Hospital of the Future

March 1, 2001
On the Cutting-edge With Advanced Electrotechnology
By Barbara L. Vergetis Lundin

Electrotechnologies may seem the way of futuristic science fiction movies, but such cutting-edge opportunities are helping healthcare facilities make the leap into the future – today – in a number of ways: conserving water and energy, improving operating efficiencies, lowering operating costs, preventing the spread of infectious disease, providing cleaner environments for employees and patients, complying with environmental regulations, and reducing electricity and natural gas consumption.

When Mercy Health Center opened its doors after recent upgrades, it showcased an array of advanced electrotechnologies that will enhance patient services while cutting costs and improving operating efficiency.

The opening of the new facility in Laredo, TX, caps an ambitious collaborative effort involving a utility, American Electric Power (AEP, formerly Central and South West Services, Tulsa, OK), its subsidiary Central Power & Light, the Sisters of Mercy Health System, and the Electric Power Research Institute (EPRI, of Palo Alto, CA) Health Care Initiative.
Teamwork On-Site and Beyond
“The Mercy Health facility not only provides direct benefits to the community, it also serves as a demonstration site where other healthcare providers can learn about a wide range of electrotechnologies,” says James “Bud” Clark, technical support engineer, AEP.
Some of the cutting-edge electrotechnologies that position Mercy Health Center as a hospital of the future are:

• Bio-medical waste disposal. The hospital’s first-of-its-kind, medical waste disposal system shreds waste, disinfects it in a fluidized bed of heated air, and then ejects the treated material into sealed containers.

• Lighting systems. High-efficiency lamps provide lighting throughout the facility, and ultraviolet germicidal lighting reduces the risk of exposure to tuberculosis and other airborne diseases.

• Ozone water purification. The hospital’s laundry uses ozone to clean and disinfect washables and is also equipped to reuse water and reclaim heat. Water heating costs have been reduced by 90 percent, water consumption and chemical usage by 50 percent, wash time by 20 percent, and fabric life has been increased by 25 to 40 percent. Ozone also purifies water in the facility’s cooling towers as an alternative to chemical treatment.
Although many hospitals may employ one or two of these systems, Mercy Health Center is one of the few hospitals in the country to use them all.

Building Mercy Hospital and incorporating advanced electrotechnologies was no easy feat, however. No stone was left unturned, and no department was left out.
“We had an all-around team to work on everything we were bringing in,” recalls Ed Woodruff, vice president of hospital support services, Mercy Hospital. “The work was pretty evenly divided up among all departments involved.”

Close-up of Electrotechnologies at Work
Mercy Hospital’s biomedical waste disposal system is based on a process used in Europe for the purpose of drying fruit. It has also been used in the mining industry for drying out stone before it was crushed so it would not have an excessive amount of water as the product was being prepared for its final use. The hospital uses the equipment as a process to heat hazardous, red bag waste.

The equipment is about two stories high, 10-feet wide, and 20-feet long. The hazardous waste is placed in a cart that is put on a conveyer belt. The conveyer belt moves the cart and trash and dumps the trash into a shredder.

“The shredder has four sets of gear teeth that shred the hazardous waste into particles about the size of confetti and drops it into a chamber that looks like the top of a space capsule,” describes Woodruff. “That chamber is heated to 160 degrees and spun around like a tornado for about 4.5 to 5 minutes.”

This heating process sterilizes the waste. At the end of this process, all the sterile waste is dropped out of the bottom of the machine into a dumpster from where it is hauled to a landfill.

The equipment is ideal for the hospital because it deals with so many infectious diseases. “It’s excellent for employees, because once the waste is put in the red bag, it is never again touched by human hands,” explains Woodruff. “It stays in the cart where the red bag is placed so they are not exposed to the contents. When the cart gets down to the loading dock, which is where the equipment is located, it is picked up by conveyer and treated with no manual assistance from anyone.” Another perk: The machine is completely computer operated.

For its lighting, the hospital installed two types of systems. Overall lighting in the hospital was upgraded to high-efficiency halogen-type bulbs to reduce electrical bills. Conversely, specially filtered, ultraviolet lights were installed in emergency and operating rooms to prevent the spread of airborne diseases.

“Tuberculosis is very prevalent here on the border of Texas, so the ultraviolet lighting is intended to destroy any airborne tuberculosis and other airborne disease spores,” contends Woodruff. He explains that the lighting uses a special kind of filter, which takes in the spores and sterilizes them so the recirculated air is clean.

The facility is in the process of installing independent electric meters in areas of the hospital, such as laundry, dietary, etc., so that savings from the halogen and ultraviolet lighting can be calculated. Woodruff anticipates that the first cost compared to the end result is going to yield significant savings.

An ozone water purification system generates ozone through the hospital’s plant and then pumps it into water-cooling towers. “We saw a steel plant in Ohio using the ozone water purification system, and the water in the cooling towers was so clear and the tank so clean it looked like you could drink the water right out of the tower,” says Woodruff.

There is no algae growth in the cooling towers, making for an inexpensive process in terms of reduced chemical usage and less frequent cleanings. “The system cuts down on pollution because of the decrease in chemical usage,” he says. “We don’t have to drain and clean the tanks as frequently as with the old towers. Overall, it’s a more efficient process.”

The hospital also uses the ozone system in the laundry where ozone is pumped into the wash machines. As a result, the amount of chemicals and bleach the hospital has to use for each load has been reduced. “A big factor for us here in Texas where it’s so dry is the cost of water. We take the final rinse water from the previous load and use that as the first wash water for the next load,” explains Woodruff. “We are actually reducing our water usage by one-third and reducing chemical usage considerably.”

