Summary of "Modulo 10.1 - Calidad en la gestión de las instalaciones"
Summary of “Modulo 10.1 - Calidad en la gestión de las instalaciones”
This video is a comprehensive lecture on facility safety management within healthcare infrastructure, presented by José Luis Cotos, an architect and infrastructure manager at the Italian Hospital. It covers the complexity, challenges, and methodologies involved in managing hospital facilities to ensure safety, quality, and continuity of care.
Main Ideas and Concepts
1. Overview of Hospital Infrastructure and Scale
- The Italian Hospital manages a large complex with:
- 10,130 staff (doctors, health, management, education)
- 28 buildings including hospitals, university campuses, medical centers, annexes, and future projects
- Approximately 116,000–117,000 m² of built area
- High patient volume: 2.7 million consultations/year, 52,000 surgeries, 764 beds, 667 transplants
- Hospital infrastructure directly impacts patient safety, infection rates, mortality, and costs.
2. Historical and Current Facility Layout
- The original hospital (1903) had a pavilion design with segregated areas for men and women, gardens for ventilation, and isolation pavilions due to past epidemics.
- Modernization led to loss of gardens and traditional pavilions, introducing new building typologies.
- Access routes were redesigned for safety and efficiency, including escalators and elevators to reduce patient travel distances.
3. Design Requirements for Safety and Functionality
- Well-organized, adaptable spaces improve:
- Accessibility for disabled or stretcher-bound patients
- Patient flow and mobility
- Integration of technology:
- CCTV, Wi-Fi, lighting, air conditioning, power installations
- Emphasis on sustainability and continuity of care through technological innovation.
4. Facility Safety Management Programs
- Based on Joint Commission guidelines, divided by specialty/departments:
- Environment safety (patient surroundings)
- Physical security (monitoring and surveillance)
- Hazardous materials and waste management
- Fire, smoke, and flame management
- Medical equipment management
- Critical facilities management
- Disaster preparedness (internal and external)
- Hospital construction and renovations
- A Facility Safety Committee meets bi-monthly to coordinate and address cross-departmental issues.
5. Asset and Equipment Management
- Identification and classification of assets:
- Critical equipment (no backup, essential for care continuity)
- High-risk, moderate-risk, and no-risk equipment
- Maintenance programs:
- Preventive and corrective maintenance schedules
- Responsibilities assigned per equipment family (e.g., elevators, pumps, medical devices)
- Approximately 15,000 work orders and 240 preventive maintenances annually
- Use of fixed asset tags linked to an asset management system for tracking age, maintenance, and obsolescence.
- Coordination with third-party service providers for specialized maintenance.
6. Waste and Hazardous Material Management
- Annual generation: 575 tons of pathogenic waste, 35 tons hazardous material
- Use of fireproof, explosion-proof cabinets and spill kits with QR codes for audits
- Strict authorization and consumption limits for hazardous substances per service
- Training and audits to ensure safe handling and storage
7. Risk Assessment and Zoning
- Risk scoring for each hospital area based on:
- Number of people, evacuation ease, equipment criticality, etc.
- Creation of risk maps with zones classified as:
- Red (high risk), Orange (medium-high risk), Yellow (moderate risk), Green (low/no risk)
- Tailored safety actions and maintenance frequencies based on zone risk level
- Example: Surgical blocks identified as red zones due to critical technology, oxygen-enriched environments, and waste generation
8. Interaction with Quality and Other Hospital Departments
- Continuous feedback loop with:
- Quality department (complaints, incident reports)
- Infection control committee (air and water quality)
- Pharmacy (cold chain management)
- Supply and healthcare departments (inventory and urgent purchases)
- Joint walkthroughs with patient experience teams to identify and correct safety or process issues
9. Protocols and Safety Procedures
- Permit systems for construction, welding, and maintenance work to prevent accidents
- Fire permits, fire watches, and coordination with maintenance leadership
- Safety training for staff, third parties, and students with annual mandatory courses covering:
- Risk prevention, fire safety, hazardous materials, medical equipment, facility safety, etc.
