Zoe Allen, the company’s Marketing and Product Innovation director, outlines the new opportunities in this field for those charged with maintaining such equipment – typically NHS EFM professionals – via the ability to audit, collate, and evaluate data on the performance, reliability, and operation over time of individual machines
In the broadcast and printed media these days we regularly see images of ambulances queuing up outside overburdened and under-resourced hospitals. This is one of the most obvious and immediate signs that the NHS is facing some of its greatest challenges in its history, especially with continuing difficulties in recruiting nurses and clinicians, and the impact of the clinical backlog that has built up in the wake of the COVID-19 pandemic. There is little sign of a respite as hospitals struggle to cope with surging patient numbers
Hard-pressed NHS Trusts are declaring critical incidents with worrying regularity – a scenario that would be even more alarming if it were reported more widely. This crisis has become so commonplace that some Trusts are quietly cancelling appointments and procedures without highlighting the situation as critical. The UK has just 2.4 hospital beds per 1,000 people, British Medical Association data reveals. That is less than half the EU OECD average, with the UK ranking second-worst in a table of 23 nations. The idea of one of your hospital wards having to close due to a healthcare-associated infection (HCAI) is unthinkable. At a time when you can’t spare a single bed, losing a ward to infection – however briefly – cannot be allowed to happen.
FM professionals on the frontline
Maintaining stringent hygiene levels in sluice rooms in hospitals is one of number of key priorities for the EFM professionals whose job it is to keep hospitals and the spaces within them in a safe and hygienic condition conducive to first-class care. Estates and facilities professionals are as much in the frontline as doctors, nurses, and other clinicians, when it comes to infection prevention and control. They’re the ones who will face additional scrutiny should infections occur because vital sluice room equipment has broken down due to insufficient planned preventative maintenance (PPM). However, with all the added pressures facing NHS Trusts, and the many competing priorities that EFM teams face, it is becoming harder than ever to monitor the condition of sluice room machines – especially when there are so many individual units scattered across Trusts’ multiple sites.
A need for regular servicing
Medical pulp macerators and bedpan washer-disinfectors need regular servicing. Reliable machines may have long lifespans, but those durations are finite. So, Trusts’ FM teams must monitor the condition of these machines closely, and be able to forecast accurately when they will need replacing. This is seldom straightforward – but even less so when the various machines across a sizeable estate have been installed at different times by a number of suppliers. Each company will have its own maintenance schedules, and its own means of delivering aftercare.
There is also the ever-pressing matter of keeping your sluice rooms supplied with consumables such as medical pulp, bedpan washer, and scale inhibitor, all while remaining in budget and on course to hit the NHS Net Zero Carbon Footprint targets. All of this is not an easy task for EFM personnel already facing the challenge of looking after ageing infrastructure amid tight budget constraints, meeting compliance requirements, and ensuring a comfortable, clean, welcoming, and accessible environment for all the buildings’ users. Playing their part – in tandem with clinicians and nursing personnel – in maintaining a clean and hygienic patient and staff environment that minimises the risk of infection transmission has always been a priority for hospital EFM teams. However in the wake of the pandemic, and the lessons learned about transmission routes, the whole area of infection prevention and control has fallen under ever-increasing scrutiny.
Helping to prevent HCAIs
Getting better performance from sluice room equipment is an obvious way to prevent and control healthcare-associated infections (HCAIs). It reduces infectionrelated bed blocking, freeing up vital bedspace, and enabling more patients to be treated more quickly – improving patient outcomes and reducing waiting lists
Improving sluice room machines’ performance also reduces operating costs and improves return on investment – enabling funds to be redirected to other pressing projects. Without the right machine auditing and review information, these improvements are less likely to happen. Intelligence and data are at the heart of the solution: knowledge is power. Ideally, all equipment should be detailed in an asset review outlining the precise location, condition, maintenance history, and requirements, of each machine. The whole report should then be summarised for an easy, at-a-glance view of all the Trust’s sluice room assets and their performance
Not enough detail supplied
Something this fundamental sounds simple enough – but in reality, few sluice room equipment manufacturers supply this information in anywhere near the level of detail required. Nor do they provide a whole-of-estate report that covers every machine used by a hospital, regardless of its manufacturer. This is because sluice room equipment is such a specialised area of manufacturing. Of the few companies operating within this important area of healthcare, only one (us at DDC Dolphin) is capable of repairing and maintaining all suppliers’ equipment, and providing the detailed level of auditing and reporting that FM managers require on a daily basis.
