Mobile and modular CSSD brings flexible on-site capacity

A mobile or modular on-site sterilisation department can ensure continuity during periods of refurbishment or exceptional demand.

Refurbishing the sterilisation or decontamination departments of a hospital – whether it is planned or the result of an emergency – can be a challenging project. Additional space will probably be needed to set up a temporary facility, and the entire flow of instruments and endoscopes within the hospital risk being disrupted.

Sterilisation and decontamination departments are often in use seven days a week, and are critical for the treatment of patients and for procedures to carry on uninterrupted. It is also essential that decontamination of any instrument used in a hospital setting meets the latest standards, and this can be difficult to achieve with a temporary setup.

Increasing demand on healthcare services has led to a growing number of instruments making their way through sterilisation and decontamination departments. This, in turn, is leading to increased ‘wear and tear’ on the specialist – and expensive – equipment needed to carry out the tasks, and sterilisation equipment having a shorter lifespan, meaning it needs to be replaced more often.

Ensuring continuity and compliance

Hospitals without the space or the budget to reconstruct a new or temporary internal sterilisation or decontamination department have limited options. Using a neighbouring hospital’s sterilisation facilities temporarily, or outsourcing the whole process, means sending instruments to an off-site location.

This means the hospital could be faced with delays in getting vital instruments back to the department, an increased risk of contamination and the hospital may also need to buy more instruments to cover the increased ‘downtime’. In the case of endoscopes this could prove a very expensive option.

Another other option is to deploy a flexible, mobile or modular solution which allows cleaning and sterilising to continue take place on-site.

Fully integrated and designed to provide replacement capacity, it can help hospitals to continue delivering the vital service of cleaning, sterilising and repackaging of surgical instruments during a temporary disruption or exceptional demand.

Keeping sterilisation on site

Mobile or modular CSSD units can be brought to any hospital site, allowing all processes to continue uninterrupted; sterilisation activity to be kept on site; and the hospital’s existing staff to remain in control of the process.

The sterilisation process is strict for surgical instruments. First, a manual clean is required, followed by a stint in the washer disinfector. Then the instruments are packaged and wrapped, steam sterilised and placed on a cooling rack. The water used in the sterilisation process needs to be purified and disinfected, and the air in the department needs to be filtered to ensure optimal cleanliness.

A CSSD unit, which is completely stand-alone, takes care of all this and contains all facilities and equipment needed for the process. Units contain an integrated RO system with water softener and brine tank to ensure water quality meets all requirements, and provides HEPA-filtered environmental air. Integration with the hospital’s own track and trace system is also provided, allowing the hospital to retain control over the flow of instruments.

Mobile sterilisation departments have one-way flow and incorporate a pre-cleaning area with a manual clean workbench, washer disinfectors and steam sterilisers, a clean packing room and a post sterilisation processing room, as well as dirty and clean utility areas. A staff changing area, including WC and hand washing facilities, is also provided for the comfort of staff working in the unit.

Endoscope decontamination

Endoscopes need even more specialist cleaning in dedicated endoscope decontamination units which are specially equipped and use a high disinfectant washing process and purified water. Mobile or modular endoscope decontamination units are also available to support hospitals that want to keep this activity on site at all times.

Our flexible endoscope decontamination solution provides separate clean and dirty staff and endoscope flows. It includes inbuilt IP65-rated equipment for the hospital’s own track and trace system, Duplex Reverse Osmosis water system, cabinets and sinks, as well as a staff welfare area with WC and a technical room.

The facility is compliant with the latest standards, including for fire safety, and can process up to 120 scopes per day. It provides a spacious, climate-controlled work environment with natural light, and has been designed and equipped in consultation with frontline staff.

What preparations are needed?

A flexible mobile or modular CSSD or endoscope decontamination facility can be installed very quickly with a minimum of preparation, depending on the characteristics of the site. All that is needed is a relatively flat hard standing area, such as a car park or concrete pad, along with connections to utilities, which need to be within a reasonable distance from where the unit will be placed.

