Hospital Engineer Vol 37 No 2 by Adbourne Publishing

VOL 37

NO 2

JUNE 2014

the australian

engineer HOSPITAL S

After the Storm Building a Specialist Ear Hospital in Nepal Filter selection for Hospitals PP 100010900

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IHEA National Board of Directors National President Darren Green National Immediate Past President Mitch Cadden National Vice President Brett Petherbridge National Treasurer Peter Easson (State Elected – WA) National Secretary/ CHCFM Coordinator Scott Wells (State Elected – QLD)

CONTENTS

BRANCH NEWS

National President’s Message

National CEO’s Message

10 State Branch Reports

INTERNATIONAL

Membership Registrar Alex Mair (Nationally Elected)

13 IHEA Journal Report

Standards Coordinator Steve Ball (Nationally Elected)

Asset Mark Coordinator Mark Stokoe (Nationally Elected) Director Kim Bruton (Interim State Elected Vic/Tas) Communication Darryl Pitcher Chief Executive Officer Jim Cozens Secretariat/Website Administrator Heidi Moon Finance/Membership Lynden Smith Editorial Committee Mitch Cadden, Darryl Pitcher, Scott Wells

FUTURE DIRECTIONS

14 IHEA Strategic Plan 2014/15 – 2016/17

CARE ENVIRONMENT

18 Hospice Centres Provide Patients’ Families With Home Away From Home

TECHNICAL PAPERS

20 After the Storm 24 Benefits from Commissioning HVAC Systems

32 Utility Service 40 Designing Light to Mimic Night And Day

Adbourne Publishing 18/69 Acacia Road Ferntree Gully, VIC 3156 PO Box 735, Belgrave, VIC 3160 www.adbourne.com

47 Modern Active Water Management in Hospitals

Melbourne: Neil Muir T: (03) 9758 1433 F: (03) 9758 1432 E: neil@adbourne.com Adelaide: Robert Spowart T: 0488 390 039 E: robert@adbourne.com PRODUCTION Emily Wallis T: (03) 9758 1436 E: production@adbourne.com Administration Robyn Fantin T: (03) 9758 1431 E: admin@adbourne.com

28 Building a Specialist Ear Hospital facility in Nepal

IHEA Mission Statement To support members and industry stakeholders to achieve best practice health engineering in sustainable public and private healthcare sectors.

ADVERTISING

42 Roof anchor safety alert: an engineer’s survival guide 44 AS 1851-2012 and your Hospital

53 How compliant is your building?

TOPICS OF INTEREST

56 Filter Selection for Hospitals 64 Fenestration 68 Heat Exchangers

PRODUCT NEWS

73 Product news Visit the Institute of Hospital Engineering online by visiting www.ihea.org.au or scanning here ➞ The views expressed in this publication are not necessarily those of the Institute of Hospital Engineering Australia or the publisher. The publisher shall not be under any liability whatsoever in respect to the contents of contributed articles. The Editor reserves the right to edit or otherwise alter articles for publication. Adbourne Publishing cannot ensure that the advertisers appearing in The Hospital Engineer comply absolutely with the Trades Practices Act and other consumer legislation. The responsibility is therefore on the person, company or advertising agency submitting the advertisement(s) for publication. Adbourne Publishing reserves the right to refuse any advertisement without stating the reason. No responsibility is accepted for incorrect information contained in advertisements or editorial. The editor reserves the right to edit, abridge or otherwise alter articles for publication. All original material produced in this magazine remains the property of the publisher and cannot be reproduced without authority. The views of the contributors and all submitted editorial are the author’s views and are not necessarily those of the publisher.

TECHNICAL PAPERS

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

National President’s Message Introduction

am pleased to advise we have now ‘bedded down’ the new National Board and I have seen great progress around portfolio responsibilities, core business activity and working relationships. Additional to this, the recent members survey and Board self-assessments have been used to define areas of opportunity and build on strengths and define targets as detailed in the 2014/15 – 2016/17 Strategic Plan. I would take this opportunity to thank all those who have contributed to the development of our Strategic Business Plans which have been reviewed, endorsed and now ready for distribution to members and implementation. On a sadder note, the Board has accepted the resignation of Mark Turnham, I would take this opportunity to thank Mark on his efforts during his tenure and wish him well in his future endeavours. Consequently we now welcome back a long standing senior IHEA member Kim Bruton as the Vic/Tas Branch representative leading up to the October AGM.

CEO Contract Review I am pleased to report that in line with the periodic review timetable the Board have concluded the annual assessment of the CEO contract inclusive of ranking progress and achievements against key activity and performance targets. In summary there were twenty three (23) key competencies in seven (7) focus areas and the assessment determined that our CEO (Jim Cozens) has either met or exceeded the required accountabilities. In line with our CEO contract and terms of engagement the next formal review will be conducted in March 2015 with an intermediate review planned later this year. I would like to congratulate Jim on his achievements and look forward to working closely with him over the following twelve months.

May Board Meeting Updates 2014/15 – 2016/17 Strategic Plan I would like to thank all IHEA members who participated in last year’s survey and commend all Board members for their participation in the strategic planning workshop and the development of 2014/15 – 2016/17 Plan. I think the Plan as presented has captured our focus areas, targets and a structured path we can now measure progress against. The development of the Strategic Plan has been a complex task that has been logically and systematically attended.

International Federation of Hospital Engineering (IFHE) As previously reported the IHEA bid to host the 2018 IFHE Congress has been progressed and I can now report at the May Board meeting, approved to proceed. This now means that our bid was formally submitted to IFHE on June 12, 2014 and a small contingent of IHEA representatives will attend the next IFHE Congress in Buenos Aires in October to present the ‘bid’. Importantly should our bid be successful Darryl Pitcher has agreed to be the nominated IHEA representative who would step through the IFHE Executive hierarchy of; 2nd Vice President, Vice President and President. Further information surrounding the bid and details of the proposed Congress will be provided as it evolves. At this stage we believe 2018 Congress will be contested by at least two other candidate countries and a ballot process will be implemented.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

National Board of Directors

Name

Position

Darren Green

President

darren.green@gsahs.health.nsw.gov.au

0412238062

Mitch Cadden

IPP

mitch.cadden@gsahs.health.nsw.gov.au

0408228419

Brett Petherbridge

brett.petherbridge@act.gov.au

0418683559

Scott Wells

Secretary

scott_wells@health.qld.gov.au

0736467902

Peter Easson

Treasurer

peter.easson@health.wa.gov.au

0426219166

Jim Cozens

CEO (ex officio)

ceo@ihea.org.au

0417835229

Alex Mair

Membership Registrar

ama58500@bigpond.net.au

0408661471

Mark Stokoe

Director

mark.stokoe@health.wa.gov.au

0412103144

Darryl Pitcher

Director

d.pitcher@bethsalemcare.com.au

0437894049

Steve Ball

Director

STEVE@BarwonHealth.org.au

0342150922

Kevin Tan

Director (co-opted)

Kevin_Tan@health.qld.gov.au

0419 721 765

Kim Bruton

Vic/Tas Branch Representative

Kim.Bruton@nhw.hume.org.au

Executive Committee

Subject to the outcome, this initiative will see the 2018 IHEA National Conference held in Brisbane and aligned to the IFHE Congress and Council Meeting. This in turn gives us both international exposure and greater access to international trends and technology. It will also increase support and attendance to our Annual National Conference to be delivered in this slightly amended format.

Constitution Review The Board has again put emphasis on review and the Constitution and I can confirm that the next iteration of the constitution will go through further assessment in the form of a peer review. There are many years of consolidated knowledge and experience held across our senior standing members and the Board will be tapping into this expertise. It is proposed once the Board has completed a full review of this complex document it will be presented to our members for review, comment and endorsement.

Membership Renewals

Board Meetings The Board has made a conscious decision to reduce the number of ‘face to face’ meetings from four (4) to three (3) each year. The commencement of monthly interim electronic Board meetings via GoToMeeting will ensure momentum and progress of core business and meet obligations as outlined in the ‘Constitution. This will be trialled for the coming year and reviewed at the February 2015 Board meeting, we are also continuing with a rotation of meetings in an attempt to meet with Branch Committee of Management and minimise operational costs.

Budget Build-ups Our National Treasurer (Peter Easson) presented the Board the draft 2014/15 budget which was built up from historic information and branch submissions. The budget was in turn scrutinised in detail and final adjustments are now complete. The ease and completeness of the process was a direct product of the preliminary work carried out by Peter and the Branch Treasurers, congratulations to all those involved.

The Board has again discussed membership renewals and personal information management and have committed to continue to cleanse data, follow the approved process to manage unfinancial members and introduction of secure online member services. Generally it was also agreed that membership costs should align to CPI annually rather than adhoc increases previously applied. Furthermore it was acknowledged that the approved ‘Retiree Member fee’ ($50) aimed to recoup actual costs was poorly communicated and the Board will now take remedial action and improve communication for any future changes.

Summary

Honorary Members

Regards Darren Green M.I.H.E.A., C.H.C.F.M. Adv Dip Eng Tech, Dip Proj Mgt, Adv Dip Mgt. IHEA National President

The Board is currently reviewing members specific to those of ‘Fellow’ and ‘Honorary Fellow’ with the intent to conform to the ‘Constitution’ and ensure we have duly reviewed and awarded such grades to those who hold appropriate levels of qualifications and experience (Fellow) or those who in the opinion of the board has provided outstanding meritorious service to health care engineering. More formal communication will be provided as this body of work progresses.

