Biomedical Engineering Reference
In-Depth Information
ventilation, and employ additional support staff for
infection control and security purposes.
demands of the outbreak has been described. On
review, long-standing partnership of the same
FMT since the inception of the hospital in 1993,
together with a shared culture of trust and cooper-
ation toward patient-centered care, had enabled the
achievement of the highest environmental quality
at the earliest possible time, enabling treatment
perceived to be dangerous by other hospitals
(namely NIV) to be carried out for the benefit of
patients [25] and in turn protecting staff from expo-
sure to high-risk procedures (namely intubation).
23.6.5.2 Implementation of infection
control policies at supporting staff level
The ICT's guidelines for standard PPE provision at
three levels of clinical areas based on risk assess-
ment were disseminated to all staff involved in
patient-related services, including catering, mate-
rials transportation, housekeeping, cleansing, secu-
rity, pest control, repair and maintenance, and
medical services. According to a subsequent audit,
availability of these guidelines had allayed anxiety
and concern of supporting staff, who before had
uniformly expressed significantly uncertainty and
stress when working in patient care environment.
Frequent training sessions on infection control and
changes in workflow were held for the supervisors
of support staff, who in turn trained and monitored
their staff's compliance. As a result, none of the
235 supporting non-HCW staff with SARS patient
contact had acquired the disease.
23.7 Further Response at Hospital
Authority Head Office (HAHO) Level
With Direct Impact on the Department
In Hong Kong, cohorting of SARS patients was
instituted in 13 acute hospitals. Similar to Singa-
pore [34], limiting the care of SARS patients to
a single designated hospital had been tried locally
in late March, but very soon the capacity was
so overwhelmed that all acute hospitals had to
receive SARS patients. By late March 2003, a
“SARS” homepage was established by HAHO
in the e-Knowledge Gateway (eKG) of the HA
intranet to continuously update all staff on scien-
tific knowledge about this disease.
23.6.5.3 Procurement and logistics
Prior to SARS, PPE materials in excess of demand
were not stockpiled. By mid-late March 2003,
there was a sudden global surge in demand.
In-coordination in procurement among local hospi-
tals led to competition for supply. This issue was
solved within a week with the introduction of
central procurement at HAHO level. PPE procure-
ment and distribution by the supply chain in
PYNEH was tightly coupled to ICT guidelines for
PPE use in different risk areas. Intensive communi-
cations at daily OMT meetings helped foster trust
between HCW and procurement staff regarding
the guarantee of adequacy of PPE supply. As a
result, none of our HCW complained through the
media to voice their concern about perceived inad-
equacy of PPE supply as those in some other hospi-
tals did.
23.7.1 Infection Control
Enforcement Team
To further enhance compliance to infection control
policies, HAHO directed the establishment of the
Infection Control Enforcement Team (ICET) in
every hospital. The objectives were: to convey
updated infection control policies on SARS from
HAHO to frontline staff; to coordinate opera-
tional logistics between hospital administration and
frontline departments; to appoint departmental and
workplace controllers to enforce and monitor infec-
tion control activities at all levels (including staff
canteen and relaxation areas); to audit compliance
to infection control practices in the workplace; and
to report non-compliance to the respective depart-
ment heads and HCE.
In PYNEH, the chairperson of ICET was elected
from among senior non-medical clinicians and this
23.6.5.4 Facilities management team (FMT)
issues
The central role of FMT and engineering personnel
in ventilation improvements to meet the stringent
