Question: We are building our hospital in Ghana. We are at the foundation level and considering drywall partitioning although the design of the hospital did not take drywalls into consideration. Do you think we can just substitute drywall for cement blocks?
– Theresa Augustt, Ghana
| Tarun Katiyar |
Answer: Drywall partition systems are a lightweight drywall system consisting of GI (galvanised iron or wood or aluminium) frame with plasterboard fixed on either side with the drywall screws. The drywall partition is used extensively in areas such as consultation rooms, patient rooms, administrative and back office areas etc. Drywalls can be substituted for regular walls since a drywall is thinner than a brick wall. Hence, a drywall can be used at any time during construction and this will in turn reduce the load. The using of drywall as a substitute to masonry walls will not affect the structure of the building at all.
Using a drywall results in flexibility in creating and dividing spaces according to your needs. Moreover, the speed of installation is 3-4 times faster than masonry work. It also results in less of dirt at the time of installation and the finish is much better with drywall.
The other major objectives of using dry wall are:
- Fire resistance from one hour to four hours
- Limited combustibility
- Systems with glass wool/ mineral wool insulation can provide STC ratings up to 60
- Can take any type of surface decoration
Recommended for drywall partitions in areas like server rooms, corridors, spandres, industrial partitions, room to room partitions in hospitals
Question: What are the steps to be taken for energy conservation in a hospital?
– Sravanthi Karlapudi, Andhra Pradesh
Answer: One of the major consumers of electricity within the hospital environment is the ventilation system. Hospitals often require 100 per cent ventilation of fresh air to reduce the risk of microbial contamination. The HVAC system accounts for 45 per cent of the total energy used in hospitals. Lighting is another area of energy consumption accounting for at least 25 per cent. Other operations such laundering, sterilisation, and cooking account for another 30 per cent of energy expenditure.
Energy management systems help in controlling air-handling units, HVAC and lighting from a centralised location. This will help in the reduction of unnecessary lighting and cooling of areas that are not being actively used.
Hospital cooling costs can be reduced by using a refrigerant additive like Permafrost to air conditioning systems and food service-related cooling equipment. This helps in reducing the amount of time that the compressor has to run and save energy which in turn, increases the compressor’s life.
Heat recovery coils, when installed in exhaust air handlers, can help in capturing waste energy without the risk of contamination. Heat recovery can also be done for sterilisation equipment, laundries, dishwashers and cleaning equipment. Hospitals should also be equipped with direct digital controls.
Equipment such as televisions, computers, lamps that give off heat should not placed near thermostats. The heat generated from this equipment can affect the thermostats leading to increase in the energy spent on cooling.
Question: While planning a hospital (new facility), what are the points that one needs to consider?
– Puneet K Jain, Jaipur
Answer: Constructing a hospital is more complex than any other building we have to incorporate all the facilities and services and face many constraints. When a hospital facility is planned, there are few important points to be considered from the various aspects of hospital building.
For convenience, these may be classified into the following categories:
- Functional aspects
- Architectural aspects
- Patient safety aspects
These aspects would have significant impact on the entire facility. Some of the important factors which fall under these categories and need to be considered while building a hospital facility are as follows:
- Understand the traffic flow (patients, visitors, staff) and adhere to the fire exit plan
- Access to the hospital such as – ramp and stretcher lifts
- Facility mix and service mix of the hospital
- Sufficient parking for ambulance and patient visitors and staff
- Space/ provision for biomedical waste management
- Radiation/ radiology unit location
Question: There are few parameters which one can use to rate a hospital’s performance financially. But, what would be the most critical operational parameters which we should look for while distinguishing efficient and not so efficient hospitals? Some benchmarks would help.
– Punit Malik, Mumbai
Answer: The operational efficiency of the hospital can be measured through several parameters such as rate bed occupancy (BOR), bed turnover rate/ratio (BTR), average length of stay (ALOS), inpatient-outpatient ratio (IP/OP), discharge against medical advice, leave against medical advice etc. However, quality in providing service would also be a parameter that one can think of. These indicators are related to various areas such as human resource, laboratory, equipment, medical records, nursing, stores, infection control.
Some of the other indicators are: percentage of mortality rates, percentage of hospital acquired infection rates, nurse-patient ratio in ICU and wards, number of incidence of protocol deviations, percentage of wrong medication, percentage of cases wherein screening for nutritional needs has been done, percentage of adverse anesthesia events, percentage of unplanned return to OT, percentage of re-scheduling of surgeries etc.
In terms of equipment, some points to be considered are – equipment downtime, number of procedures done on the equipments, the workload etc.
There are in total 63 indicators of quality which are given in detail in the new edition of NABH quality indicators. These would serve as some of the benchmarks for operational efficiency.
Readers can send in their questions or feedback to us at email: tarun.faq@gmail.com