The process for providing a solution starts with a free, no-obligation site survey.  We will assess space, access, clinical adjacency, services, risk, and other issues critical to providing hospitals with an analysis of possible solutions.

Water validation, electrical testing and validation of washers and sterilisers form an essential part of the commissioning and validation process that takes place once the unit has arrived on site. We work closely with the hospital throughout the commissioning phase and provides staff training and an induction on the unit, which includes ‘sign-off’ of hospital staff.

For many hospitals, achieving compliance new sterilisation standards will mean remodelling or upgrading the central sterilisation department, and bringing a fully compliant mobile CSSD unit on-site will enable this to be achieved with a minimum of disruption.

Get in touch to find out more about our CSSD and endoscopy decontamination unit

Modular ward provides Covid-free zone at Kettering General Hospital, UK

A new 18-bed modular ward has been installed at Kettering General Hospital (KGH), UK to provide extra capacity during the Covid-19 pandemic.

A new 18-bed modular ward has been installed at Kettering General Hospital (KGH),UK to provide extra capacity during the Covid-19 pandemic.

The ward, which was supplied by Vanguard Healthcare Solutions and has been set up in the car park at the hospital’s main site in Rothwell Road, is being used as a contingency measure, providing the hospital with temporary additional bed capacity for non-Covid patients.

Over the past few months, many hospitals have needed to reconfigure internal theatre and ward space to ensure sufficient capacity is retained for Covid-19 patients. Kettering’s main hospital is no exception.

A bed modelling exercise at the start of the pandemic suggested the hospital may need additional bed capacity to deal with the crisis effectively, and the Trust decided to commission a modular ward to create another ‘green’ zone, away from Covid-19 areas, where at-risk patients could be safely cared for.

The stand-alone ward facility was completed within a period of five weeks, a very short timescale for a project of this nature, even without the additional challenges caused by lockdown restrictions that were in place during the build.

The modules were built off-site by Young Medical, Vanguard’s specialist modular subsidiary, and were lifted into position by crane. The remainder of the work was then completed on site to an extremely tight schedule.

Vanguard’s project team worked in close collaboration with the Trust on all aspects of the commissioning, deployment and delivery. This approach minimised risk as well as any ‘drift’ in the project timeline, something that was crucial to ensuring the facility was delivered on time and within budget.

The finished building is 600sqm and consists of 18 beds. There are also utility rooms, storage space and a nurse station area on the ward. The internal configuration was designed with efficient patient flow in mind, maximising the use of available space and ensuring the practical – and safe – transfer of patients arriving from the main hospital building.

Having been open to patients since 1 June, the ward is being used to house primarily at risk, vulnerable or elderly patients before, during and after treatment. To ensure the ward stays Covid-free, all patients are screened and tested before coming onto the unit.

The facility is expected to remain on site for an initial period of 6 months, allowing the hospital to retain Covid-19 capacity within the hospital in case of a second wave.

A KGH spokesman said: “The new block housing the 18 bed ward was installed as a contingency measure to support the safe management and flow of non-Covid patients, as we continue to care for Covid-19 patients at the hospital. Since the facility became operational, both staff and patients have been pleased with the spacious, clean and bright new ward space.

“Having the additional bed capacity at our disposal at this critical time has been extremely valuable, and the fact that it’s situated away from the main hospital building has provided reassurance for at-risk patients, who may have been worried about the risks of attending hospital.”

Brian Gubb, Vanguard’s Director of Operational Solutions, said: “We’ve worked closely with the Trust throughout the project, and are very pleased to be able to provide a solution to KGH’s additional capacity needs during the Covid-19 pandemic. Vanguard’s flexible temporary solutions are ideal for use as a Covid-free zone, as they can be completely stand-alone.”

Rob van Liefland, Managing Director of Young Medical, said: “Given that the UK was in full lockdown during the build, and that strict infection control and social distancing guidelines needed to be observed, the tight timescale proved particularly challenging.

“The modular construction method, whereby units were built off-site before being craned in and finished, meant we were able to get the new ward up and running very quickly, despite the additional challenges caused by the lockdown restrictions.”