- Incident reporting and corrective action follow-up
10. Examples of Safety Improvements
- Redesign of logistics for surgical box transport to prevent accidents
- Suicide prevention adaptations in vulnerable areas
- Installation of external staircases for safe evacuation routes
- Clearing evacuation routes and technical rooms of obstructions
- Use of ventilated facades and reflective glass to improve energy efficiency and sustainability
- Rainwater collection and greywater recycling systems
11. Disaster Preparedness
- Classification of disasters as internal (fire, electrical failure, bomb threats) or external (mass casualty incidents, infectious outbreaks)
- Risk scoring and mitigation plans for each scenario
- Regular drills and coordination with external emergency services (firefighters, civil defense, rapid response teams)
- Real-life incident example: Fire during construction and its management
- Preparation for mass casualty events and infectious disease outbreaks (e.g., H1N1, COVID-19)
12. Continuity of Critical Services
- Redundancy and backup systems for:
- Water supply (two-day autonomy with interconnected tanks)
- Power (multiple feeders, transformers, generators covering 70% of critical areas)
- Medical gases (two cryogenic oxygen tanks)
- Air conditioning prioritized in critical areas (operating rooms, therapy, transplant rooms)
- Identification and maintenance of critical vs. special facilities
13. Summary and Final Lessons
- Infrastructure safety is crucial to avoid harm to patients and staff
- Functional infrastructure must operate under normal and emergency conditions
- Continuous improvement is driven by audits, incident reports, drills, and patient feedback
- Written procedures, training, and accountability are essential for effective safety management
- Coordination across departments and with external agencies strengthens safety culture and readiness
Detailed Methodology / Instructions Presented
Facility Safety Management Program Structure
- Define specialty-based safety programs (environment, security, hazardous materials, fire, medical equipment, critical facilities, disaster preparedness, construction)
- Form a multidisciplinary Facility Safety Committee meeting every two months
- Assign responsibilities and maintenance frequencies for all equipment and facilities
- Maintain written procedures, checklists, certificates, and reports for audits and continuous improvement
Asset Management
- Tag all equipment with fixed asset labels linked to management software
- Classify equipment by criticality and risk level
- Schedule preventive maintenance and corrective maintenance on demand
- Manage third-party service contracts for specialized equipment
Risk Mapping and Zoning
- Score risk per hospital area based on multiple variables
- Create color-coded risk maps (red, orange, yellow, green)
- Tailor safety actions and maintenance frequencies based on risk zone
- Conduct more frequent inspections and drills in high-risk zones
Safety Training and Incident Management
- Conduct annual mandatory safety courses segmented by staff roles
- Use quizzes and evaluations to ensure knowledge retention
- Implement incident reporting systems accessible via intranet
- Review incidents in committee and update protocols accordingly
Construction and Renovation Safety
- Coordinate with infection control on dust and air quality management
- Manage noise, vibration, and temporary evacuation route changes
- Post temporary signage and communicate changes clearly
- Use sustainable building materials and techniques to reduce environmental impact
Disaster Preparedness
- Develop risk matrices for internal and external disasters
- Create and rehearse action plans with all relevant hospital departments
- Coordinate with external emergency responders
- Conduct tabletop exercises and live drills regularly
Waste and Hazardous Material Handling
- Audit and map hazardous materials storage and usage
- Limit access and quantity per service
- Use specialized fireproof and explosion-proof cabinets
- Train staff on segregation, handling, and spill response
Speakers / Sources Featured
José Luis Cotos Architect and Infrastructure Manager of the Italian Hospital, primary and sole speaker throughout the video.
This summary encapsulates the key lessons, methodologies, and operational details shared in the video on managing healthcare facility safety and quality infrastructure.
Category
Educational