Mobile

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

In closing I would like to acknowledge the work carried out behind the scenes over 3 months particularly by the CEO, the executive and the IFHE bid team. Work on the marketing of the IHEA, the ‘Constitution’ review, Strategic Plan and other key activities noted previously have all assisted the development of the IHEA. I also believe that the Strategic Plan will lay the foundation for the next three (3) years business drivers and key activity establishing the ‘roadmap’ for the betterment of the IHEA and our members.

www.ihea.org.au

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

National CEOâ&#x20AC;&#x2122;s Message focused. Poor marketing and broader engagement compounds this perception. Lack of communication also was noted as a weakness. The reduced engagement of members at state and national seminars and conferences was seen as a possible measure of ineffective communication and lack of industry relevance. It is respecting these Member opinions that the development of a communication strategy is essential. This is happening with the Board endorsing a revision of the website to enable Member access, social media communication (Facebook, LinkedIn), regular monthly E Bulletins, Member access to Institute Policies and other documentation of relevance to Members through I Cloud or similar. These initiatives will be introduced over the coming months with Members to be well informed on progressive implementation.

he scene is now set to progress Board initiatives to positive outcomes relative to Member services that will meet Member needs into the future.

The past year has been one of evaluation of Member needs. Evaluation undertaken through the conducting of a Member Survey, preparation of a 3 year strategic plan and the development of a communication strategy. These processes have laid a foundation for the progression of the Institute to a meaningful collegiate forum providing professional development opportunities and health services engineering career progression. A summary outcome of the Member Survey brought forward a Member Satisfaction rating of 74.6%. The challenge now being to address the 25.4% of dissatisfaction. The latter has been addressed by the Board through the introduction of a 3 year Strategic Plan, the Action Plan of which is contained in this Edition of your Journal. The prime drivers of the Strategic Plan were influenced by the results of the Member Survey and the Board recognising that the IHEA is not wide within the health services sector, and engineers within the sector. This could be due to a lack of relevance to members, and health organisations which in turn could lead to lack of employer support. Also, whilst there is a sound membership base, the membership is ageing and participation and contributions across the membership is uneven, and in some areas, low. This may be due to daily demands on members, lack of membership induction, less value perceived by some potential members, and lack of support from hospital management. These factors are presented as realities and are brought forward for Members to consider the relevance and value of the Strategic Plan to address them looking to ensuring the sustainability of the Institute in the years ahead.

It is recognised that pressures on membership may come from competing work priorities, need for work life balance and lack of time to participate in membership activities. In determining â&#x20AC;&#x153; nowâ&#x20AC;? as the current position of the Institute has resulted from consideration of past Board decisions and the views of Members through the most recent Member Survey. On this basis Members are earnestly encouraged to support the current National Board initiatives and respective State Branches through membership renewal, attending Professional Development Programs, State Conferences and nationally by attending the National Conference. In addition to these forums it is noted that there has been considerable decline in taking up CHCFM Accreditation and AssetMark. To support the Vision that the IHEA be recognised as the peak professional body for health engineers and facilities management, Member support and engagement is essential. In this context Members are earnestly encouraged to review the Strategic Plan to gain an understanding of Board consideration of the changes impacting on the organisation and its members, and what that means for future IHEA direction and benefit to Members. The Board now having established what I believe is a future direction for the Institute it is my intention to visit State Branches during the remainder of 2014. The purpose being to meet with State Branch Committees and Members to assist where appropriate with the implementation of the Strategic Plan and Communication Strategy and other matters of relevance as they relate to the Governance and Management of the Institute. Regards Jim Cozens Chief Executive Officer

From the Member Survey further issues raised include a Member perception that the IHEA is too tight knit and internally

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

STATE BRANCH REPORTS

State Branch Reports NSW/ACT Branch Report – Peter Llyod, State Branch President

Queensland State Branch Report – Alex Mair, State Branch President

he NSW/ACT Branch has been working progressively through the first half of 2014 to plan and deliver a successful Mid-Year Conference, Awards and Annual General Meeting. This year we will be visiting the South Coast of NSW, with the Wollongong Hospital and its current redevelopment being utilised as a back drop to our Day and a Half event; Friday 20 June and Saturday 21 June.

ince February the main focus has been on the National Conference. There was to have been a PD in May but this has been postponed to coincide with the AGM in July. With the changes in Queensland Health, most members are finding that their workloads have increased and until the organisation has settled time, away for PD and conferences is difficult to organise. The new leaner organisations of the Hospital and Health Services, no longer have any spare capacity and so there is a continual backlog of work.

Members will have access to four technical presentations which will include Hazardous Substances, Schneider, Web FM and a Wireless Monitoring Supplier. Members have been invited to stay overnight then join us for a technical tour of the Hospital site and redevelopment on the second day. The Committee of Management are confident of a really positive experience for those members that attend.

The Gold Coast Hospital is now on line and operating with its outsourced service model. There is currently no advice on the effectiveness of this model. National Conference Planning for the conference is extremely well advanced with the registrations opening today, a couple of days ahead of schedule. The Program is all but complete with only minor details to be finalised and most sponsor positions are filled. AGM The state AGM is scheduled for 24th July

Western Australia Branch Report – Mark Stokoe, State Branch President Branch Meeting for 6th March breakfast meeting held at Sir Charles Gairdner Hospital in the Social Club Block “.

The meeting was sponsored by KCare Health Care Equipment

Agenda Branch Meeting Presentation by Cortec Graham Cassidy on the final integration between BMS and commissioning and continuous commissioning. KCare Sponsors presentation Douglas DeSouza MIHEA and Campus Facilities Manager QE2 Medical Centre provided members with a tour of the new central plant building facilities at end of the presentations. Branch Meeting and Professional Development 3rd April An evening meeting was held at Graylands Hospital in the Graylands Engineering Workshops. The meeting was sponsored by Pride Plumbing and a Professional Development session was presented by Schneider Electrics, Irina Lindquist.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

STATE BRANCH REPORTS Branch Meeting Agenda Presentation Schneider Electrics – Irina Lindquist. Pride Plumbing Sponsors presentation Graylands hosting the BBQ and networking Bali Country Conference 16th to 18th May An excellent opportunity to enjoy business and pleasure was provided at the Bali country conference. The Bali conference theme. “Destination Bali Awareness”, location – Sanur, Bali Was well attended by 30 WA Members and National Secretary, Scott Wells. The program incorporated site tours on the Friday with the main reception and presentations in the evening, site visits to Siloam Hospital and Puri Rahayu Hospital on the Saturday with a conference dinner in the evening. The group was most appreciative colleagues from the Indonesia Hospital Engineering Association joining in the meeting activities. A significant aspect of the Conference was the opportunity to visit the John Fawcett Foundation which provides voluntary Ophthalmic to rural and underprivileged communities. Follow up to this aspect was to endeavour to invite those involved with John Fawcett Foundation and Indonesian

Colleagues to participate at the 2015 National Conference and for our Indonesian Colleagues to meet and with their Australian counterparts. This matter will be pursued by the WA Conference Organising Committee in association with IFHE Executive Committee Member Darryl Pitcher with the ongoing consideration of the IHEA developing an Exchange Program with Indonesia and for evaluating the feasibility of the IHEA Members offering, on a basis to confirmed, training programs in Indonesia. I.T. Technology The Branch has adopted “Cloud Google” WA Branch records and other documentation storage with the option of Dropbox being considered. State Conference September 2014 Planning is well underway for the WA State Conference with the venue at the Hyatt Regency Perth booked for the 5th September 2014. The theme for the conference is “Healthcare Facilities and the bottom line”. The conference is also an opportunity for the presentation of the WA Health Facility Manager of the Year and nomination forms have been circulated to members calling for candidates to be put forward.

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

INTERNATIONAL

IHEA Journal Report

– IHEA Board Member and Australian IFHE ExCo Member Supports Establishment of new Indonesian Healthcare FM Association Darryl Pitcher

uring November 2013 Darryl Pitcher, IHEA National Board member and IFHE Executive Committee member, travelled to Jakarta, Indonesia to support the work of IFHE “A Member” HATIMI. A national seminar had been planned to promote the benefits of robust and well planned Hospital Engineering to improve the outcomes in Indonesian hospitals. Invitations had been sent across the country to encourage support of this important day that was promoted by the Ministry of Health and the Ministry of Higher Education. On the invitation of HATIMI and with support from the Indonesian Ministries , the Institute of Hospital Engineering Australia and the International Federation of Hospital Engineering, Darryl was able to attend the seminar and present on the importance of a robust Hospital Engineering Association to support the development of engineers and to promote IFHE and IHEA to an audience of over 290 people. Panel discussions were held with each group of speakers taking questions from the floor throughout the day long seminar and providing advice and recommendations on the essential components of hospital engineering, education and training, asset procurement, maintenance and sustainable design. Following the national seminar which had representation from as far east as Papua and as far west as Banda Aceh in Sumatra, a delegation of representatives met to form a new organisation to support the broad and diverse needs of Hospital Engineering in Indonesia. This was achieved with 21 people representing

universities, hospitals, industry professionals and the Education and Health Ministries reaching agreement on the formation of a new body to embrace HATIMI and engage with IFHE and other international and regional associations. Darryl was able to add his signature to the agreement as the international IFHE delegate. Since this meeting further planning has been done to develop an ongoing program of activities for the newly formed association into 2014 and beyond. During the visit to Indonesia, Darryl was able to visit a number of sites in Jakarta including a biomedical calibration laboratory and pathology service and also undertook an overnight trip to Surabaya in east Java to visit the University of Airlangga. This visit included a presentation to graduates of the Faculty of Public Health on the importance of hospital engineering and the benefits of an association to support sustainable hospital facilities and development and training. Darryl was also able to tour the recently completed University of Airlangga teaching hospital and the Tropical and Infectious Disease Research Facility and held a meeting with the Director of the University and a number of Faculty heads to discuss the challenges they were facing specifically around hospital engineering. It is planned to build twenty new teaching hospitals across Indonesia under the guidance of the Ministry of Education and these facilities require proper planning and development to ensure the objectives of both the Health and Education ministries can be met. There is a passion to improve health

outcomes for the people of Indonesia and to further develop local clinicians and health professionals with education in purpose-built teaching facilities that also deliver localised emergency health and clinical solutions. The visit is evidence of the good work able to be achieved by collaboration between regional Associations and Institutes and between members of IFHE, and how, with the support of member organisations more positive outcomes can be achieved as countries share their experiences and support further education and development. Special thanks to Johnny Sinaga, Imam Rafia and the Ministry of Education for supporting and hosting Darryl during this visit, and also to IHEA and IFHE for sponsoring the travel to allow Darryl to contribute to the Indonesian health sector.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

FUTURE DIRECTIONS

IHEA Strategic Plan 2014/15 – 2016/17 On Thursday 6 February 2014 the Board of the Institute of Hospital Engineering, Australia (IHEA) met to discuss the future strategic directions of the organisation.

he purpose of the workshop was to develop a clear, agreed future strategic direction for IHEA for the next three years based on:

• A reflection of what has worked and not worked in the past, and what this means for the future • Outcomes and needs analysis as defined by members in the recent members survey

• Consideration of the changes impacting on the organisation and its members, and what that means for future direction • Consideration of what will make the organisation current, relevant and sustainable • Consideration of the best management structure, including roles, responsibilities and relationships to enable the preferred future In order to provide member an update on key focus areas the following table broadly summarises the focus areas, proposed strategies and activities/actions to be carried out.