To find out more about Vanguard’s mobile and modular facilities and Covid-19 solutions, please get in touch.

Modular solutions provide additional COVID-19 capacity

In response to the COVID-19 outbreak, Vanguard Healthcare Solutions has made available some additional modular facilities to support healthcare providers in Europe with capacity planning and the need for increased resilience as a result of the ongoing crisis.

A number of hospitals with an existing Vanguard mobile theatre or ward on site have been able to repurpose these flexible units to support their efforts in dealing with the current crisis.

While some hospitals are using the facility to isolate patients with COVID-19 symptoms or to decant existing internal surgical or clinical space needed for additional intensive care beds, others are using the external units for critical day surgery with the aim of keeping patients away from COVID-19 zones within the main hospital. Examples of procedures that are now being undertaken in Vanguard’s mobile units include emergency surgery, urgent care such as cancer treatment, and the treatment of trauma patients.

In response to the COVID-19 outbreak, Vanguard Healthcare Solutions has made available some additional modular facilities to support healthcare providers in Europe with capacity planning and the need for increased resilience as a result of the ongoing crisis.

A small number of high-quality modular wards and operating theatres, which can be used to provide additional surgical or ward capacity are available immediately and can be configured, equipped, transported and made operational very quickly. The modular buildings can also be adapted to suit individual providers’ needs, even as their requirements change, providing additional flexibility.

Options include 10 and 18 bed wards. The 18-bed ward is available for transport to site immediately and provides 16 beds in double rooms and 2 beds in single rooms, with a bathroom containing a shower, sink and toilet. The unit also contains a reception room, main reception, office, medicine room, kitchen, toilet and a dirty utility. This option can also be extended to include an additional 6 beds, though this option will require additional time to set up before the module can be shipped.

The 10 bed wards can be configured and made ready for shipping in 3-4 weeks. A double operating theatre complex with a recovery area is also available for shipping immediately.

Also available are hybrid operating theatre modules that can be configured to house CT scanners, supplied through Vanguard’s onward supply chain. All the modules are currently situated in the Netherlands.

The modular options that are currently available are listed below, but additional wards and theatres in different configurations can be supplied on request.

To enquire about any of our modular solutions, please contact info@vanguardhealthcare.co.uk .

Module Type # beds Total m2 Current Location Status
Ward 18 beds 660 NL 16 beds in double rooms and 2 in single rooms. Packed and ready to ship.
Double operating theatre complex with recovery OT complex 340 NL Ready to ship as operating theatre complex. Reconfigurable to a ward with a maximum of 11 beds in total. Takes 3 weeks to configure, plus shipping.
Ward 10 beds 216 NL Modules in stock and can be configured in 4 weeks, plus shipping.

 

Modular healthcare facilities – more than just a temporary building

Most health service organisations will find themselves in need of a temporary infrastructure solution at some point, either because of a planned event, such as refurbishment of the existing facility; or an unexpected event, the Covid-19 outbreak being a recent example.

Most health service organisations will find themselves in need of a temporary infrastructure solution at some point, either because of a planned event, such as refurbishment of the existing facility; or an unexpected event, the Covid-19 outbreak being a recent example. But while modular facilities often provide the answer to a temporary issue that requires a quick resolution, that doesn’t mean the solution has to be short-term.

Why use a modular facility?

A common reason for commissioning a temporary solution is insufficient capacity or a spike in demand, due to seasonal pressures or another temporary reason, which can present a risk of compromised care standards and patient dissatisfaction.

The need to maintain high standards of patient care, compliance and safety throughout a refurbishment or service reconfiguration project, or during an unforeseen event such as Covid-19, is another reason additional healthcare infrastructure may be required.

However, it’s not all about being able to respond to an urgent need or crisis; temporary healthcare facilities are also an essential component of strategic plans. Although the very nature of emergencies means that they are unpredictable, planning for different scenarios using flexible and adaptable solutions is essential.

A modular building can also be used to pilot new surgical delivery methods, new models of care delivery or new technology and equipment without risk to existing routines, and can also enable health service organisations to deliver community-based diagnostics and care outside of the acute hospital setting. This makes them a potentially core element of planned Community Diagnostic Hubs.

