Intelligent infrastructure for healthcare

With overall energy use by health services expected to rise and Australian hospitals already using twice as much energy as commercial office buildings, hospitals are taking creative approaches to energy management. 

Despite the development of more precise and less invasive diagnostics and interventions, heathcare costs continue to increase without improvement in patient outcome. One reason is the hidden cost of treating patients for harm sustained during their hospitalisation. Adverse patient events (APEs), which include but are not limited to healthcare-associated infections (HAIs), falls that result in injury, serious medical errors and wrong site surgeries, can cause this harm.  

APEs come with a high cost - not just for a hospital budget, but also for human health and wellbeing. Building automation solutions could help prevent these issues and reduce costs. Proper safeguards used within a healthcare or hospital facility’s infrastructure can lead to improved clinical outcomes and increased patient satisfaction and safety, as well as an overall reduction in costs for the healthcare organisation. For example, if a hospital decreased the occurrence of three prevalent APEs, they could expect to see a total savings of over $151,000 per bed per year. 

Understanding the disconnect

In a busy healthcare environment, hospital staff may make mistakes or not follow proper protocol. Patients’ lives could be at risk if the hospital infrastructure is not designed or regulated to prevent APEs.

Clinical staff primarily focuses on providing patient care, but rarely do they understand how the hospital’s structure could benefit a patient’s wellbeing. Conversely, the hospital’s facility management staff is not involved with clinical care and may not fully understand how the physical structure can support patient safety and healing.

Patient care and hospital budgets have suffered tremendously as a result of this disconnect: studies show that seven to 10 of every 100 hospitalised patients in developed countries like Australia will acquire healthcare-associated infections. Worldwide, the expenses incurred by hospitals due to APEs are far too high.

Using human anatomy as a model to improve infrastructure

The human autonomic nervous system (ANS) regulates the physiological structure of the body unconsciously so humans can focus their thinking on functional activities. The ANS only demands conscious attention when there is a problem. Without this specialised neurological network, we would never be able to sleep or work because we would be necessarily preoccupied with keeping our bodies alive.

The human body’s strategy provides the following guidelines for a well-designed and fully integrated hospital: 

• A functional layout that reduces opportunities for infections, falls and human errors 
• Barriers against infection transmission from external sources 
• Automatic alerts when a critical barrier is breached or when other problems occur 
• Minimal opportunities to harbour infectious organisms in sterile spaces 
• Facilities that are continuously cleaned and disinfected 

In order to design and optimise a hospital’s infrastructure to mimic the human ANS and improve patient care, it is important to understand the various origins of harm.

It is impossible for each individual in a hospital to know if all safety measures are functioning properly. Like the human body, a healthcare facility needs a fully integrated ANS for continuous, behind-the-scenes surveillance, alerting the proper staff only when problems arise. This ANS, or intelligent hospital infrastructure, integrates mechanical system monitoring, interdepartment communication and automatic alerts to reduce the chances of APEs regardless of the origin - from the patient or staff to the room or physical infrastructure. 

Built-in protective mechanisms sustain optimal conditions, commanding clinical staff attention only when intervention is required to correct a potential accident. Records of both routine monitoring and alerts are then available to monitor trends and improve processes and efficiencies across the healthcare organisation. For example, automatic hand-hygiene monitoring records can be used for staff feedback and in research.

To implement an automated, human-hospital model, hospitals should: 

• Seek out organisations with both physical infrastructure and healthcare knowledge and expertise to address the unique challenges of hospitals
• Integrate solutions that address the needs of the healthcare facility, while automating tasks to improve the quality of patient care
• Assess current facility policies and procedures for patient safety and identify areas where additional safety measures are needed
• Prioritise the potential hazards and note any regulatory compliance issues, associated loss of revenue and potential ROI on possible solutions
• Re-evaluate the performance of the system on a regular basis to ensure continuous improvement as well as accommodate future needs, changes or expansion

Building automation and monitoring solutions can optimise a hospital’s infrastructure, improve clinical care and support better patient outcomes, thereby decreasing costs. Using ANS as a model for creating an ideal structure can help hospitals save millions of dollars and, most importantly, patient lives