The ‘state-of-the-art’ showroom features a fully equipped operating theatre and ICU facility designed ‘to inspire and facilitate collaboration’ within the healthcare industry. The impressive new facility played host to the IHEEM North-West Branch’s latest meeting, with members given early access to this innovation hub, providing them with the unique opportunity to explore the facility before its official opening later in the year. The Branch Chair, Alistair Cameron, and IHEEM President, Alison Ryan, were among the attendees.
MIG Medical delivers turnkey healthcare fit-out projects and specialist construction services within the public and private healthcare sectors. Its services include medical gas pipeline systems, operating theatre construction and fit-out, clinical equipment supply, and mobile gas pod and plant room fit-out. The Innovation Centre provides the opportunity for FM providers, architects, contractors, healthcare professionals, and M&E consultants, to explore hard-to-access clinical areas without the risk of disruption to live services — such as pendants, lights, and acute medical devices and connected technologies. The facility also boasts a spacious lounge, events space, boardroom, and Washroom Workshop facility.
MIG brands include MIG Medical, Mechanical, Facades, and Qatar, and the company operates across the UK, as well as in Middle East, Asia, and Africa. Showroom partners include Dräger, Arthrex, Barco, Concept Cubicle Systems, Medi-Form, Washroom Fit-Out Company, Aspire, Norwood, SDS, Altro, and Saturn Visual.
Case study
North Devon District Hospital
Attendees at the event were shown a short video explaining how MIG Medical has helped North Devon ‘crown’ its new Coronation Suite. The Royal Devon University Healthcare NHS Foundation Trust (RDUHT) is Devon’s largest employer, with over 15,000 staff providing healthcare services to more than 615,000 people. One of its acute hospitals, North Devon District Hospital in Barnstaple, is included in the New Hospital Programme (NHP), and was confirmed as a priority for investment in 2020. MIG Medical managed and delivered a full modular fit-out for the hospital’s new Jubilee Ward. The project saw the company shortlisted for the 2022 Healthcare Estates IHEEM Healthcare Supplier of the Year Award.
Following this success, RDUHT approached MIG Medical again to fit out North Devon Hospital’s new Coronation Suite discharge lounge, which features 12 beds alongside a staff base. The modular construction project took just 12 weeks to complete, including all partition walls, flooring, ceilings, and mechanical and electric services — including nurse call alarms and both HVAC and air-conditioning systems.
MIG Medical coordinated carefully with a range of different trades to ensure the success of the project, with Wernick Buildings providing the outer shell before MIG carried out the full fit-out.
Dräger, for its part, describes itself as ‘a global leader in medical and safety sectors’, providing ‘Technology for Life’ dedicated to improving acute care environments through innovative solutions. The business was founded in 1889 in Lübeck in Schleswig-Holstein, Germany, and has grown into a worldwide enterprise now in its fifth generation as a family-run business. Dräger has more than 16,000 employees, and is present in over 190 countries.
Stefan Dräger, Chairman and CEO, is quoted as saying: “Helping to reduce the number of preventable deaths in hospitals is a pledge that I made. My personal goal goes beyond, being: ‘Improving Acute Care with technologies and services that lead to therapy assistance, and ultimately to hospital automation’.” Joanna Tolputt and Dan McNeilage, both Business Development managers at the company, provided an introduction to Dräger Medical UK, explaining that with over 130 years of innovation in medical technologies behind it, Dräger is a specialist in high acuity medical workplace design, and ‘provides support in every step of the planning process, to enable delivery of bespoke solutions’. Dräger says its expertise in OR, CCU, NICU, and ED ‘enables a patient-centred design approach, improving ergonomics and outcomes by optimising workflows’.
A key consideration for the NHP, and hospital refurbishment design, is the ability to ‘flex’ healthcare spaces rapidly to meet the demands of changing healthcare needs, reducing risk and providing a better place to work. In addition to medical supply systems and lights, Dräger also supplies patient monitoring, connected technologies, anaesthesia, and ventilation and warming therapy devices for acute care. During the presentation, the Dräger speakers provided an overview of its 3D Tool, which assists clinicians and designers to visualise workspace design.
Improving critical care environments
Dräger explained that its Ambia medical supply units, which were also covered, ‘reduce risk in the clinical area, enabling devices to be mounted to the pendant column, providing a clear ergonomic, patient-centric, working environment’. Different arm length lifters and column sizes can be customised to fit within the environment and pivot around the patient. Dräger says: “The Ambia system’s innovative mounting concept is designed so that changes to the workplace can be quickly and easily adapted to changing clinical needs. Its curved edge design aids the cleaning process, and thus ensures more safety against infections in the acute workplace. The numerous colour designs and lighting options allow family-integrated care, helping to create a healing patient environment that has been shown to improve patient outcomes.”
Connecting medical technologies can revolutionise care, Dräger says — one of many advantages being better-informed treatment decisions with the help of comprehensive patient data. The company said: “Patient monitoring alarms play a vital role in protecting patients in intensive care units by alerting clinicians, enabling them to respond to time-critical changes in a patient’s condition. However, the sheer number of acoustic alarms can be stressful and overwhelming, leading to sensory overload, resulting in desensitisation to alarms and alarm fatigue — potentially missing important alarms.”
Dräger continued: “The noise in an ICU environment can also lead to patients developing delirium. Over 30% of patients treated in ICUs become confused or develop delirium, leading to longer patient recovery times, and requiring increased input from caregivers. Standard ICUs recorded noise levels above 45 dBA at all times, over the 35 dBA suggested by the World Health Organization”. David McNeilage and Joanna Tolputt explained that one study had suggested that 771 alarms may occur on average per day in each ICU bed. More than 80% of all alarms were found in the research to be’ clinically irrelevant’, with 50% ‘not even noticed’ (Source: AAMI Foundation 2012).