Adding capacity

Whenever waiting times increase due to a temporary fall in activity for any reason – such as the recent suspension of all non-urgent surgery in many countries following the Covid-19 outbreak – a modular facility can add much needed extra capacity.

Even once the service resumes to normal levels, it can become difficult to get on top of waiting lists. To use an example from the current pandemic; the need to retain significant capacity in Australian hospitals for a potential influx of Covid-19 patients meant providers in some states were ordered to limit elective surgery at 50% or 75% of previous theatre capacity. A temporary modular healthcare facility could add sufficient capacity to bring this back up to 100%, or even above this level.

Temporary and semi-permanent stand-alone operating theatres can be set up and connected to the main hospital very quickly. Equipped with air conditioning systems that allow variable humidification, modular theatres also incorporate IPS, UPS, integrated water system and medical gas bank, vacuum and scavenging systems, and an environmental control system ensuring temperature, humidity and sanitation are always optimal.

Completely stand-alone, so called ‘cold’ sites for surgery, are also being set up using modular infrastructure during the pandemic. A combination of an operating theatre and a hospital ward can create a visiting hospital, which provides a complete clinical environment including an anaesthetic room, scrub and recovery areas, clean and dirty utility areas, a reception/nurse station, waiting room, ward and WC.

Reassuring patients

Modular wards are being used during the pandemic not only to supply additional hospital bed spaces, but also to provide additional reassurance for patients. This was the case at Kettering General Hospital in the UK, which commissioned a modular ward at the start of the pandemic to provide a Covid-free zone.

As well as providing the hospital with temporary additional bed capacity for non-Covid patients, the 18-bed modular ward offers reassurance for at-risk patients who may have been worried about attending hospital during the pandemic. The facility will remain on site for an initial period of 6 months, meaning Covid-19 capacity can be retained within the hospital in case of a second wave.

The modules were built off-site by Young Medical, Q-bital’s specialist modular subsidiary, and the stand-alone ward facility was completed within a period of just five weeks, despite the restrictions imposed by the lockdown protocol that was in place at the time.

Delivering new models of care

To deliver fully integrated community-based healthcare, flexibility is required. A modular outpatient clinic can offer the opportunity to care for and process outpatients in the heart of their own communities, either on an ongoing basis or as part of a specific programme.

In terms of healthcare service delivery, one concept that is being implemented widely in areas where accident & emergency departments are under particular pressure, is the separation of urgent cases from patients with less serious injuries or ailments, either on a temporary or a more permanent basis, to improve patient flow.

To effectively reconfigure a service, buildings and facilities often need to be adapted. Setting up a temporary modular facility can allow hospitals to test out scenarios before investing significant amounts of money in a new or remodelled permanent building.

Enabling rapid response

Temporary healthcare facilities can also enable hospitals to respond quicker to a crisis or emergency. One of the most recent examples is the priority assessment spaces or isolation pods, created with the intention of preventing patients with suspected Covid-19 who arrive at the hospital from mixing with vulnerable patients. In many cases, hospitals also had an urgent need for extra space to house staff and changing areas.

Modular units like these can remain on for an indefinite period, and can be moved, repurposed or handed back when they are no longer needed. But modular facilities are often designed to be in place for much longer than that.

When the Centre Hopital Universitaire Point-a-Pitre in Guadeloupe experienced a catastrophic fire in November 2017, the surrounding patient community was left with no access to surgical services or a functioning Emergency and Trauma department, since it was the only hospital on the island.

A temporary solution that could remain in place for a longer period of time was required. A solution that would use both modular and mobile healthcare facilities was devised, and Q-bital, together with Young Medical and a range of partner companies across Europe, successfully delivered an operating theatre complex, which remains in place today.

Ensuring uninterrupted care

A less dramatic but more common reason for using modular is the need to minimise disruption to healthcare services during a reconfiguration of departments or a refurbishment programme. Where a major project is taking place, there may even be a need for a bespoke semi-permanent building.