ACTION PLAN – YEAR ONE (1) – 2014/15 Membership Strategies

Activity/Actions • Market to facility engineers with benefits of joining • List of facilities • List of benefits • List of activities (PD/Conferences etc.)

Build and Maintain membership base and, provide value for membership

• Write to individuals • Advertisements in Hospital Engineer • Targeted invitations to professional development • Broaden membership base, e.g. trades, aged care, mental health • Expand Use of IT for PD, Website, Webinar, YouTube... • Cleanse database • Contact contracted providers

Communications and Marketing Strategies

Activity/Actions • Develop educational/training programs • Establishing and maintaining a PD program (Registered Training Organisation)

Improve communication and marketing

• Continue and enhance CHCFM program • Trade competency assessment accreditation • PD specific to members’ needs • Customised Short courses and seminars Online

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

FUTURE DIRECTIONS ACTION PLAN – YEAR TWO (2) – 2015/16 Technology Strategies

Activity/Actions • Develop educational/training programs • Establishing and maintaining a PD program (Registered Training Organisation)

Improve engagement with members, and professional development through the use of technology

• Continue and enhance CHCFM program • Trade competency assessment accreditation • PD specific to members’ needs • Customised Short courses and seminars Online

Training and Professional Education Strategies

Activity/Actions • Develop educational/training programs • Establishing and maintaining a PD program (Registered Training Organisation)

Continue and enhance education and training programs

• Continue and enhance CHCFM program • Trade competency assessment accreditation • PD specific to members’ needs • Customised Short courses and seminars Online

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FUTURE DIRECTIONS ACTION PLAN – YEAR THREE (3) – 2016/17 Governance Strategies

Activity/Actions • Review and determine validity of existing documentation. • Undertake gap analysis against existing documentation. • Develop/revise/communicate policies and procedures as required • Process of compliance and controls

Provide sound organisational governance

• Allocate appropriate resources • Develop/agree format (style guide) – Board approval and adoption • Develop/agree review process and frequency etc. – Board approval and adoption • Develop 3 year sustainable process – automated/monitored • Consultation (2 yearly or as required) • Communicate and process policies and procedures etc.

Partnerships Strategies

Activity/Actions Target Australian potential partners • FMA • Plumbing industry climate centre • AIRAH • Standards Australia • Property Council of Australia • ACHCS • ACHSM • CHAA • State Health departments • Contracted service providers Seek/contact

Build strategic alliances and partnerships to increase recognition for IHEA and enable member benefits

Regional – Asia Pacific • Introduce delegate exchange program (2 years) • Support conference presentations, e.g. DP trip to Indonesia (Indonesian representative to present at Queensland National and WA National) (1 year) • Expand AssetMark to regions (3 years) • Potential for CHCFM introduction and available to Asia Pacific (3 year) Australia • ACHCS – adoption of AssetMark as an industry standard (3 years) • FMS • Centre • AIRAH • Cross promotion/participation in training programs • ACHSM (2 years) • Standards Australia

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

CARE ENVIRONMENT

Hospice Centres Provide Patients’ Families With Home Away From Home Barbara Horwitz-Bennett

Providing a serene, comfortable environment where the terminally ill can spend their final days, hospice is a slowly but steadily growing market sector.

riginally integrated into hospitals, hospice care began breaking out into standalone facilities in the early 1990s. They started out small with just a handful of beds, but once industry pioneers figured out that it would take an average of 7 beds running at an 85 percent occupancy rate to break even, facility size slowly increased. With an average of 83.4 percent of patients in hospice and palliative care centres over the age of 65 combined with the massive baby boomer population moving into this age group, the market is likely to swell. “Now we hardly ever build a facility that’s less than 12 beds and have completed a couple that are in the 32- and 48-bed range,” reports Tom Mullinax, president, Hospice Design Resource (Bent Mountain, Va.), who’s designed dozens of hospice facilities all across the country. Although the majority of terminally ill patients receive hospice care in their own homes in the U.S. (around 1.5 million), the percentage of those utilising hospice care facilities is gradually increasing. According to market research firm IBIS World (New York), there were 4,264 U.S. hospice centers in 2005; that number has more than doubled, standing at 8,802 today.

care spaces, hospice design has evolved into a mix of hospitality and residential styles with plenty of room and amenities for both patients and their families. Granted, hospice still requires medical resources like patient beds, gas hook-ups, and nurse call systems; however, creative strategies can mask an institutional look, when possible. For example, moveable artwork or casework can conceal medical gases, and beds with moveable foot ends can enhance patient comfort and mobility and enable loved ones to sit at the foot of the bed, explains Kelley Hoffman, project manager/senior designer, Spellman Brady & Co. (St. Louis). Likewise, Mullinax says he frequently replaces nurses’ stations with standalone desks that are visible to the public, while the medical staff is based in an out-ofsight workroom. At the same time, nurses must keep patients within sight, but this can be accomplished through view windows, which also enhances patient privacy and interruption by limiting the need for staff to enter the room.

The comfort of home

“Designing a hospice room is a sacred assignment,” explains Douglas W. Whitney, president, WBRC Architects and Engineers (Lakewood Ranch, Fla.). “A hospice room is not only a place to keep a terminal patient comfortable, it’s also a place where patients and their families will visit, reminisce, comfort each other, and, ultimately, say goodbye.”

With new standalone facilities no longer restricted by design guidelines for acute

“Today, there’s less focus on the clinical aspects of hospice care and greater

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

understanding of the need to create a peaceful, nurturing environment for patients and families,” adds Whitney’s colleague Richard Borrelli, healthcare studio director, WBRC (Portland, Maine). “This trend is encouraging small, wellappointed centers that focus on living, not the ending of living.” In order to execute this approach, today’s hospice facilities feature private outdoor patios, walking trails, pianos, fireplaces, dining rooms, lounges, and personal shelving space for pictures, cards, and flowers. “Some plans go as far as designing patient rooms with direct access to a courtyard, allowing the bed to be rolled outside should the patient wish to do so,” Hoffman says. Soft, indirect lighting is common, along with natural materials such as stone and wood panelling, casework, and trim. Ceilings are sometimes higher, or even vaulted, in smaller, one-story facilities, with ceiling fans and operable windows adding to the residential feel, explains Jeni Wright, principal, Kahler Slater (Madison, Wis.). Mullinax says that while the use of carpeting or wood flooring can further enhance the feeling of home, maintenance issues have made fauxwood vinyl with a foam backing a more common choice. In terms of the building’s exterior, more and more designs are mimicking the

CARE ENVIRONMENT architectural form of a residence with design features such as sloped roof lines. “Most of the designs we’ve seen use Craftsman-style elements such as long eave and soffit overhangs supported by ornamental knee bracing,” says Kevin Kitchens, project manager, Perkins & Williamson Architecture (Hattiesburg, Miss.). “Tapered columns are often featured in these designs along with materials such as stone, brick, and lap/ shingle siding.”

For the family Family needs are a high priority in hospice. As such, a pull-out bed in patient rooms, where at least one family member can spend the night, has practically become a design standard. For example, at Agrace HospiceCare’s new inpatient hospice facility in Janesville, Wis., Kahler Slater designed a small, discrete area within each patient room that can be used as a living room by day, and a family sleeping area at night. “Access to an Internet connection, refreshments, and meal preparation areas are now three must-haves that weren’t necessarily incorporated just a few years ago,” WBRC’s Whitney says. Additional in-room amenities include ample furniture, space for family members’ personal belongings, shower access, laundry facilities, in-room refrigerators, microwaves, a coffee pot, and sometimes even a second TV set with pillow speakers. “Unlike a hospital room where the patient moves as quickly as possible, a hospice room offers encouragement to spread out and to linger,” says Ila Burdette, principal, Make3 Architecture (Atlanta). Outside of the patient room, other building features can be added to enhance the family’s experience, such as exercise rooms, a library, sunrooms, meditation areas, private alcoves, and comfortable family room and living roomtype seating. “We’re seeing the use of more and more therapy areas, mostly manned by volunteers, that could be used for hair care, massage, or acupuncture,” Mullinax says. Although much attention is centred on the family’s privacy, facility designs also

aim to create spaces, such as a larger dining area, where people will naturally cross paths. “This serves as a ‘melting pot,’ allowing families to come close and share counter space, providing a launching pad for conversation and friendships,” Mullinax says. Hospice care also needs to meet the needs of visiting children and teenagers, who are likely to become bored or restless after spending extended periods of time in the building. Experimenting with different solutions, Mullinax has found children’s playrooms to be quite effective. For example, his team designed one for a hospice facility in Bloomington, Ind., with access through a 4-foot-high door so that the children would feel like it was “their” space. As for the teenagers, Mullinax says spaces with access to computers and recliners with attached DVD players and headphones have been the most successful. “This gives them a place to go off by themselves, do homework or watch a movie, and not be a distracted by the serious activities that are constantly going on in these facilities,” he says.

