A smarter HVAC system The HDR-developed software package HVAC ONE attempts to not only increase energy efficiency but also reduce the amount of facility-related errors in the OR
By Chris Gaerig, Online Editor
It seems simple enough: Given all of the data that a hospital tracks throughout the day on its conditioned air, surgery schedules, and otherwise, why not try and integrate all of them together to make not only a more efficient facility, but also one that’s safer for the patients? That was exactly the question that HDR asked two-and-a-half years ago when it began developing the innovative HVAC ONE system for OR suites. The HVAC ONE program, which began as software that connects the various data points of an operating room in an effort to lower the occurrence of mistakes and hospital acquired infections, has since grown into a comprehensive software package for all of the mechanical systems in a hospital.
The program functions in a relatively intuitive way: After tying all of these data-gathering programs together, the HVAC ONE system is able to alert staff members if a problem is occurring without having someone manually monitor the various systems. And since all of the integrated programs in OR rooms are digital, the staff alerts can vary from facility to facility, depending on the administration’s desired model and current infrastructure. “The great thing about digital technology is you can do anything you want,” says Von Lambert, director of HDR’s Healthcare Technology Solutions Group. “I can have the alarm sent to your phone as a text message or a big red light in the room; I can put it as a pop-up on the scheduler screen computer; I can send it to a pager or Vocera. I can do anything with it.
“Part of the beauty of it is that most people have everything they need already. Let’s get in and determine what your culture expects. If one place uses pagers and another uses screen pop ups, it’s not a problem.”
After the original system was created though, Lambert and the rest of the HDR team discovered that HVAC ONE could be used on a wider scale throughout the facility. By simply connecting all of the digital systems in hospitals, the program can significantly increase the energy efficiency and care delivery of the hospital.
“As we kept digging and digging, we saw that there are other things that it can achieve like we can tell the occupants of the room what’s going on with the room, if there’s something that goes on behind the scenes,” says Lambert. “I spent about 25 years managing hospital facilities, so I know what goes on behind the scenes. So when I would tell that to the nurse that’s on our team, who’s a perioperative nurse who worked in the rooms, she would say, ‘I didn’t realize there was a possibility that could happen’—things such as if you put a drape over a surgical back table and you push it against a wall and that drape gets sucked into the return air for the room, now you’ve modified how that system is working within the room. So you actually have an impact on the environment, and you probably don’t know about that until maybe an hour or two later when the room starts warming up, so you call facilities and say, ‘The room’s hot,’ and they say, ‘OK, well, I’ll go check’.”
The inspiration behind the system was patient safety, spurred on by HDR’s own interest in eliminating particulate from OR suites, as well as a 1999 study (and its 2009 follow-up) that showed that hospitals are responsible for thousands of deaths each year because of HVAC malfunctions, a problem that has not been solved or mitigated in the 10 years between studies. But the HVAC ONE system gives hospitals the added benefit of saving on energy costs—Lambert’s conservative estimate is 5 to 10% per facility, though it largely depends on the region the hospital is in. “If you’re in the southern regions where you’re cooling all the time, you’re going to save more money than if you’re in Minnesota where you can use pre-air cooling six months out of the year. It depends on your region but 5-10% is a good rule of thumb,” says Lambert.
And retrofitting a facility with the HVAC ONE system takes the bare minimum of requirements—for the most part, simply using current design standards. “You need to be able to modulate the air in and out of an OR. That’s current design: everyone’s doing that currently,” Lambert says. “If you have a place that’s 20 years old and you’re using constant volume, it’s more difficult to do on a per-room basis and you have to do it on a per-unit basis. If you have one air handler serving four rooms then you have for all four rooms to be empty to shut it down. That still happens and you still get the benefit of the alarm if that goes on. If you look at the energy savings that you can get, you can put that toward the renovation of these systems, which you’re probably going to have to do anyway if you have a 20-year-old hospital.”
Lambert calls the system a “no brainer”, something that can both save the facility money on their operating costs as well as helping deliver a higher quality of care. “One surgical infection costs you $50,000 per patient. Worse, it causes pain and suffering and sometimes death,” says Lambert. “We have all the measuring tools we need, we just need to get the right people with the right knowledge at the right time. The beauty of all of this is that we can also save you a bunch of money.”
In my discussion with Von Lambert, director of HDR's Healthcare Technology Solutions Group, he referenced a 1999 study that showed that hospitals are responsible for thousands of deaths each year because of HVAC malfunctions. A reader was curious about the study and e-mailed the HEALTHCARE DESIGN staff, asking for a reference. To clarify, the study was called To Err is Human: Building a Safer Health System. You can read it here.