This was the case for Skåne University Hospital (SUS) in Malmö, which is currently undergoing a major construction programme that is estimated to take seven to ten years to complete. The hospital is Sweden’s third largest and it represents one of two national centres for cardio-thoracic surgery.

During the build, an urgent need arose for increased capacity for performing high-risk orthopaedic procedures, and the hospital’s management wanted an interim solution that would be quick to implement, while being robust enough to fill the gap until the new building was complete.

Young Medical provided the hospital with a 324 m2 operating theatre complex to strict requirements, including an ultra-clean air system, the latest surgical lights and a bespoke building management system. The interim facility was to be integrated with the existing operating theatre department on the third floor of the hospital to ensure a seamless extension, something that involved a precision engineered steel construction that was fixed at the exact same height as the existing facility.

The entire project was completed within just 10 months from start to finish, and while commissioned as an interim facility, the complex is designed to serve the hospital for a period of up to ten years.

More than just a temporary building

The use of modular construction techniques and volumetric buildings in the healthcare sector is not new; offsite manufacturers have supplied healthcare buildings for many years. However, modular is often seen as just a ‘box’ or ‘shell’; a short-term solution that is necessary but basic, and that may look unsightly.

Over the past decade, the modular concept has moved on and a range of different solutions can be achieved; from a basic container concept to bespoke, sophisticated facilities housing fully equipped operating theatres that can be integrated with the existing hospital’s own infrastructure if required.

Modular solutions don’t have to be temporary; it is possible to have a permanent extension to an existing hospital built entirely using a modular concept, and designed to fit seamlessly with the rest of the building.

Mobilising flexible infrastructure can support hospitals in; maintaining control of the patient pathway, preventing operational downtime, reducing build and refurbishment project time scales and facilitating uninterrupted patient care. A modular solution is also usually much quicker to implement, can deliver cost savings, and provides a more sustainable option compared with a traditionally built healthcare building.

For further detail on modular healthcare buildings, please contact us.

Modular solutions provide additional COVID-19 capacity

In response the COVID-19 outbreak, we have made available some additional modular facilities to support healthcare providers in Europe with capacity planning and the need for increased resilience as a result of the ongoing crisis.

In response the COVID-19 outbreak, we have made available some additional modular facilities to support healthcare providers in Europe with capacity planning and the need for increased resilience as a result of the ongoing crisis.

A small number of high-quality modular wards and operating theatres, which can be used to provide additional surgical or ward capacity are available immediately and can be configured, equipped, transported and made operational very quickly. The modular buildings can also be adapted to suit individual providers’ needs, even as their requirements change, providing additional flexibility.

Options include 10, 12 and 18 bed wards. The 18-bed ward is available for transport to site immediately and provides 16 beds in double rooms and 2 beds in single rooms, with a bathroom containing a shower, sink and toilet. The unit also contains a reception room, main reception, office, medicine room, kitchen, toilet and a dirty utility. This option can also be extended to include an additional 6 beds, though this option will require additional time to set up before the module can be shipped.

The 10 and 12 bed wards can be configured and made ready for shipping in 3-4 weeks. A double operating theatre complex with a recovery area is also available for shipping immediately. Alternatively, this module can be reconfigured as a ward providing 11 extra bed spaces, a process which will take around 3 weeks.

Also available are hybrid operating theatre modules that can be configured to house CT scanners, supplied through our onward supply chain. All the modules are currently situated in the Netherlands.

The modular options that are currently available are listed below, but additional wards and theatres in different configurations can be supplied on request.

To enquire about any of our modular solutions, please contact us.

Module Type # beds Total m2 Current Location Status
Ward 18 beds 660 NL 16 beds in double rooms and 2 in single rooms. Packed and ready to ship.
Double operating theatre complex with recovery OT complex 340 NL Ready to ship as operating theatre complex. Reconfigurable to a ward with a maximum of 11 beds in total. Takes 3 weeks to configure, plus shipping.
Ward 10 beds 216 NL Modules in stock and can be configured in 4 weeks, plus shipping.
Ward 12 beds 144 NL Modules in stock and can be configured in 4 weeks, plus shipping.