clinical outcomessupport clinical outcomeswith a focus on betterwith a focus on better

infection prevention andinfection prevention andcontrolcontrol



VACIC VACIC

l Maintenance of critical areas was firstraised at VACIC in August 2006 when it

was included as a future agenda item.l VACIC is auspiced by the Statewide

Quality Branch

l

SQB commissioned the development of maintenance standards this year aspart of an ongoing commitment for theimprovement of health delivery

l Maintenance of critical areas was firstraised at VACIC in August 2006 when it

was included as a future agenda item.l VACIC is auspiced by the Statewide

Quality Branch

l

SQB commissioned the development of maintenance standards this year aspart of an ongoing commitment for theimprovement of health delivery



Statewide Quality BranchStatewide Quality Branch

l The Statewide Quality Branch (formerlyQuality and Safety Branch) is

committed to playing a strategic role indelivering the best possible outcomesfor all Victorians using healthcareservices.

l The Statewide Quality Branch (formerlyQuality and Safety Branch) is

committed to playing a strategic role indelivering the best possible outcomesfor all Victorians using healthcareservices.



Statewide Quality BranchStatewide Quality Branch

l The Statewide Quality Branch is theprincipal adviser to the Minister for

Health and the Department of HumanServices executive team for state widepolicy development, planning, resourceallocation and monitoring of

performance in relation to thesystematic improvement of safety andquality in healthcare.

l The Statewide Quality Branch is theprincipal adviser to the Minister for

Health and the Department of HumanServices executive team for state widepolicy development, planning, resourceallocation and monitoring of

performance in relation to thesystematic improvement of safety andquality in healthcare.



The issuesThe issues

l At present no maintenance standardsor guidance exists for healthcare

facilities.l Maintenance practices vary widely,

from comprehensive plannedmaintenance systems to basic break down maintenance.

l At present no maintenance standardsor guidance exists for healthcare

facilities.l Maintenance practices vary widely,

from comprehensive plannedmaintenance systems to basic break down maintenance.



The issuesThe issues

l Industry consultation by DoH revealeda strong desire for a standardised

approach to maintenancel Industry consultation by DoH deemed

poor maintenance to be an infectioncontrol risk with a potential forincreased hospital acquired infections.

l Industry consultation by DoH revealeda strong desire for a standardised

approach to maintenancel Industry consultation by DoH deemed

poor maintenance to be an infectioncontrol risk with a potential forincreased hospital acquired infections.



l “The design, construction andrenovation of health care

establishments should take account of infection control and there should be amonitoring and maintenance programfor the physical environment.

l The importance of monitoring andmaintaining the physical environmentof a health care establishment shouldnot be underestimated.

l “The design, construction andrenovation of health care

establishments should take account of infection control and there should be amonitoring and maintenance programfor the physical environment.

l The importance of monitoring andmaintaining the physical environmentof a health care establishment shouldnot be underestimated.

Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting






l “It is the responsibility of health careestablishments to make equipment andsystems (whether they are purchased,

contracted, loaned or on trial) available,before they are used, to the engineering andbuilding services department so that it may:l undertake a safety and operational inspection;

l

develop an appropriately scheduled preventivemaintenance plan; and

l ensure that the equipment manufacturer’sinstructions, where appropriate, are available tousers.”

l “It is the responsibility of health careestablishments to make equipment andsystems (whether they are purchased,

contracted, loaned or on trial) available,before they are used, to the engineering andbuilding services department so that it may:l undertake a safety and operational inspection;

l

develop an appropriately scheduled preventivemaintenance plan; and

l ensure that the equipment manufacturer’sinstructions, where appropriate, are available tousers.”





l It is the primary responsibility of theengineering and building services

department to maintain the services,equipment and fabric of theestablishment to a safe and usablestandard.

l Equally important is the maintenancedepartment’s role in ensuring that allfacilities meet current standards, codesand regulations.”

l It is the primary responsibility of theengineering and building services

department to maintain the services,equipment and fabric of theestablishment to a safe and usablestandard.

l Equally important is the maintenancedepartment’s role in ensuring that allfacilities meet current standards, codesand regulations.”