A detailed Asset Report
A typical DDC Dolphin monthly Asset Report will include line after line of detailed information about every single medical pulp macerator and bedpan washer-disinfector in the hospital(s). Extensive detail about the performance and condition of scores of machines can be summarised in just half a dozen pages. Information is conveyed in an easy, at-aglance format. A typical Asset Summary Review will include the:
total number of sluice room assets.
number of DDC Dolphin machines within the facilities.
number of machines on service contracts.
number of machines by type.
number of machines under warranty. A condition summary will highlight the number of machines that are:
brand new to three years’ old.
four to six years’ old. n seven years’ old or more.
10+ years’ old
It will also detail the number and value of any outstanding repairs, along with numbers of call-outs, parts fit visits, and services. Below this summary appears an even more detailed asset review. This spreadsheet lists the following information for each individual machine:
account.
make, model, and serial number.
delivery date.
machine condition (on a scale of 1 to 10).
last case date – when the machine was last seen.
contract end date.
outstanding repair quotes.
call-outs (over the past three years).
total spend (over the past three years)
The bottom line totals the outstanding repair quotes plus the number of call-outs and total spend over the last three years
A range of data formats
Data can be provided in the usual formats. PDFs look good for reporting and presentations, but spreadsheets enable fast filtering and data sorting. Estates and facilities managers can see very quickly which manufacturers and machines have enjoyed the best reliability record and provided excellent value for money. This enables smarter and better-value purchasing – maximising machine uptime, and providing superior protection against the risk of HCAIs
Filtering and sorting the data also enables EFM personnel to see more quickly which wards at their hospitals have experienced the most issues with their machines. This may indicate that the medical staff in those wards require further training to ensure that they are using the equipment correctly – improving machine uptime. In turn, this will also enable clinicians to work more safely and efficiently. Faster, better operation of sluice room machines allows staff to dedicate more time to other aspects of patient care
The spreadsheets and PDFs also make it easier to produce detailed reports for Care Quality Commission (CQC) inspections. Compliance becomes simpler and less time-consuming, assisting in the drive to attain or maintain the highest CQC ratings.
Reporting via an online portal
All this detailed reporting can be made available via an online portal. This enables smarter real-time reporting. Users see the full information on repairs, call-outs, and reports, without the need to get in touch with an Account manager, and when they do wish to speak with their Account manager, they see the same precise information that DDC Dolphin team members are viewing on their system. Everyone is looking at the same picture at the same time, avoiding confusion and speeding up the process. FM teams can quickly grasp the challenges facing them and agree solutions to resolve them. They can swiftly approve maintenance or the replacement of capital assets, and then move on to their next task – secure in the knowledge that their Trust’s depth of defence against HCAIs will remain strong and resilient.
DDC Dolphin’s online portal enables FM teams to log in and view data ‘24/7’ from any location with a broadband connection or mobile signal. This means fewer meetings, less travel, more time saved, greater productivity – and a smaller carbon footprint. It’s another step forward in the NHS’s journey to reduce direct carbon emissions by 80% by 2028-2032, and to achieve Net Zero by 2040 (direct emissions) and 2045 (indirect emissions, such as those from suppliers). Aside from the obvious cost efficiencies, work/life, and environmental benefits, the online solution comes back to the vital issue of infection prevention and control. Working from home or elsewhere off site during a major COVID outbreak, or the annual ‘flu season, minimises the risks to patients and clinicians on the wards
The true cost of sluice room machine breakdowns
Medical pulp macerators and bedpan washer-disinfectors should be serviced twice a year. Planned preventative maintenance extends machine life – leveraging greater value from each unit – and reduces the risk of unplanned downtime. The typical life expectancy of a medical pulp macerator or bedpan washer-disinfector is usually 10 years, although some private sector operators choose to run their machines beyond this point Fail to service a sluice room machine correctly, and its lifespan may be cut to seven years. That in itself is wasteful, but unserviced or poorly/irregularly serviced machines can break down as many as three times a year. At best, this costs an average £2,100 per machine in call-out charges, labour, and spare parts – and that’s before you factor in the loss of productivity. Based on two shifts of four nurses per ward, the average cost of lost productivity is conservatively estimated to be £1,584 (based on three machine failures per year).
At worst, a machine failure can result in an infection spreading in the hospital – harming patients and clinicians. Medical negligence compensation claims for HCAIs can run to £40,000. Even a minor claim for an HCAI-related illness can be as high as £3,000
Claims for sepsis – the body’s extreme reaction to an infection – can cost millions of pounds. In January 2023, a young girl who had both arms and legs amputated after delayed diagnosis of meningococcal sepsis had a £39 m settlement approved in the High Court
Dealing with downtime in the most efficient way
Enhanced reporting is one thing – but what happens when a medical pulp macerator or bedpan washer-disinfector breaks down? Spreadsheets or PDFs – as useful as they are – won’t wave a magic wand over the machine and fix it – but there is another very costeffective solution: DDC Dolphin operates a demonstration service. In certain circumstances, it may be possible for NHS Trusts (and large operators of multiple care homes) to request a medical pulp macerator on free trial. This enables them to evaluate machine performance, functionality, ease of use, and running costs, in the real world.