Dealing with the inevitable An inherent function of hospice facilities is to care for patients until death and after, requiring careful planning for on-stage/off-stage areas to transport deceased patients discreetly. This can be challenging in smaller facilities, but it is possible. For example, in designing the OSF Richard L. Owens Hospice Home in Peoria, Ill., Spellman Brady added extra exits to each residential wing in order to provide back-of-house egress paths. In other cases, facilities can transport deceased patients through the chapel, through staff support areas, or through an exterior door directly connected to a patient’s room. “However, many hospices embrace the celebration of the lives of their patients by providing a quiet processional ceremony that moves the deceased patient and their family through a front door or a secondary door into a garden space,” Wright says. “The philosophy here is that patients should leave the facility with the

same respect and dignity in which they entered.” Ultimately, this is a very sensitive decision made by individual facilities, and designers can ease the process by providing end users with a range of egress options.

For the staff As much as hospice is all about patients and their families, another core group that must be considered is the staff that runs these facilities. Providing care to the terminally ill is difficult, and staff members will often develop personal relationships with their patients and families. As a result, Whitney says, they may endure quite an emotional hit from the continued loss of their charges. “Space to escape from the stress and have a private conversation is critical to maintain emotional equilibrium,” she explains. This might be provided through a private, back-of-the-house area; a staff lounge; or an outdoor patio/garden area. “We’ve started recommending small exercise rooms where staff can get on a treadmill and work out some of their emotions,” Mullinax says. Burdette has also received requests to create staff areas where both the inpatient caregivers and home care staff can interact and help reinforce a sense of shared mission.

Key role Although hospice centres are relatively small in scale compared to other healthcare projects, they’re considered an important piece in the full continuum of care. As a result, a continued growth and prioritisation of hospice care is expected for years to come. While the proportion of over-65 seniors, as compared to the U.S. population, is projected to grow at an annualised rate of 3.1 percent over the next five years, IBIS World projects that the number of hospice establishments will hit 9,440 by the year 2019. Barbara Horwitz-Bennett is a contributing editor for Healthcare Design. She can be reached at bbennett@beqeqint.net This article originally appeared in Environments for Aging’s sister magazine Healthcare Design.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

After the Storm David Stymiest PE, CHFM, CHSP, FASHE

As mission-critical equipment, hospital emergency power systems are expected to provide power consistently to what they must, when they must and for as long as they must. This is a tall order, and the impact of an emergency power system failure when normal utility power also has failed is potentially severe for patient care.

he failure of some facility emergency power systems during and after last fall’s superstorm Sandy already has spawned investigations, which ultimately will result in lessons learned and more knowledge upon which health facilities professionals can base best practices to reduce vulnerabilities.

caregiver communication Some clinical personnel believe emergency power is or should be uninterruptible. They believe it should never fail. Unfortunately, nothing is guaranteed under all circumstances, including uninterrupted power. Despite best efforts, emergency power systems sometimes fail, even when they are needed. Part of this may stem from a misunderstanding about the operational aspects of emergency power equipment and related transfer devices. For instance, one medical journal article mentioned “usually less than 1-second” duration upon the loss of commercial power, which is substantially less than the 10-second maximum duration required by codes and standards. In fact, because monthly emergency power load tests do not involve the loss of normal utility power, one wonders if the very short hot-to-hot power source transfer times during monthly tests themselves may lead to unrealistic expectations by some affected clinical personnel.

Although facilities professionals know that there are different types of electrical system failures that can occur, it appears that there has not been enough discussion of these issues with clinical professionals. Facilities professionals should take the time to educate physicians, nurses and others about the different potential failure modes of their electrical power systems. The education should be comprehensive enough so that clinicians understand the three or four different potential types of electrical failure in any critical care clinical space, each with its own response, including: • Failure of the normal power supply to the space or equipment with the emergency power system – also called the essential electrical system (EES) – still online; • Failure of one or more of the EES branches (life safety branch, critical branch or equipment system) serving the space or powering equipment serving the space with the normal power system still online;

With each of these scenarios, the impact on procedures and required actions by caregivers may be different. For example, the expected response in most hospitals to the most commonly discussed potential electrical failure – failure of normal utility power – is to ensure that critical equipment is plugged into emergency power (red) outlets. However, if the failure is the critical branch serving a space instead of normal power, the appropriate response would be just the opposite – to ensure that critical equipment is plugged into the normal power (gray, white and brown) outlets. Quickly differentiating between the scenarios and their necessary responses can improve patient care and safety. Many hospitals already have basic electrical utility failure procedures that were prepared many years ago. However, the ongoing enhancement of computerisation in modern operating room (OR) suites may require regular

• Failure of one of the two critical branches with the other critical branch source still online in critical care spaces served by two separate critical branch sources as permitted by the National Fire Protection Association’s NFPA 99, Health Care Facilities Code; • Total electrical failure to the space, either simultaneously or as the result of cascading failures over a period of time, similar to some of the hospital emergency power failures in the Northeast after superstorm Sandy.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Bypass isolation transfer switches can be maintained without turning off their loads, improving operational reliability.

TECHNICAL PAPERS reviews and updates to these earlier versions of utility failure procedure manuals. Regardless of the type of event, appropriate responses for each foreseeable failure mode should be covered fully in these manuals and the manuals should be accessible to those who need them. These responses for different types of failures also should be covered in training and regular exercises.

Expanding the concept Recent events may cause facilities professionals to expand the concept of emergency power to the issues of availability and dependability. Maintenance management, production scheduling and data centre infrastructure experts often consider these additional attributes as well. In systems engineering, dependability is a way to measure a system’s availability, reliability and its maintenance support. Reliability can be considered the probability that a system operates and gives the same result on successive trials. Availability, on the other hand, can be considered the probability that a system will be able to function at any instant required, including within the next instant and for as long as required from that point. Because no facilities system can guarantee 100 percent reliability, no system can assure 100 percent availability. The most commonly accepted metric of major commercial data centre availability – a function of its power system design, among other factors – is a facility availability of “four nines” or 99.99 percent, and data centre power systems tend to be more robust than many hospital systems. The Joint Commission’s Sentinel Event Alert Issue 37, titled “Preventing adverse events caused by emergency electrical power system failures,” was published Sept. 6, 2006. The Joint Commission addressed the topic again in its Environment of Care News a year later. Most hospitals addressed elements of Sentinel Event Alert Issue 37 at the time. Recent events indicate that it may be time to address at least one of those recommendations – the power

system vulnerability analysis – again and perhaps more comprehensively this time.

failure procedures all work together to prevent that occurrence.

Though not addressed in Sentinel Event Alert Issue 37, an updated review of vulnerabilities also might include an analysis of the potential for commonmode failures, which are failures of two or more systems or components due to a single event or cause. A safety engineering concept states that once a failure mode is identified, it usually can be mitigated by adding extra or redundant equipment to the system. However, the existence of an uncorrected common-mode failure potentially removes the advantage of other redundancies.

Whether a duplex fuel pump skid has a single source of power or is located in an area where it is subject to the same event that takes out the utility power source, the result is potentially a full power outage. Pieces of equipment on an upper floor can be rendered unusable if their power feeders are located in an area that is subject to flooding or damage from other common-mode causes.

One example of a potential source of common-mode failures is a single fuel oil storage tank containing fuel oil that serves multiple generators, including redundant ones. Fuel oil contamination could adversely affect all generators served by that system.

• Consider each component that must operate;

The 2013 revisions to NFPA 110, Standard for Emergency and Standby Power Systems, include numerous improvements and new recommendations that provide more ammunition to fight against the damaging effects of fuel oil contamination on emergency power reliability. The 2013 edition of the standard should be reviewed to ensure that both its new requirements and its recommendations, many of them best practices, are given due consideration in existing facilities. An emergency power fuel oil storage tank located on the same building level as normal power equipment also may leave these two systems — both normal power and emergency power — subject to the same common-mode failure potential, whether it is flooding or any other cause that renders the systems or components unusable. Examples of other fuel system commonmode failure causes are the fuel transfer system components such as pumps, controls and their power sources. The failure of fuel oil transfer pump power or controls can bring down an entire emergency power system unless the design, vulnerability analysis, inspection, testing, maintenance, operation and

One effective approach to take when analysing these and other potential vulnerabilities is to:

• Determine what scenarios will cause it to fail, including all “What if?” scenarios that could damage the power sources or feeders that keep it running; • Compare those scenarios with others that may take out other redundant components, redundant power sources or redundant feeders; • Investigate all the possible causes of those scenarios, including commonalities in power sources, feeders or controls; • Address the resulting common-mode failure modes that have been identified. Automatic transfer switches are major components of most hospital emergency power systems. Normal power flows through them to critical equipment when it is available, they tell generators when to start if they sense a loss of normal power and then they switch to generator power when it becomes available. However, automatic transfer switches themselves may be a point of commonmode failure because both normal power and emergency power flow through the same point to the critical equipment. A transfer switch failure likely will cause an outage of the critical equipment that it feeds. The good news with smaller transfer switches is that the impact of any single common-mode failure of this type probably will be limited to a smaller area or smaller grouping of equipment. Larger transfer switches, however, will feed more equipment and larger spaces. With a larger transfer switch, the impact of its

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS common-mode failure will have a greater impact. Hospitals should be cognisant of requirements from NFPA 110 such as “8.1.1 – the routine maintenance and operational testing program shall be based on all of the following: (1) manufacturer’s recommendations, (2) instruction manuals, (3) minimum requirements of this chapter, and (4) the authority having jurisdiction.” The necessity of maintainability is very important. Transfer switch failure potential can be affected adversely by the lack of maintenance, which should be performed to minimise the potential for wear outbased failures due to component ageing and use. Many hospitals still are burdened by being limited to automatic transfer switches that do not have a bypass isolation feature. This feature is not typically a requirement for hospitals, but it is a best practice, because it enables transfer switch maintenance to occur safely without shutting off the critical equipment that the transfer switch feeds. A review of the recommended maintenance in consensus industry standards and manufacturers’ operating and maintenance manuals indicates that certain tasks typically included in recommended annual maintenance only should be performed with the transfer switch removed from service or in the bypass mode. If a facilities professional seeks to perform maintenance on a transfer switch that does not have the bypass isolation feature, it probably will be necessary to take the transfer switch out of service and turn off its loads, which is unacceptable in many hospitals. As a result, many hospitals do not perform full maintenance on these devices because they are unwilling to turn off the critical equipment. Testing company reports may show that certain recommended annual maintenance tasks simply were not performed if the owner did not allow the power to be removed from the transfer switch. Another potential of common-mode failure in facilities with multiple paralleled generators is the paralleling switchgear,

the complex equipment that ties those generators together. As unlikely as it may be, this equipment can fail. If a hospital has a paralleling switchgear and that switchgear fails, how will it get generator power to the loads? It is important to have analysed this scenario ahead of time to create a failure procedure that addresses the necessary steps to take if it occurs. As stated, NFPA 110 requires that the paralleling switchgear manufacturer’s recommended maintenance be incorporated into the ongoing emergency power management process. NFPA 110 also includes the requirement that “8.3.6 – Paralleling gear shall be subject to an inspection, testing, and maintenance program that includes all of the following operations: (1) checking of connections, (2) inspection or testing for evidence of overheating and excessive contact erosion, (3) removal of dust and dirt, and (4) replacement of contacts when required.”

