The Changing Scene of Health Care and Technology : Proceedings of the 11th International Congress of Hospital Engineering, June 1990, London, UK

This book provides an excellent opportunity to review developments in the health care technology, many facets of which are just as applicable to professionals in the wider field of building services as to those working in health care facilities. This book reflects the adaptation of strategies in health care to economic and demographic change in both developed and developing countries. Book Cover......Page 1 Title......Page 2 Copyright......Page 3 The First Twenty Years......Page 4 CONTENTS......Page 6 Foreword......Page 10 Energy Strategy in English Hospitals......Page 11 Outstanding Potential......Page 14 4. The Green Bill......Page 15 1. Hospital Strategic Needs......Page 16 4. Energy Conservation......Page 17 Steam Raising Solar Array......Page 18 Future Potential......Page 21 2. Energy Related Hospital Services—Forms of Energy Used......Page 23 3. Specific Energy Consumptions: Statistical Data......Page 25 5. Efficient Use of Energy: Trends and Emerging Technologies......Page 26 5.2 Cold Production......Page 27 5.4 Energy Management Systems......Page 29 Bibliography......Page 30 Novem......Page 31 Developing the Software......Page 32 Targets for Energy Management......Page 33 Analysing Tools......Page 34 Energy Registration......Page 35 Acknowledgement......Page 36 Coal Types......Page 37 Wide Belt Unloaders......Page 38 Combustion Equipment and Boilers......Page 39 Flue Gas Cleaning......Page 40 Acknowledgement......Page 41 Background......Page 42 Alternative Energy Sources......Page 43 An Alternative Site Energy Strategy......Page 44 Conclusion......Page 45 The Incentives......Page 46 Gas......Page 47 Options Considered......Page 48 Steam Injection......Page 49 Capital Costs......Page 50 Development......Page 51 2. Factors Affecting the Selection of Systems......Page 53 System Types......Page 54 Electrical Aspects of Cogeneration Plant......Page 58 Economics......Page 59 The Future......Page 62 Conclusions......Page 64 Background......Page 65 Programming and Contract Organisation......Page 66 The Combined Heat and Power Unit......Page 67 Queen Elizabeth Hospital......Page 68 1. Introduction......Page 70 3.1 Tasks of a Hospital in Developing Countries......Page 71 Pharmacy......Page 72 Water, Sanitation......Page 73 Maintenance Workshop......Page 74 Literature......Page 75 1. Introduction......Page 77 3. Strategy and Approach......Page 78 4.2 National Training Centres (NTC)......Page 79 7. Future Action......Page 80 8. References......Page 81 Introduction......Page 83 Training of Personnel in Hospital Maintenance......Page 84 Sourcing of Skilled Manpower......Page 85 Area 3......Page 86 Summary......Page 87 1984 and All That......Page 88 Residential Training Courses......Page 89 Training for Overseas Healthcare Personnel......Page 91 Finance and Information Systems Development......Page 92 So—What of the Future?......Page 93 Background to the Groote Schuur Hospital Redevelopment Project......Page 94 Departmental Briefs......Page 95 The Biomatrix and Telsonics......Page 96 The Process (Teleonic) Field......Page 97 References......Page 101 The Concept......Page 103 Programming......Page 104 Constraints......Page 105 Energy Conservation......Page 106 Conclusion......Page 107 Introduction to the Health Care Problem in South Africa......Page 110 Framework for a Solution......Page 111 Meadowlands West Planning......Page 112 Primary Health Care Planning Guide......Page 113 Primary Health Design Guide......Page 115 References......Page 117 The Plan......Page 119 The Burn......Page 120 The Concepts......Page 121 The Outsiders......Page 122 The Tribulations......Page 123 The Message......Page 124 Reference......Page 125 The Benefits of a Well Designed Environment for Healing......Page 126 A Concept of Quality......Page 127 A Sense of the Personal......Page 128 Reference Material:......Page 129 Estate Management......Page 130 Value......Page 132 Quality Environment......Page 133 Acceptable Cost......Page 134 1. What Size Should the In-House Team Be?......Page 135 3. How Do We Handle the Demand for Services (Trade) That We Don’t Employ?......Page 136 5. Selling Our Services......Page 137 7. Professional Services......Page 138 9. Economic Factors......Page 139 References......Page 140 Introduction......Page 141 Total Equipment Management......Page 142 Factors Inhibiting Third Party Maintenance......Page 143 Lack of Co-operation from Manufacturers......Page 144 Conclusion......Page 145 The Effect Upon Hospital Services......Page 146 Ward Facilities and Duty Stations......Page 147 Operating Theatres......Page 148 Conclusion......Page 149 WIMS 1......Page 153 WIMS 2 APPLICATIONS......Page 154 I. Property and Land Applications......Page 155 II. Asset Operational Application......Page 156 III. Financial Control Application......Page 157 V. Capital Asset Application......Page 158 Conclusion......Page 159 Realised Costs per Year Maintaining Buildings Up to Date......Page 161 Safety......Page 162 Building Management System......Page 163 Bacteria Management System......Page 164 Technical Management......Page 165 Security......Page 166 Communication......Page 167 Financial Result......Page 168 Sick Building Syndrome......Page 169 Finally......Page 170 The Origin of Very Old Hospitals......Page 171 Characteristics of Old Hospitals......Page 172 What Fate for Old Hospitals?......Page 