l ASHRAE define maintenance as “theperiodic servicing needed to preserve

an asset in its original condition ratherthan to improve that asset”. If maintenance is deferred, the buildingor equipment will suffer a loss in

function or will not efficiently performthe service for which it is used or maypose an increased risk to patients.

l ASHRAE define maintenance as “theperiodic servicing needed to preserve

an asset in its original condition ratherthan to improve that asset”. If maintenance is deferred, the buildingor equipment will suffer a loss in

function or will not efficiently performthe service for which it is used or maypose an increased risk to patients.




l Planned preventive maintenance is theprogramming of maintenance tasks or

schedules at specific intervals. In an airconditioning system it could includesuch tasks as checking the air filters,fans, coils and controls every three

months.

l Planned preventive maintenance is theprogramming of maintenance tasks or

schedules at specific intervals. In an airconditioning system it could includesuch tasks as checking the air filters,fans, coils and controls every three

months.




l Reactive maintenance is the principle of run to failure then repair or replace.

Planned preventive maintenancemitigates the risk of a reactiveapproach, such as major equipmentfailure, but can be wasteful and does

not prevent all failures.

l Reactive maintenance is the principle of run to failure then repair or replace.

Planned preventive maintenancemitigates the risk of a reactiveapproach, such as major equipmentfailure, but can be wasteful and does

not prevent all failures.




l A broad planned preventivemaintenance program will increase the

reliability of a health care facility’sbuildings and systems with lessinterruption to the provision of patientcare.

l A broad planned preventivemaintenance program will increase the

reliability of a health care facility’sbuildings and systems with lessinterruption to the provision of patientcare.



Maintenance in the healthcare

facility


facilityl Maintenance of a healthcare facility

differs from almost all other types of

buildings. The biological flora that areendemic to all health premises pose arisk to both patients and staff.

l Maintenance of a healthcare facilitydiffers from almost all other types of

buildings. The biological flora that areendemic to all health premises pose arisk to both patients and staff.




facility


facilityl The design and maintenance of the

building play a key role in controlling

both the proliferation and disseminationof harmful organisms.

l The best designed healthcare facilitywill cease to function to the designintent if the building is not maintainedto the original specifications.

l The design and maintenance of thebuilding play a key role in controlling

both the proliferation and disseminationof harmful organisms.

l The best designed healthcare facilitywill cease to function to the designintent if the building is not maintainedto the original specifications.



DoH maintenance standardsDoH maintenance standards

l The maintenance standards closelyfollow the cleaning standards risk

categoriesl The standards will determine minimum

acceptable quality levels in the healthindustry

l The standards will be a practical tool toimprove infection control and clinicaloutcomes

l The maintenance standards closelyfollow the cleaning standards risk

categoriesl The standards will determine minimum

acceptable quality levels in the healthindustry

l The standards will be a practical tool toimprove infection control and clinicaloutcomes



CommunicationCommunication

l Clear and open dialogue is essential toensuring each client knows the full

extent of services provided by themaintenance department /maintenance contract including serviceintervals.

l Clear and open dialogue is essential toensuring each client knows the full

extent of services provided by themaintenance department /maintenance contract including serviceintervals.




l Meaningful communication betweendepartments can identify critical needs

and expectations in both service designprinciples (what the client, includingthe patient, want and need) andgovernance principles (how the

maintenance system should work).

l Meaningful communication betweendepartments can identify critical needs

and expectations in both service designprinciples (what the client, includingthe patient, want and need) andgovernance principles (how the

maintenance system should work).




l It is vital to ensure clients understandwhat services can be provided to avoid

confusionl The maintenance department is

responsible for providing maintenanceservices within a predefined scope of

works. The limits of the scope of worksshould be clearly articulated to eachclient to ensure clarity of the range andscope of services provided

l It is vital to ensure clients understandwhat services can be provided to avoid

confusionl The maintenance department is

responsible for providing maintenanceservices within a predefined scope of

works. The limits of the scope of worksshould be clearly articulated to eachclient to ensure clarity of the range andscope of services provided