Lessons learned Health facilities professionals should be ready to learn from the lessons of recent failures, including those occasioned by superstorm Sandy and the several years of events that preceded it. The health care industry undoubtedly will be exposed to new recommendations, perhaps asked to consider an array of new best practices and even may be subject to new regulations in the not-toodistant future. David Stymiest, P.E., CHFM, CHSP, FASHE, is a senior consultant for compliance and facilities management at Smith Seckman Reid Inc., Nashville, Tenn. He can be reached at DStymiest@SSR-inc.com

References “Response to a Partial Power Failure in the Operating Room,” Tammy Carpenter, M.D., and Stephen T. Robinson, M.D., Anaesthesia & Analgesia, vol. 110, no. 6 (June 2010) 1644–46 “Electrical Power Failure in the Operating Room: A Neglected Topic in Anesthesia Safety,” John H. Eichhorn, M.D., and Eugene A. Hessel II, M.D., Anesthesia & Analgesia, vol. 110, no. 6 June 2010) 1519–21

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

“Preventing adverse events caused by emergency electrical power system failures,” The Joint Commission Sentinel Event Alert, Issue 37, Sept. 6, 2006 “Sounding a Sentinel Event Alert on Emergency Electrical Power Systems” Environment of Care News September 2007 “Averting Common Causes of Generator Failure (Part 1),” Darren Dembski and Sarah Escalante, Facilities Engineering Journal, September/October 2009 “Averting Common Causes of Generator Failure (Part 2),” Darren Dembski and Sarah Escalante, Facilities Engineering Journal, November/December 2009 “Generator Fan Failure Triggered AWS Outage,” Rich Miller, Data Centre Knowledge blog June 21, 2012 “Multiple Generator Failures Caused Amazon Outage,” Rich Miller, Data centre Knowledge blog July 3, 2012 “Managing Hospital Emergency Power Systems – Testing, Operation, Maintenance and Power Failure Planning,” David Stymiest, ASHE management monograph, 2006 (accessible only by ASHE members) NFPA 110-2013, Standard for Emergency and Standby Power Systems, Quincy, Mass.

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Benefits from Commissioning HVAC Systems Lasath Lecamwasam CPEng NPER I MIEAust MCIBSE MASHRAE MAIRAH Principal Engineer, Building Services, GHD Canberra

Lasath is a Chartered Professional Engineer having 28 years’ experience with building services design and maintenance management in England, Scotland, New Zealand and Australia. He was the lead author of the Guide to Best Practice Maintenance and Operation of HVAC Systems for Energy Efficiency published by the Department of Climate Change and Energy Efficiency. One of Lasath’s projects – 4 Mort Street, won the AIRAH 2012 Award for Excellence – Best HVAC and Refrigeration Upgrade, presented by the NABERS team. Lasath has carried out Level 2 and 3 Energy Audits at major hospitals in New Zealand and in Australia and in this article explains potential benefits from commissioning.

Background

acility Managers are increasingly under pressure to focus on reducing energy costs and to improve building performance. New hospitals are typically specified to achieve high environmental performance standards including Green Star and proper commissioning is essential to deliver high performance. However, the vast majority of hospital facilities are older buildings, many of which have had poor maintenance and ad-hoc fit outs and changes carried out over the years. Such buildings typically operate inefficiently and would benefit significantly from re-commissioning or retro-commissioning.

account of poor initial commissioning and/or subsequent ad-hoc system alterations, then similar results should be achievable. Benefits from good commissioning include reduced energy costs, better indoor air quality, improved occupant comfort, lower maintenance costs due to enhanced reliability and longer life expectancy of plant. For infection control in hospitals, pressure differentials across certain areas must be maintained, therefore proper commissioning to balance air flows is also beneficial to patient health. Overall, well commissioned facilities have higher asset values.

This article addresses the commissioning of heating ventilation and air conditioning (HVAC) systems, which typically consume the highest proportion of energy in hospital facilities. Commissioning represents one of the quickest and most cost effective opportunities to increase energy efficiency because typically, 20-40% of energy in older buildings is wasted. Even in well-managed buildings, there is scope to improve energy efficiency by 10-15% through commissioning and implementing ‘energy smart’ control strategies.

Commissioning of HVAC systems and controls is an area which has often been perceived in the past to be ‘too difficult’ or has delivered poor outcomes. This is due to a lack of awareness of its cost effectiveness, poor design, inadequate specifications and engaging unskilled commissioning technicians offering the lowest price. This has resulted in safety issues, energy wastage and poor performance. In response to requirements for better environmental performance, the HVAC industry is now becoming more aware of the importance of good commissioning for the delivery of energy efficiency and optimal performance.

Information from the United States indicates that payback periods from retro-commissioning existing buildings can be less than 1 year. No equivalent data is available in Australia, however, if a facility has a fairly modern controls system (which can be re-programmed with energy smart features), the HVAC equipment is less than 20 years old and the system performance has not been verified and re-tuned over the years to take

Facility Managers have an important role to play in accelerating changes that ensure new facilities are commissioned thoroughly and older buildings are re-commissioned or retro-commissioned to improve energy efficiency. An awareness of what constitutes proper commissioning and the implementation of processes that will deliver a good outcome is important.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS Proper commissioning requires a good specification (or commissioning brief), planning, coordination across different trades and the allocation of sufficient time. It is important to engage skilled commissioning technicians who are familiar with current technology and commissioning standards and have access to good instrumentation. An established track record is essential and checking references for relevant projects is important through contacting clients, design consultants and installation contractors.

What is Commissioning? Commissioning is a Quality Assurance process for setting up equipment to work safely, efficiently and in accordance with the manufacturer’s recommendations whilst meeting the building’s performance objectives specified by the services design engineers. Proper commissioning covers a range of activities by multi- discipline trades that include tasks such as installation checks, pressure tests, proving of safety and functional controls, setting up of flow rates for fluids such as water, air and refrigerant. HVAC systems typically have water and air distribution networks consisting of pipes and ducts respectively. For systems to work efficiently, the setting up of the design flow rates for water and air through key equipment and the distribution network across the building is important during the commissioning process. This is referred to as ‘balancing’ the system. Unless systems are properly balanced, water and air flow will occur through paths of least resistance and this could lead to occupant discomfort due to either a lack of (or excessive) heating or cooling. Poor balancing can also cause energy wastage, noise and premature plant failure.

When to Re-commission Re-commissioning (or re-tuning) is carried out in older buildings, which have been in operation for a number of years. Recommissioning essentially restores system operating parameters to the original design intent, which should be available in the operating and maintenance manuals. Re-commissioning should rectify issues that have occurred over the years and have an adverse effect on HVAC system performance and efficiency. These typically include: • System changes caused during building alterations (fit outs) due to poor trade practices. These include squashed or extended flexible ducts that increase system resistance, ductwork with open ends that cause air leakage, partitions erected that affect air distribution to rooms, location of office equipment that affect temperature sensors and cause poor control and alteration of regulating valves and damper positions that affect system resistance. • System changes caused due to a change of occupancy. Examples include the conversion of patient ward areas or laboratories that have high outside air requirements to office type areas. Conversely, changing offices to meeting rooms, with significant changes to occupant density and office equipment and excessive after-hours use of HVAC by some occupants can lead to poor performance.

• Wasteful operational practices such as ad-hoc adjustments to control set points and plant set to operate manually (rather than automatically) by staff and maintenance contractors as ‘quick fixes’ to complaints, resulting in issues such as simultaneous heating and cooling, which are very wasteful. • Deterioration of equipment such as sensors drifting out of calibration, faulty field items such as leaky dampers, valves and malfunctioning actuators. • Inadequate maintenance. Examples include blocked strainers, dirty air filters, fouled heat exchangers, leaking ducts and pipes. The need for re-commissioning can be identified through an increase in energy consumption, occupant complaints of discomfort or interrogation and trending on the building management system (BMS). Re-commissioning should be periodically carried out in buildings typically every 5 years. Calibration of sensors that operate key functions such as the economy cycle, chiller & boiler flow temperature control and sequencing, air handling unit static pressure and CO2 monitoring should be carried out more often, typically every 12 months, as routine maintenance. Also, Facility Managers must put in place measures to prevent poor fit out practices affecting the performance of HVAC systems. Interrogating and fine tuning the BMS is also an important element of re-commissioning, which typically is very cost effective since it only involves programming changes. Maintaining a facility in optimal performance requires ongoing monitoring of key parameters and continuous attention, similar to an athlete maintaining physical fitness through regular training. Facility Managers should ensure that the energy performance is continually tracked and key performance indicators (KPIs) are set on the BMS that provide warnings of a loss of efficiency and the need for re-commissioning.