173 What Has Been Happening?......Page 174 To Save old Hospitals......Page 175 Firecode......Page 176 Health Service Estate Journal......Page 177 Age and Condition of the Existing Building Stock......Page 178 Role of Management in Fire Precautions......Page 179 The Relationship of HTM 82 with the BS Code and Why the HTM is Needed......Page 180 A Brief Review of Some Points of Significance Within the Revised HTM......Page 181 Choice of System Type......Page 182 Manual Call Points......Page 183 Conclusion......Page 184 1. Introduction......Page 186 2. Literature Review......Page 187 3.1 General......Page 188 4.4 New or Existing Building Factor......Page 189 4.8 Results......Page 190 6. Summary......Page 191 Constructing A Hospital Around A Hospital......Page 192 2. Health Care Ruilding Programmes in Rome......Page 197 4. Modifications and Integrations to the System......Page 198 2. The Updating of Communication System— Today’s Trends......Page 199 4.1 How it Operates......Page 200 5. The Room Terminals......Page 201 Type of Calls......Page 202 10. Conclusions......Page 203 1. Introduction......Page 204 2. Development of Voice Communication Systems......Page 205 4. System Wiring......Page 206 5. Time-Division Multiplexing......Page 207 7. System Integrity......Page 210 9. Future Developments......Page 212 10. Conclusion......Page 213 Telephone Technics in the St Josefs-Hospital......Page 214 Installation at the Bedside......Page 215 Phone......Page 216 Telefax......Page 217 Financial Concept......Page 218 Telephone within the Apartments......Page 219 Future Aspects......Page 220 The Use of Communication Systems in Planning Hospitals—The Example of Bologna......Page 222 System Improvements......Page 224 High Speed Multiplexing......Page 225 Full Communication Integration......Page 226 Flexible Nursing......Page 227 Summary......Page 228 1.2 Memorial’s Centres of Excellence......Page 229 2.1 What is AIMS?......Page 230 2.5 Work Order Control Software......Page 231 2.8 Monthly Accountability Analysis Report......Page 232 3.1 Architectural Drawing......Page 233 3.3 Scope of Projects Schedule......Page 235 Project Construction Cost Report......Page 236 5. Summary......Page 239 Category A......Page 240 1. Gravitational Forces......Page 241 1. Drop Pumps......Page 242 1. Description......Page 243 2. Modifications Required......Page 244 Air New Zealand......Page 245 Acknowledgement......Page 246 References......Page 247 Logistics: The Key to Good Management and Design......Page 248 2. Hull Royal Infirmary......Page 250 Ward Leonard System......Page 251 Statically Controlled DC Drives......Page 252 3. Hospital No 2 -Huddersfield Royal Infirmary......Page 253 4. Variable Voltage Variable Frequency Drives (VWF Drives)......Page 254 Reduction in Required Supply Capacity......Page 256 5. Conclusions......Page 257 1.1.2 Energy Costs......Page 258 2.1 General Description......Page 259 2.1.3 The Timetable for Transport......Page 260 2.1.4 Staff Requirements and Emergency Cover......Page 261 2.2.5 The Wards......Page 262 4.2 Conclusions......Page 263 1. Are the Current Standards Enough to Ensure the Safety Application of the Electromedical Equipment?......Page 265 2.5 Safety......Page 266 2.10 Instruction and Training......Page 267 3.2 Auditor......Page 268 5. Conclusions......Page 269 Annex......Page 270 Introduction......Page 272 USL 31: Experience and Management......Page 273 Safety......Page 274 Conclusion......Page 276 Crime Prevention......Page 278 Security......Page 280 Access Control......Page 281 Psychiatric Hospitals......Page 282 System Management......Page 283 Piped Medical Gas Services......Page 285 History......Page 289 The Future: A Discussion......Page 290 References......Page 291 Legionnaires’ Disease —Aspects of Prevention......Page 295 References......Page 296 (Combination of Circumstances to IncreaseRisks of Legionnaires Disease)......Page 297 (The Increasing Risk for Multiplication of Legionella)......Page 299 (Diagram—Hot Water System)......Page 300 The Summary of Experiences......Page 301 Air Flow Control Systems for Hospitals and Hospital Laboratories for the 1990’s......Page 302 Processes......Page 309 Effective Disinfection and Sterilisation......Page 310 Reliability and Safety......Page 311 References......Page 312 Gas Sterilisation in the Medical Field......Page 314 Introduction—Ethylene Oxide......Page 316 Refrigerants and The Environment......Page 317 Alternative Refrigerants......Page 318 Alternatives and Sterilisation Mixtures......Page 320 References......Page 321 2. Background......Page 323 3. The Control of Pollution Act 1974......Page 324 Table 1 Part II......Page 325 5. Sections 3 to 11 of COPA and the 1988 CADOW Regulations......Page 326 6. Clinical Waste......Page 327 Group C......Page 328 7. Hazardous and Special Wastes......Page 329 8. Crown Immunity......Page 330 10. Future Legislation......Page 331 11. Conclusion......Page 332 Test Procedures......Page 333 Comparison with Other Results......Page 334 References......Page 336 Equity Joint Venture......Page 339 Outright Purchase of Plant with Facility Management Contract......Page 340 Summary......Page 341 The Control of Pollution......Page 342 The Consent System......Page 343 Public Health Act......Page 344 Selection of Emission Control Plant......Page 345 Electrostatic Precipitators......Page 346 Bag Filters......Page 348 Gas Washing......Page 349 Selection of Plant......Page 350 Clinical Waste Disposal in the NHS......Page 353