Trusts can see how macerators such as the Pulpmatic Eco+ (the most environmentally friendly, economical and hygienic macerator on the market,) and the larger Uno and Ultima, outperform their existing machines. This free trial also applies to DDC Dolphin’s Panamatic bedpan washer-disinfectors.
From breakdown to opportunity
So, what starts as a machine breakdown issue swiftly becomes an opportunity to improve infection prevention/control, save time and money, and reduce carbon emissions. It is also an opportunity to review other advanced waste disposal solutions such as Vacumatic, a 100% hygienic, efficient, and odourless system. Hermetically sealed bags store waste safely and vacuum-compact it – reducing the cost of disposal.
If a sluice room machine breaks down, then the impact is all too obvious. Equally insidious, however, are the hidden extra costs that are accruing in machines which appear to be working perfectly, and yet may be underperforming. Limescale build-up in a bedpan washer-disinfector can significantly increase its operating costs, because more energy is needed to heat the chamber. A mere 1 mm of limescale can increase operating costs by 11%. Limescale can also stop the heating filament from reaching the temperature needed to properly disinfect waste utensils.
Multiply that 11% rise in operating costs by the dozens of bedpan washers in the average hospital, and the energy bill swiftly mounts up. For every nine bedpan washers you operate, you’re effectively paying for the energy of a 10th machine that isn’t there – and that is before you begin to consider the negative impact on your hospital carbon footprint – at a time when environmental targets are very much a priority
Degreaser and scale inhibitor
Furthermore, bedpan washers need degreaser and scale inhibitor, and medical pulp macerators require disinfectant to stop bacteria from growing inside, which must, incidentally, be the right disinfectant. Cheap alternatives may look good on paper, but they often need higher dosages – so more has to be purchased. That means more administration, and more time… and suddenly the so-called saving is not the value proposition it promised to be. Use the wrong chemicals or the incorrect dosing, meanwhile, and your machine may not last as long. Worse still, the risk of infection increases – making the possibility of an HCAI outbreak more likely.
Outsourcing the servicing, maintenance, and supply of chemicals is the obvious solution. As a facilities management professional, however, do you really want to be dealing with a plethora of suppliers, all with their own contracts, timescales, quirks, and foibles?
Servicing all makes and models
As previously stated, DDC Dolphin is the only sluice room equipment manufacturer capable of servicing all makes and models of sluice machines, using its own directly employed engineers. They provide a rapidresponse call-out service throughout the UK, based on 24- to 72-hour service level agreements. Engineers are based all over the country, minimising the time spent travelling to hospitals – speeding up the response to call-outs. These engineers are trained to operate within strict infection prevention protocols, and are equipped with high levels of personal protective equipment (PPE). Hospitals that specialise in treating highly contagious tropical diseases depend on these specialists for sluice room equipment servicing, maintenance, and installations.
Streamlining administration
Estates and facilities managers can streamline the administration of this vital servicing work through a series of ‘360° care packages’ and agreements that help Trusts to:
avoid unplanned costs.
catch potential issues before they develop, preventing unexpected downtime, and extending the lifespan of machines.
accurately forecast budgets, thanks to fixed-price packages over five years.
guarantee the timely supply of all the necessary chemicals (with discounts) based on yearly, quarterly, or monthly deliveries
This creates a virtuous circle which enables Trusts to improve their sluice rooms while still remaining within budget. Money saved through extended machine life, greater reliability, and lower energy usage, enables Trusts to replace older equipment with new machines… which in turn perform better and save yet more money. This is all to the benefit of patients, clinicians, and the wider community, through superior infection control and lower carbon emissions.
Zoe Allen
Marketing and Product Innovation director at DDC Dolphin, Zoe Allen, joined the company in May 2016 as Marketing manager, before becoming Marketing director in January 2017. In October 2021, her role expanded to include product innovation to further strengthen DDC Dolphin’s position at the forefront of sluice room technical development. DDC Dolphin manufactures medical pulp macerators, bedpan washer-disinfectors, and incontinence product macerators. The company also supplies the Vacumatic waste disposal system and UVMATIC air purifiers.
Zoe Allen is responsible for the planning, development, and delivery, of all of DDC Dolphin’s global marketing, brand, and communication strategies and activities. She works closely with the group’s UK and international sales teams and global distributor network. In February 2021, she also became Marketing director at Hygenex, a DDC Dolphin brand now a separate company in its own right whose products include machine and patient care consumables, hospitalgrade stainless steel furniture, and sluice room accessories.