Retro-commissioning Retro-commissioning goes beyond re-commissioning with a view to enhancing some of the original system operating parameters. Retro-commissioning typically involves making major improvements to BMS control strategies as well as air and water flow rates. Typically, retro-commissioning is beneficial in the following circumstances: • Where the building use, operation or the building fabric has undergone a significant change. • Where the original BMS had very limited functionality (perhaps it was a pneumatic system) which has been replaced with a more modern system but ‘energy smart’ controls strategies were not included. Examples are – optimum start and stop, economy cycle, night purge, critical zone re-set, chilled water re-set, heating water re-set, condenser water re-set, cooling tower wet bulb tracking and dynamic set points for fan and pump speed controls have not been programmed. • In older buildings typically designed prior to the 70’s when energy costs were not high, system design parameters such as air and water flow rates are likely to be conservative and not conducive to energy efficiency. For example constant flow THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS systems and dual duct systems with set temperatures for hot deck and cold deck. Retro-commissioning is an opportunity to re-assess the air and water flows and to implement variable flow control strategies that save energy. • Where equipment such as chillers have been replaced with modern variable speed machines, which have the capacity for introducing new control strategies that significantly improve part load performance. Similarly, the replacement of conventional boilers with high efficiency condensing type boilers requires alternative control strategies for optimal performance. • Where major changes have been carried out to the air or water systems. E.g. conversion of a constant volume re-heat or dual duct system to a modified VAV system, conversion of constant volume chilled water and heating water systems to variable flow. When re-commissioning and retro-commissioning it is important to obtain the original commissioning documentation and functional descriptions for controls and to determine what changes need to be made. Where no existing information is available from operating and maintenance manuals, it is important for Facilities Managers to seek specialist advice and to ascertain the key system parameters including air and water flow rates to which a system is to be commissioned.

Further Information: References 1 to 3 provide general information on commissioning and benefits. References 4 to 6 are internationally accepted guides for those tasked with commissioning HVAC systems and should be appropriately referenced in commissioning specifications. 1. G uide to Best Practice Maintenance and Operation of HVAC Systems for Energy Efficiency. Department of Climate Change and Energy Efficiency. Free download from http://ee.ret.gov.au 2. A Retro-commissioning Guide for Building Owners. US Environmental Protection Agency/PECI. Free download from www.peci.org 3. The Cost-Effectiveness of Commissioning New and Existing Commercial Buildings: Lessons from 224 Buildings. National Conference on Building Commissioning. IRAH DA 27 Building Commissioning. The Australian Institute of 4. A Refrigeration Air Conditioning and Heating. www.airah.org.au 5. C IBSE Commissioning Codes: Air Distribution, Boilers, Controls, Commissioning Management, Refrigeration & Water. Chartered Institution of Building Services UK. www.cibse.org 6. A SHRAE Commissioning Guidelines 0 and 1. American Society for Heating Refrigerating and Air Conditioning Engineers. www.ashrae.org 7. B SRIA Commissioning Guides. Building Services Research and Information Association UK. www.bsria.co.uk

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TECHNICAL PAPERS

Building a Specialist Ear Hospital facility in Nepal Glen Hadfield

SW IHEA member Glen Hadfield recently returned to Nepal to visit various health and community development projects associated with a mission agency, International Nepal Fellowship. Included in the itinerary was a visit to the site of a new specialist hospital building project in Pokhara. The hospital will specialise in the treatment of ears and will be a facility to train Nepali specialist surgeons. Background: The International Nepal Fellowship (INF1) is Nepalâ&#x20AC;&#x2122;s longestserving international non-government organisation and has a number of health and community development projects throughout the West and mid-West regions of Nepal. INF has also been running medical camps for 20 years. Since 1993 there have been more than one hundred INF medical camps in many different remote communities in the west of Nepal, treating tens of thousands of outpatients and performing thousands of operations. An average INF medical camp lasts about 8-9 days, treating several hundred outpatients and performing around a hundred operations. Short-term volunteers from around the world, including Australia come together with Nepali colleagues to carry out surgical, dental, gynaecological, ear, and other types of medical camps to around 4,000 people each year. Poor patients are given free food, lodging, and clothing. The vast majority of patients require financial assistance and the INF Medical Camps Poor Fund helps thousands of patients each year with the costs of treatment. The Strategic Case. Deafness is the commonest disability in Nepal; chronic infection and congenital deafness being the biggest problems. INF Ear Camps have treated more than 30,000 people as outpatients, and carried out 3,200

Site for the new Ear Hospital

Dr Mike Smith, ENT Surgeon and visionary behind the project

operations over the past 20 years. Many of the camps are not equipped to conduct all the surgery necessary, and many people are turned away. An Ear Hospital and Training Centre will not only treat these conditions but train local clinicians, too. Over half the unit would

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

be serving the needs of children and young people under 20. In terms of services to be provided, it includes a surgical and medical service from the hospital; a training service for surgeons, audiologists, and hearing aid technicians; a support service for Primary

TECHNICAL PAPERS in Kathmandu. The facility has been designed for remote monitoring of surgery, as well as an observation room specifically designed for training other local surgeons. The building is divided functionally into four (4) departments, Administration, Out Patient Department, Operating Theatres and Inpatient Department and service department. Water supply is provided by the existing hospital supply which is sourced from a tubewell supplemented by townwater and rainwater harvesting. Care; and a centre for research into low cost and appropriate interventions. It is planned to deliver the services to the highest standards possible and in active collaboration with other local Nepali health resources in Pokhara. The building being constructed is a single storey facility with a total of 16 beds, 4 male, 4 female, 4 private and 4 paediatric. The facility is being built to the Nepali building standards which broadly follow the Indian standards. Nepal is in an active earthquake zone, so the buildings have all been designed to comply with seismic loading codes. The external walls are to be made of reinforced stone masonry buttressed with engaged piers and reinforced concrete ring beams at ground level and roof level. Partition walls are of reinforced brick and the light roof is of steel trusses clad with corrugated colourbond. The total internal floor area is 1500m2. Construction commenced in March 2014 and is expected to be complete in 15 months. The hospital was designed by a local Architect, John Sanday Associates based

The form of contract being used is based on the Nepali Government standard form which includes anti corruption clauses. The total construction cost is around $A1m. This does not cover medical equipment, beds or other items of FFE. Beds will be sourced from India while medical equipment is being largely sourced from overseas. Construction costs are being funded by a Swiss charity. An “A” class contractor has been engaged who will use modern methods of construction. There will be no air conditioning installed with the exception of the operating theatres which will have a 2 kW split system installed. Otherwise wards and administrative offices will be fitted with ceiling fans. This is the standard in most Nepalese hospital facilities. The hospital includes two audio test rooms which are double glazed and sound insulated, and each have an audio box for hearing testing. Free hearing aids will be issued to poor patients. Power supply will be fed from the Green Pastures Hospital’s transformer which is

75 kVA. The Green Pastures Complex Generator, also 75kVA with automatic switchover will back up the Hospital supply during the day. In addition multiple smaller PV systems with a combined PV Peak of 10 kW will be installed to provide standby power to the facility and light for the nights, when the Green Pastures Hospital Generator is not running. In reality the environmental footprint would be a tiny fraction of that of an average Australian or European facility of a similar size. Estimated consumption is only 20,000 kwhrs p.a., equivalent to around 3 Australian households. Medical Gases include oxygen and medical air. Oxygen will be supplied from a bank of cylinders and compressed air from a medical air compressor. There is a centralised fire alarm system with a Fire Indicator Panel monitoring 35 smoke detectors, heat detectors, response indicators and an electronic strobe beacon. Extinguishers provided are of the Dry Powder type. Flooring will be predominately terrazzo, which is the most serviceable and economical surface. Ongoing maintenance of the facility will be carried out by the Green Pastures Complex maintenance team who also maintain the other facilities. In terms of financial sustainability, it is planned that the facility will be financially self sufficient within approximately 3 years primarily through income generated from private patients and the fact that many of the services will be provided through overseas volunteers. After some years, it is anticipated that fee paying medical students will also contribute to the revenue of the hospital.

Opportunities for IHEA Involvement in Overseas Hospital Projects Involvement in assisting in projects in countries of the “Global South” like Nepal can be one of the most rewarding experiences. IHEA members have contributed to a number of overseas projects in various capacities in the past.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

Solar PV System installed on the adjacent Partners for Rehabilitation Building also located on the Green Pastures Hospital Complex.

References

The Ear Hospital in Nepal represents a further opportunity for potential assistance. E.g. IHEA members were asked to review the specification for medical gases and were able to provide some technical advice. Hospital engineers interested in offering assistance to the small team of volunteer expatriate engineers or if you plan to visit Nepal and would be interested in visiting the project, please contact the author.

Acknowledgements

More details of the project and how you can become involved in supporting the project can be found on the website www.earaidnepal.org

Ellen Findlay, INF Camps and Trustee of EarAid Nepal.

Gordon Russell, Construction Engineer (Australia), INF Peder Eriksson, Electrical Engineer (Sweden), INF Thomas Meier, Electrical Engineer (Germany), INF Dr. Mike Smith, Ear Surgeon (UK) and Trustees of EarAid Nepal

2. www.earaidnepal.com 3. Working Drawings INF Ear Hospital, Pokhara Nepal (2013) John Sanday & Associates Pvt Ltd.

Phil Morris, INF Australia

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1. I NF Nepal is an international nongovernment organisation which implements a range of health and development programmes in western Nepal. It has a staff of about 320 Nepalis and 20 expatriate volunteers. It works in TB and leprosy control, community health and development, hospital and rehabilitation services for people with disabilities, drug awareness/ rehabilitation and HIV/AIDS education, counselling and care. B Gautam & Dr M Smith (2013) Business Plan January 2013-December 2018 (6 years) for an Ear Hospital & Training Centre, International Nepal Fellowship

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TECHNICAL PAPERS

Utility Service

Building a high-performance central energy plant David Stokes

Financial pressures are pushing health care organisations to invest in and leverage efficiencies in every facet of their operations.

taffing efficiencies, technological innovations and procurement strategies all can impact financial performance, but no single strategy can lower operational costs more than a highperformance central energy plant (CEP).

and reported, the planning, design, construction and operations process can begin. This generally can be segmented into the following areas:

Imagine a scenario in which energy savings of up to 60 percent can be achieved, sustainability benchmarks can be met, operational costs can be reduced and reliability can be improved. It’s possible, but getting there doesn’t happen by accident.