The hospital’s pneumatic system is the “same old tube-type system” the hospital has always used, according to Woodruff, but this one’s completely computerized. If a nurse is ordering narcotics, for instance, he or she can call the pharmacy and ask for x amount of morphine. Pharmacy will give the nurse a code that is required to retrieve the medication when it is sent to the nurse. Once the tube gets to the nursing area, instead of being released into a basket intended for medications, it is held and locked until the nurse that ordered it goes to a control panel and punches in the code she was given by the pharmacy. Then, and only then, will the tube drop out so the intended nurse can retrieve the morphine.

The pneumatic system records that the medication left the pharmacy, who it went to, the security code, and that the nurse received it. Laboratory testing is also expedited as the pneumatic system is used for transport between the emergency room and laboratory.
“In the past, we had a sub-lab station in the emergency room, which was costly both through duplication of equipment and the number of full-time equivalents involved in supplying that particular service to the emergency room,” says Woodruff. “Now that we have the tube system, we can send all of the specimens from the ER directly into the lab and stats can be turned around quickly. Most of our results are done within 45 minutes or less, unless it’s a specific test that needs to be sent out to be analyzed.”

One of the biggest complaints the old Mercy Hospital experienced involved the facility’s HVAC system; oftentimes, one patient in its semi-private rooms was too hot and one patient was too cold. The new hospital has all private rooms, each with its own thermostat control. In the room, the temperature can be adjusted 2.5-degrees up or down simply by adjusting the thermostat – which patients can do themselves.

“If that’s not enough, the patient can call the plant with the phone number we provide and tell them whether they are too hot or cold. One of the plant operators will go into the computer and adjust the temperature in the room,” says Woodruff. “From a patient satisfaction standpoint, it has been worth every penny we put into it.”

He can say the same thing about the hospital’s new laser a la carte food processing system with which the hospital is now cooking and quick-freezing its foods. After a patient orders a meal, the meal is cooked and sent to the patient’s floor up to an hour and a half before the meal is to be served, and plugged into an electric “gas station.”

“The food is maintained at a temperature according to the way it’s supposed to be served. For example, the ice cream is maintained at a cool temperature while the coffee is kept hot. This is done by splitting the tray into sections and using laser power,” explains Woodruff.
“Since we have done this, we have had little to no complaints about the food being too hot or too cold,” he says. “Now the only complaints we get are from people on salt- or sugar-free diets who claim the food is bland or they haven’t gotten dessert.”
Doing Your Homework
When looking to hire an architect, Mercy Hospital interviewed about seven firms, subsequently narrowing them down to three based on their experience with building hospitals. Ultimately, the chosen architect had designed in excess of 50 hospitals – more than 20 of them in recent years. For the contractor, Mercy Hospital received recommendations from the architect, as well as referrals of firms its sister hospitals had worked with in the past.
After the architects and contractors had been hired, attention turned to choosing and purchasing new equipment. Woodruff offers this piece of advice: Make sure you see the equipment in operation.

The representatives of Mercy Hospital wanted especially to see how the waste disposal system worked for destroying hospital waste. “We told them we were coming and wanted to see how the system did with destroying the type of waste we would have,” explains Woodruff. “The vendor went to Parkland Hospital in Dallas, had them sterilize a bunch of their waste, and sent that waste by plane to Ohio so actual hospital waste could be run through the machine.”

Woodruff and others witnessed the system chopping up surgical scalpels, syringes, and other hazardous hospital waste, as well as 4 by 4 wood blocks, computer keyboards, and steel-belted radials.

Woodruff admits to minor problems shredding certain large sharp containers used in hospitals. Many were sliding on the gears and not going into the machinery properly. The vendor was contacted and made the necessary modifications.

“We are still in close contact with the vendors of all our equipment,” says Woodruff. “We are a beta site for all of the new electrotechnology brought in and are working with the vendors to make corrections we feel need to be done.”
Deregulation Challenges
For other hospitals contemplating similar advanced electrotechnology upgrades, these projects may not be as straightforward due to the state of utility deregulation.
“Deregulation will make a project like Mercy Hospital difficult in the future,” contends Clark. “The deregulation issue right now is still unclear. AEP is operating in 11 states and what we can or can’t do in the future for our customers from a regulated wires perspective is uncertain.”

For example, in Texas, according to Senate Bill 7, regulated utilities will not be allowed to work with end-users beyond making sure the wires are connected to the building and power is flowing. They will only be able to work with customers on reliability- or power quality-related issues. The bill has evaluated many of the services provided by utilities and grouped them into what they called “competitive energy services,” meaning that the regulated utility had a monopoly and competitive advantage on offering these services. Under Senate Bill 7, regulated utilities can no longer offer these types of services.

On the other side of the coin, even if utilities are allowed to offer these services, they may simply not be able to
afford to. “Depending on how individual states require the utilities to unbundle their services, the revenue component for generation and transmission may be taken away,” contends Clark. “When you do that, there simply isn’t enough margin in distribution to justify offering those types of services.”

That isn’t to say that electrotechnology upgrades like the one at Mercy Health Center can’t be done. They will simply be more challenging. Short of contacting each electrotechnology manufacturer individually and having them perform upgrades on a separate contract basis, facilities professionals can contact consultants who can complete the project turnkey for a fee. Unregulated retail subsidiaries or energy service companies (ESCOs) will still be able to offer these types of services if they choose.
The trick will be in finding one.

Barbara L. Vergetis Lundin is a freelance writer living in West Bend, WI. Lundin has eight years experience writing about facility issues.

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