TrainingTraining

l Conduct regular in-service training of maintenance staff including regular

contractors

l Incorporate infection control intocontractor OHS induction

l Build & maintain good relationshipswith infection control staff

l Conduct regular in-service training of maintenance staff including regular

contractors

l Incorporate infection control intocontractor OHS induction

l Build & maintain good relationshipswith infection control staff



Product evaluationProduct evaluation

l A formal product evaluation committeeshould evaluate all patient related plant andequipment prior to it being put into service.The evaluation should include a written risk management process that includes inputfrom appropriate departments such asclinical units/ wards, engineering, infectioncontrol, occupational health and safety,clinical product advisor, biomedicalengineering or supply

l A formal product evaluation committeeshould evaluate all patient related plant andequipment prior to it being put into service.The evaluation should include a written risk management process that includes inputfrom appropriate departments such asclinical units/ wards, engineering, infectioncontrol, occupational health and safety,clinical product advisor, biomedicalengineering or supply



Audit & report Audit & report

Maintenance audit program consists of

l Physical audits

l Desktop audits

l Audit scoring system

l Corrective action

Maintenance audit program consists of

l Physical audits

l Desktop audits

l Audit scoring system

l Corrective action



Auditing Auditing

l An auditing process will form part of the standard via an internal self audit

systeml Internal audits can be conducted by

hospital staff

l An auditing process will form part of the standard via an internal self audit

systeml Internal audits can be conducted by

hospital staff



ReportingReporting

l Requirement for routine reporting tothe client

l

Requirement for variance reporting tothe client and infection control

l Requirement for annual audit report

l Issues have been raised relating to the

format, frequency and process andreport distribution (IC & client)

l Requirement for routine reporting tothe client

l

Requirement for variance reporting tothe client and infection control

l Requirement for annual audit report

l Issues have been raised relating to the

format, frequency and process andreport distribution (IC & client)



Functional areas included in risk

category A


category A l Operating Theatres: This may include

procedure areas in other departments

where significant invasive proceduresare performed and patients are at avery high risk of infection.

l Invasive procedure areas: Endoscopyand Catheter Laboratories

l Intensive Care Unit (ICU)

l Operating Theatres: This may includeprocedure areas in other departments

where significant invasive proceduresare performed and patients are at avery high risk of infection.

l Invasive procedure areas: Endoscopyand Catheter Laboratories

l Intensive Care Unit (ICU)




category A


category A l Level 2 and Level 3 Nurseries

l Special needs patient/area: areas with

patients in protective isolation or whoare immuno-suppressed, such as burnsunits and infectious disease unitsincluding negative pressure isolation

l Central Sterilising Department (CSD)

l Level 2 and Level 3 Nurseries

l Special needs patient/area: areas with

patients in protective isolation or whoare immuno-suppressed, such as burnsunits and infectious disease unitsincluding negative pressure isolation

l Central Sterilising Department (CSD)




category B


category Bl Sterile stock storage

l Emergency department

l Pharmacy – clean areas includingcytotoxic preparation suites

l General wards: This includes Level 1Nursery and CCU, oncology and dialysis

units, delivery and birthing suites, andnon-invasive treatment and procedurerooms.

l Sterile stock storage

l Emergency department

l Pharmacy – clean areas includingcytotoxic preparation suites

l General wards: This includes Level 1Nursery and CCU, oncology and dialysis

units, delivery and birthing suites, andnon-invasive treatment and procedurerooms.




category B


category BlMedical laboratories including

anatomical pathology

l Any area where a process orprocedure would elevate that areato a high risk category an additionalrisk assessment is necessary, forexample medical research involvingdangerous chemicals, radiation orbiological material.

lMedical laboratories includinganatomical pathology

l Any area where a process orprocedure would elevate that areato a high risk category an additionalrisk assessment is necessary, forexample medical research involvingdangerous chemicals, radiation orbiological material.




category B


category Bl Main food preparation kitchen

l PC 3 laboratories

l Dialysis unitsl Reverse osmosis filtration plants

lWater filtration plant

l Any area required to have a HEPA filter system, including biosafetyand clean cabinets

l Main food preparation kitchen

l PC 3 laboratories

l Dialysis unitsl Reverse osmosis filtration plants

lWater filtration plant

l Any area required to have a HEPA filter system, including biosafetyand clean cabinets

kevin moon proposed doh maintenance standards ppt

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