PHOTO BY DAVID STOKES, COURTESY OF CBRE HEALTHCARE Construction of a new central energy plant is well under way.

Preliminary activities Before starting the process of developing and implementing a CEP project, several preliminary activities should be completed. For instance, the organisation must have completed a strategic master facilities plan in which a central plant retrofit or new central plant project has been vetted, approved and funded. Many times a CEP is part of a larger capital project. However, to truly pass muster, the component initiative should be able to stand on its individual merits. Moreover, a solid business case must be made for the central plant to ensure success and executive buy-in. Additionally, specific objectives and performance metrics should be established as guiding principles for the project. These can include targeting energy savings versus a baseline; targeting performance in U.S. Green Building Council Leadership in Energy

& Environmental Design (LEED) ratings; adopting alternative and renewable energy strategies such as solar, geothermal and wind; incorporating energy innovation like combined heat and power; embracing design and construction practices such as integrated project management; and practicing active commodity management. One further point of consideration is that the new plant must be designed with the future in mind. The health facility professional must consider other facility projects that are in the pipeline, how much future capacity should be included and how he or she can construct the plant while maintaining existing hospital operations.

Navigating the process Once these preliminary activities have been adequately explored, researched

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Planning. Much like a strategic master facilities plan is a 5- to 10-year road map for an organisation, a strategic energy management plan can serve as a more detailed approach to developing a highperformance central plant. An energy management plan should contain the vision, business case, specific goals and responsibilities for the proposed project. It can be supported by additional tools such as a facility infrastructure assessment and an energy practice checklist, which can be accessed on the website of the Northwest Energy Efficiency Alliance’s BetterBricks building initiative at www.betterbricks.com. One final piece of planning information is the health care facility’s load profile. This provides critical data such as design and connected electrical loads, cooling capacity, heat loads, water consumption and other utility usage levels. The load analysis also is an important piece of information when conversations begin with utility providers and building plan reviewers because specific inputs may require utility distribution upgrades at the provider level. Design. Armed with these tools, it’s now time to start thinking about the design elements and how the information and ideas can be converted into a visual representation. Again, it is important for the facility professional to work

TECHNICAL PAPERS collaboratively with the strategic master facilities plan to optimise placement, square footage and ultimate size of the campus. Understanding the LEED target and use of alternative and innovative energy initiatives will have a significant impact on the planned space, systems and infrastructure. Designing in a building information modelling (BIM) platform will help to minimise conflicts, streamline fabrication and maximise space utilisation. Designing a high-performance CEP is different from designing a functional central plant. Committing to a highperformance plant design means more than buying highly efficient equipment components. A high-performance CEP means developing a system that begins with design and proceeds all the way through operation and maintenance (O&M) plans to sustain the initial performance metrics over the useful life of the assets.

It also means working with an integrated design team of architects, engineers, construction managers, mechanical and electrical subcontractors, and commissioning agents. The purpose of the team and the integrated design process is to balance energy management with facility sustainability and internal climate control. One way to initiate the process is by scheduling an early design charette with the team. The meeting should be scheduled as a full-day workshop with follow-up meetings as required. Focusing on such areas as sustainability, performance metrics, energy programming, and core and shell modelling will yield productive material. Taken further, a deeper dive into lighting controls, daylighting, mechanical systems, ventilation and distribution systems will reap significantly larger opportunities for efficiency. The goal of the charette is to make key decisions early to right-size the design and equipment for optimal performance while enhancing efficiency and

supporting future growth. Sometimes this means paying a little more up front for equipment while balancing this cost against future energy savings. Too often, organisations will look at a simple payback methodology versus a full lifecycle cost analysis. Understanding when to use these different methodologies will help the integrated team to make better decisions utilising the right information.

A simple payback analysis is valuable when the first cost is relatively small, there is only one substantial life-cycle cost (i.e., electricity), the annual cash flow is fairly even, the equipment comparison is simple and off-the-shelf equipment is being installed. A life-cycle cost analysis is preferred when the first cost is relatively high, there are multiple life-cycle costs

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS (i.e., gas, water and electricity), the annual cash flow has substantial variation, complex decisions impact other aspects of the project and the design will be customised.

HVAC system to economise air flow based on the thermostatic reading in a particular zone, so the efficiency of the total system is multiplied.

The value of conducting the proper financial analysis and working in an integrated design mode can be visualised in the graph on this page.

During the design phase, the team should determine the extent to which optimising software will be used because this, too, can impact not only cost but also equipment selection. A commissioning agent also should be involved in this decision because he or she will assist in developing the sequence of operations for all equipment components and systems.

Technology coordination. While most hospitals are familiar with building automation systems (BASs), building a new central plant affords the opportunity to leverage this system in a way that previously was not possible. Typically, a BAS has been used to monitor and troubleshoot all aspects of a central plant’s equipment. Basic functionality includes maintaining set points and determining when variable-speed drives ramp up or shut off completely. A high-performance central plant employs optimisation software as part of the BAS logic. Using sophisticated algorithms, the optimisation platform monitors real-time inputs from building loads and usage, as well as thermal comfort settings and automatically calculates equipment performance calibrations. In essence, this application functions as a type of artificial intelligence for all of the equipment and looks at the entire system rather than the sum of its individual components. For example, current BAS technology can adjust the chiller motor and variable-frequency drives to function most efficiently given a predetermined control set point. Optimising software goes several steps further in that it also directs the system to adjust the chilled water valves and variable air volume boxes in the

Modular central plants offer cost and space advantages With the advent of building information modelling (BIM), 3-D design is allowing fabricators and integrators to assemble entire central energy plants (CEPs) off-site to be delivered in modules that can be bolted together and connected in the field. There are several advantages to this approach, and the most compelling is cost. All of the pieces of equipment are built as modules and come complete within their own enclosure. The health care organisation is immediately spared the cost of core-and-shell construction. Secondly, and also due to BIM and prefabricated assembly, the health facility professional can optimise the spatial impact and condense the same equipment into a smaller footprint versus traditional construction. There are also less-tangible considerations. For instance, prefabrication in a controlled environment results in a cleaner and safer construction site, takes less field labor and encourages Lean production innovation. Another considerable advantage is time, especially as it relates to construction scheduling. In many new construction projects, the CEP falls on the critical path. With the modular concept, fabrication of the CEP can begin at design

Construction. With the design work completed, the health facility professional can begin discussing the best way to deliver the end product. Assuming that he or she has incorporated the integrated team approach, the construction manager and selected trade subcontractors are already heavily engaged and are ready to build. Utilising a BIM design platform now provides some flexibility in the construction phase. One option is to “stick-build” the design on-site. The equipment has been specified, design coordination is complete and all that remains is to strategically schedule the work. Another option is to prefabricate the central plant and deliver it in a modular fashion [see sidebar, Page 26]. Regardless of the methodology, having completed the homework on the planning and design phases will make construction a cleaner affair with reduced change order costs to the health care organisation. If a facility professional is replacing an existing plant infrastructure, he or she should be sure to build a sequential timeline for disruptions related to the new project. It is important

completion, while early construction activities are getting started. In one recent project, the CEP was fabricated, delivered and connected prior to the hospital’s being fully enclosed. Additional advantages may be realised within the context of the specific regulatory environment. For example, the CEP in this project came with a master equipment label. As a result of this designation, the modular CEP did not count against the hospital’s zoning coverage and certificate of need square footage calculations, thereby allowing the organisation to potentially develop additional square footage on the campus. However, there are also some downsides to the modular CEP approach. First of all, most modular CEPs are not that attractive. They can be painted or hidden behind a screen wall, but at the end of the day, they truly fit the concept of form following function. Second, to maximise the schedule advantage, the modular concept must be selected early in the design phase and there must be follow-through. Building programs must be developed early to capture the correct heating and cooling profiles. Decisions on equipment manufacturers must be made early, and the major mechanical subcontractor must be brought on early to assist in the procurement of the right integrator.

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TECHNICAL PAPERS to schedule shutdowns with minimal impact to existing operations and still allow for maximum efficiency during construction. One method for controlling this process is to set a regularly occurring “disruption meeting” with the integrated team and key hospital operational personnel. The purpose of this meeting is to review the construction schedule of activities and any touch points with the existing infrastructure. It is important to include all stakeholders in these meetings to minimise complaints. Commissioning. Commissioning should not be an afterthought to the process. Ideally, the commissioning agent (CxA) has been a part of the integrated team approach since the design phase. The CxA’s initial role is to ensure that all of the equipment and system components work in harmony as designed, and to formalise the testing protocols prior to startup. Additionally, the CxA serves on behalf of the health care organisation to ensure that intended operational usage is facilitated in the final product.

Measurement, verification and management. All of this work will get a health facility professional to a point where he or she has a functioning high-performance central plant. But, to achieve the long-term goal of sustainability and energy efficiency, especially the level needed to support the return on investment (ROI) goals laid out in the business case, the health care organisation must invest in the ongoing maintenance of the system. This goes beyond the typical preventive equipment maintenance. Historically, maintenance has been reactionary — something breaks and it gets repaired. To maintain the higher level of efficiencies within the system at the end of useful life, health facility professionals need to perform routine maintenance throughout the period of performance. Maintenance also must become predictive by allowing the facility professional to look at the available data and spot a problem before it occurs.

Commissioning also plays a key role in achieving a targeted LEED score. For example, to achieve a LEED Silver or higher rating, a CxA must be hired to perform enhanced commissioning services. This is not just a series of tests, checklist verifications and reports. Commissioning also sets the table for future operations. Commissioning scopes of work also should include a final O&M manual preparation as well as protocols for establishing the operational sequences for all of the equipment.