Dräger said: “Effective alarm management in critical care environments enables you to systematically reduce noise pollution for patients and staff to an acceptable level — this has particular significance in neonatal units. Alarm management reduces risk of harm to patients by ensuring that the right person is alerted to important alarms with the right priority.” Dräger collaborates with Ascom for an integrated alarm distribution solution — via the sending of alerts from the Dräger patient monitors and ventilators via the Distributed Information System (DIS) to a caregiver via mobile handheld device.
The two Dräger speakers explained that an estimated 50 petabytes of data are generated by hospitals per year — associated with clinical notes, lab tests, medical images, sensor readings, genomics, and operational and financial data. Currently, 97% of this data goes unused (Source: World Economics Forum, Dec 2019).
Medical device interoperability
The two speakers went on to explain that ISO/IEEE 11073 SDC is ‘a revolutionary new open standard that enables connectivity across medical devices for bi-directional and secure interoperability’. Dräger says: “Acute care in hospitals looks after patients in critical health conditions. Doctors and nurses have to make quick decisions under rapidly changing conditions to keep patients safe. Data from point-of-care medical devices has the potential to help them make decisions and optimise their workflows. However, proprietary protocols hinder the open transfer of data between medical devices from different manufacturers. SDC (Service-oriented Device Connectivity) is a new international ISO/IEEE standard that enables interoperability between point-of-care medical devices, and the exchange of data between these devices and HL7-compliant hospital information systems. SDC enables a hospital’s medical technologies to exchange data and information bidirectionally and securely in a dynamic system to improve the capabilities of caregivers in acute care settings.”
David Head, head of Safety Marketing, provided an overview to attendees of Dräger’s Safety offering, which includes:
Respiratory.
Fixed and mobile gas detection.
Area monitoring.
Clearance checks.
Smart solutions.
Impairment.
Training.
Engineered solutions
Rental.
Servicing.
A little more detail on some of these follows:
Fixed gas detection: Fixed gas and flame detection systems are designed to provide an early warning of potential gas leaks and fire hazards. These detectors are strategically installed in high-risk areas, and are linked to a control unit, tasked with issuing warnings during incidents, or further interfacing with other systems. This ensures timely actions, whether it’s emergency evacuation, ventilation, or shutdown.
Mobile gas detection: Dräger can supply portable gas detectors ranging from a simple single gas monitor, to multi-gas systems which cover a whole host of sensors to protect workers from toxic, flammable, and oxygen-depleting gases.
Area monitoring: In areas which have been identified as high-risk for gas build-ups or leaks, area monitors can be provided. Typical examples include de-commissioning and plant shutdowns.
Clearance checks: In environments characterised as a confined space or a potential hostile area, ensuring that clearance checks are performed is critical to ensure the wellbeing of personnel. Clearance checks give peace of mind before entry, and also ensure compliance with confined space regulations. The Dräger portfolio of gas clearance monitors and detection tubes can detect over 120 substances depending on the application.
Case study
Raising awareness of the risks of working in Confined Spaces
David Head also presented a case study describing how an employee suffered a brain injury after he was found unconscious in a manhole. The man had been unblocking a drain at the hospital when he was discovered by other members of staff. He was rescued from the manhole by the Fire and Rescue Service, and treated at hospital for acute sulphate intoxication.
In hospitals, David Head explained, there are key regulations associated with safe systems of work, confined spaces, and working at height to ensure the safety of staff and patients. These regulations are designed to mitigate the risks associated with these environments and activities.
1 Safe Systems of Work
Hospitals must adhere to regulations such as the Health and Safety at Work Act and the Management of Health and Safety at Work Regulations. These regulations require hospitals to establish safe systems of work for all activities, including patient care, equipment handling, and emergency procedures. Staff training and regular risk assessments are essential to ensure that safe systems of work are maintained and adapted to evolving circumstances. Compliance with infection control measures, proper waste management, and adherence to protocols during medical procedures, are also crucial aspects of safe systems of work in hospital settings.
2 Confined Spaces
Hospitals often have confined spaces such as utility tunnels, storage areas, and service ducts, where work may need to be performed.
The Control of Substances Hazardous to Health (COSHH) Regulations and the Confined Spaces Regulations require hospitals to assess the risks associated with confined spaces and implement necessary control measures. Staff entering confined spaces must receive appropriate training, and there should be effective emergency procedures in place — including the provision of suitable personal protective equipment (PPE) and rescue equipment.
3 Working at Height
Maintenance work, construction, and equipment installation in hospitals may require working at height, such as on roofs, scaffolds, or ladders. The Work at Height Regulations mandate that hospitals plan, supervise, and conduct work at height in a manner that prevents falls and reduces the risk of injury. Hospitals must provide suitable access equipment, guardrails, and fall protection systems, ensure that staff are trained in their proper use, and that inspection and maintenance regimes are in place.
Compliance with these regulations is critical to safeguard the wellbeing of hospital staff, patients, and visitors. It is essential for hospitals to continuously review and update their policies, procedures, and training programmes, to align with the latest regulatory standards and best practices.
Further guidance
Further HSE guidance can be found at:
Introduction to working in confined spaces (www.hse.gov.uk).
Law:
The Confined Spaces Regulations 1997.
Equipment required before entering a confined space:
Personal Protective Equipment Regulations 2002 (legislation.gov.uk)
Personal Protective Equipment at Work Regulations 1992 (as amended) (legislation.gov.uk)
See also — https://www.hse.gov.uk/pubns/indg258.htm