Meirovich 5th E. Africa Regional Healthcare Engineering Conference & Exhibition 16-18th November 2016 - Nairobi Introduction Project Backgrounds Question Traditional Work Scheme Challenges of Traditional Work Scheme Integrated Work Scheme Advantages of the Integrated Work Scheme Scope of Work Pre-installation works Computerized Planning Tools and Applications Conclusion Project Backgrounds MKCCA Project: 3 donor-funded hospitals in the City of Kampala Equipment value for the new hospitals: 35 -38% Equipment value for the rehabilitated hospital: 70% Dr Owen King EU Hospital St Lucia: co-funded by EU and the Govt. of St. Lucia Equipment Value: 40% Projects scheduled for completion within 24months Delays partly due to lack of synchronization between planning, design, construction, procurement & installation of medical equipment Question • How is it possible that given the functional importance and investment value of the medical equipment, it is not managed and synchronized with the construction works in the right way? Traditional Work Scheme • Does not consider link between medical equipment and built infrastructure • Is not attentive to special works for equipment to be installed • Assumes a parallel work flow where construction and equipment installation run in parallel or as consecutive activities • Fails and comes along with a several problems = negatively impact time and budget Traditional Work Scheme Traditional Work Scheme The planning team may have a physician or biomedical engineer who work independently. Forecast based on the needs and budgets reduced without the equipment team’s knowledge. Design is updated and changes are not reported until the works start. "Standard" needs of ventilation, temperature and humidity without consulting the specific requirements of the planned equipment. Heavy equipment that later requires structural reinforcements. Challenges of the Traditional Work Scheme Architecture solutions do not match purchased equipment requirements. The equipment is not considered when planning works ending with the removal of partitions, doors, windows and walls in order to get the heavy equipment in. Drawings of equipment sizes do not match planned/acquired equipment. Installation of equipment is considered to last just the final 3 months. Integrated Work Scheme Integrated Work Scheme Use planning tools that allow for integration and collaboration Identify the magnitude of the project in order to define the work team Define the scope of the works to be carried out Participate in the definition/discussion/changes of the functional plan Participate in the definition/discussion/changes of the architectural solution. Advantages: Integrated Work Scheme Definition of the requirements of installations in conjunction with sanitary engineering, installations and telecommunications equipment. Participate in the purchase and installation strategy together with the architects and the client during the design phase. Supervise the pre-installation and subsequently the purchase, installation and commissioning of the equipment. Document the entire process to facilitate its future management and maintenance. Evaluate the results obtained and propose improvements for future projects. Scope of Work Analyze the Functional Plan and propose technological options/alternatives (especially in critical areas, surgical block and in diagnostic imaging). Scale the main equipment according to the expected use. Make a preliminary budget estimate based on the functional plan. Develop the equipment plan for the entire hospital ("Room by Room"). Prioritize and incorporate the equipment based on VEN categorization of the Equipment Plan. Write the technical specifications of all the equipment. Scope of Work Make room layout plans ( "Room by Room Layouts") Prepare the room by room pre-installation requirements Make generic plans of equipment and furniture installation. Coordinate design changes with the Architecture and Engineering departments Perform the selection/contracting of equipment Develop the pre-installation and equipment installation schedule Supervise the reception, installation and start-up of the equipment Pre-installation requirements Electrical and lighting Insulation for operating theatres and special laboratories. Hot and cold water Steam for sterilization, laundry and kitchen Medical gases Ventilation, air conditioning, humidity Vapor extraction for hoods, biosafety cabinets, anaesthesia tables Armor for radiology, radiotherapy, brachytherapy equipment Wall and ceiling reinforcements for anchoring equipment and furniture Computerized Planning Tools and Applications: Room Editor Computerized Planning Tools and Applications: FF+E Details Editor Computerized Planning Tools and Applications: C-Sheets Computerized Planning Tools and Applications: Asset Data Collector (Testing & Commissioning) Computerized Planning Tools and Applications: Asset Data Collector (Testing & Commissioning) Computerized Planning Tools and Applications: Reports Conclusion • Equipment should be considered as an integral part of the project requiring adequate resources & planning time to avoid surprises during installation • The hospital equipment planning team should be incorporated and the process integrated from facility’s conception to completion and commissioning. • The planning team should include members with diverse skills to contribute specialized knowledge which improves planning; equipment solutions; reduction in costs and installation times Conclusion • The use of an integrated work scheme enables smooth information flow; budget control; synchronization of the equipment procurement & installation with the civil works • BIM/Computer tools and applications enable better management of complex data associated with the design, construction, equipping, up to full operationalization of a health facility Thank You/Gracias/Asante Sana Equipment Planning Synchronized with Hospital Design and Construction
by
Dr. Ruth Sengonzi & Claudio
Meirovich 5th E. Africa Regional Healthcare Engineering Conference & Exhibition 16-18th November 2016 - Nairobi