Trending analysis from the BAS will show when a particular piece of equipment is not functioning to its inherent efficiency capability. Rather than waiting for a catastrophic failure, repairs should be made as soon as the trouble is noted. This becomes obvious when measuring the cost of total future replacement against the maintenance cost in today’s dollars. Moreover, the increased cost of operation calculated against the targeted energy efficiency even more convincingly justifies such intervention.

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The role of the health facility professional is now more complicated. Beyond just keeping the system running, facility professionals also must have the proper tools in place to measure system performance. Additionally, they must be empowered to actively manage the efficiency of the central plant operations.

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Above the norm With advances in design capability, energy modelling, energyefficient equipment and integrated delivery approaches, any facility is capable of achieving energy cost savings well above the norm. And while this may be implemented best with a new central plant, many of these considerations can be employed to leverage an existing system. Even if an organisation’s most current strategic master facilities plan does not call for a new high-performance central plant, it is worth tasking the integrated team to consider such an option. A new high-performance CEP may seem costly, but compared with the possible energy savings, the projected ROI should speak for itself. If the capital allocation process allows the organisation to proceed, following these steps should enable health facility professionals to provide patients and staff with a high level of comfort and operate in an efficient manner.

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David Stokes is a principal consultant at CBRE Healthcare, Richmond, Va. He can be reached at David.stokes@cbre.com

TECHNICAL PAPERS

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TECHNICAL PAPERS

Engineering for Health & Hygiene

Legionella prevention: How to effectively remove biofilm in cold, warm or hot water pipe systems. Recent outbreaks of Legionella in healthcare facilities and commercial buildings around Australia have raised valid concerns that existing Legionella management systems may not be as effective as once thought. The active ingredient in Ecas4 (Electro-chemical anolyte solution) is hypochlorous acid, which is 80 times more effective than sodium hypochlorite in eliminating Legionella. Ecas4 also requires significantly less contact time to

inactivate this harmful pathogen. Ecas4 both eliminates and prevents the biofilm that acts as the Legionella host in water piping systems, therefore providing superior eradication with less ongoing maintenance than is necessary for many existing water treatment systems. In this issue and the next, we will present the outcomes of two real life hospital water management case studies in which Ecas4 has been applied, in both new and existing facilities.

Case Study 1: Hospital of Asti Amedeo di Savoia Hospital, ASL TO2, Turin, Italy

Evaluation of two disinfection systems for Legionella eradication from a hospital water supply. Background: Nosocomial infections are prevented using control measures against Legionella proliferation in the water distribution system. However, complete elimination of the bacteria has proved to be difficult to achieve with any disinfection approach. In this study the efficacy of two continuous dosing methods for the eradication of Legionella from a hospital water supply has been evaluated and compared. Methods: Both approaches requires the continuous dosing of a biocide into the water system: System 1 involves the use of an electrochemically activated water (ECAS anolyte), containing hypochlorous acid at a neutral pH, while method 2 refers to a solution of hydrogen peroxide and silver. It is worth mentioning that the latter approach is not always applicable â&#x20AC;&#x201C; for example, it is not permitted by German legislation, for the continuous treatment of drinking water. The two continuous disinfection systems were installed in the hospital in two distinct water supplies, both located after the hot water tank but before its distribution. Seven points within each water system were chosen for analysis. Before systems installation, two samplings were performed; after installation and the beginning of the disinfection procedures, eight samplings were periodically performed for five months. A total of seventy samples were analyzed for each system. Cultures were performed following a standard quantitative protocol (detection limit: 20 cfu/L).

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Samples (5 litres each) were concentrated by filtration; then, the washed suspensions were plated on BCYE, BMPA and MWY, incubated at 37Â°C for 15 days, to allow Legionella colonies counting and typing. Results: System 1. Pre-treatment samples from water supply 1 showed Legionella contamination of 60-180 cfu/L in hot water tank and of 300-16000 cfu/L in distal points. After starting the continuous disinfection treatment (free chlorine 0.3-1.2 mg/L, mean 0.6 mg/L) all samples were negative. System 2. Pre-treatment samples from water supply 2 showed 180-24000 cfu/L. After starting the disinfection, at the level of 2 mg/L of hydrogen peroxide, the contamination was 20-15000 cfu/L; during the observation period the product showed variable concentrations and only in the second-last sampling, with higher concentration of product, the culture was negative. However, the contamination appeared again in the last sampling, with values up to 600 cfu/L. Conclusions: System 1 proved to be effective in eradicating Legionella from the hospital water supply, with free chlorine concentration > 0.2 mg/L (level suggested by Italian legislation 0.2 mg/L). System 2, based on hydrogen peroxide and silver, was not efficient, at least at the concentration proposed by the manufacturer. For systemic disinfection modalities, the disinfectant levels must be carefully monitored.

TECHNICAL PAPERS

Summary of results After the six-month research at one of the twelve hot water circuits of the large Hospital of Asti, as documented by the adjacent report, the medical management decided to install the ECAS-Anolyte system on all hot water systems. The works were realized in October/November 2008. The experiences and current samplings were published in November 2009 at a congress of the ISS (National Institute of Health) in Rome by R.Broda â&#x20AC;&#x201C; Health Department, Hospital of Asti and F. Migliarina â&#x20AC;&#x201C; Technical Management, Hospital of Asti, entitled Prevention and control of legionellosis: experiences from the Hospital of Asti. The following is a brief summary of the results. Tables: Amount of Legionella in hot water supply line, hot water return line and on defined points-of-use in the building in the period October 2008 - June 2009. Hot water supply

Hot water return

10,000

10000 Boiler 1 Boiler 2

8000

6000

Boiler 3 Boiler 4 Boiler 5

cfu/L

Boiler 6

4000

Boiler 7

4000

Boiler 8 Boiler 9

2000

Boiler 10

2000

Boiler 11.1 Boiler 11.2

0 27/10/08

22/12/08

23/03/08

26/06/09

27/10/08

22/12/08

23/03/08

26/06/09

Sampling point-of-use hot water distribution 50000

40000

cfu/L

30000

20000

10000

BO spogi. lav.

OB020

Cam. mort.

3B054

OS004

4D049

OM019

4F023

ON002

3F030

3Q037

1F080

40050

3P050

OQ057

1R065

OR036

3R058

OQ016

OM019

SR025 OD137

0 27/10/08

22/12/08

23/03/08

26/06/09

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TECHNICAL PAPERS

Designing Light to Mimic Night And Day

Creating environments that mimic natural circadian light levels will improve residents’ lives in long-term care facilities Michael White

isiting day rooms in many long-term care facilities can be a daunting experience for the uninitiated. Residents are often slumped over in their chairs, napping while games or other activities take place around them. A short while later these same residents may be awake and active, only to nod off again a few minutes later. Conventional wisdom tells us that this is what happens as we age; however, the scientific literature tells a different story. Frequent napping is a disorder, which in a sense is good news, because it means that there’s something we can do about it. Evidence from clinical trials indicates that by providing a regular pattern of light and darkness, we can restore a more stable wake/sleep rhythm that aligns better with the natural day/night cycle. The potential benefits of this include improved daytime alertness and nighttime sleep as well as positive effects on cognition and mood. Each day we eat and process nutrients, and sleep and repair our systems, with our bodies creating a cascade of proteins and hormones in an orchestrated sequence of events that control our physiology, biochemistry, and behaviour. Since most of these processes occur on a daily basis, we call them circadian (taken from the Latin words circa, meaning “close to,” and dia, meaning “day”). Timing is key to maintaining order among circadian rhythms so that potentially conflicting processes are scheduled at different times, and complementary processes occur together or sequentially. An example of this is the way cortisol and melatonin rise and fall in counterpoint to each other. Cortisol is a hormone that promotes alertness and typically peaks in the morning, while the hormone melatonin causes drowsiness and plays a role in sleep. What keeps these rhythms in sync is the natural light/dark cycle that drives all life on earth. The general truth of this is well established, but what’s new is an understanding of how light and darkness affect us, which gives us tools to use in creating a built environment that supports our health and well-being.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Shedding light Recent research tells us that light at the eye not only causes a sensation in the part of the brain where visual images are produced but signals are also sent to a control centre in another part of the brain that orchestrates our circadian rhythms. This control centre is often called our “circadian clock.” This clock tends to run longer than 24 hours, and in our natural state, the light/dark cycle resets our clock each day so we’re in sync with the natural world. Residents in long-term care, however, spend their days in the artificial built environment, with little access to bright light. Indoor light levels are quite low compared to sunlight, and lights are often left on at night so caregivers can work. Without a clear signal of daytime and denied darkness at night, the circadian clock can’t tell day from night, and disruption can occur. Symptoms of circadian disruption include napping during the day, periods of wakefulness at night, being hungry at odd times, depression, and a loss of cognitive ability. Evidence from clinical trials indicates that by providing bright light during the day and darkness at night, we can mitigate these symptoms.

Designing light and dark Quantity and colour are the prime considerations when it comes to lighting design in long-term care environments, along with controlling the timing of exposure. Daylight provides the natural quantity and colour of light for all living things, but residents often spend their days indoors and don’t have access to the outdoors. The best solution is to design a building with skylights or daylight monitors to provide a high volume of natural light indoors. If the source must be electric light, bright light should be provided by a glare-free source such as a twolamp fluorescent cove or a well-shielded pendant. The colour of light is also important since the response of the circadian system peaks in a narrow band of light in the

TECHNICAL PAPERS blue range of the colour spectrum. In order to be sure that the lamps we’re using include this part of the spectrum, we need to dig into the technical specifications published by lamp manufacturers (see resources box for more). In general, lamps that are cool white create more light in the blue part of the spectrum than warm white lamps. Locate the bright light system in high-activity areas where residents are likely to spend a good deal of time so that their circadian clock gets a daily dose of bright light. Designing for darkness is just as important as designing for light. Working with caregivers, a darkness protocol should be created to help preserve a dark environment in bedrooms and bathrooms at night to ensure the circadian system will get the signal it needs to begin and sustain dark-induced functions. Nighttime lighting in the bedroom should include step lights activated by motion sensors so residents can find their way to the bathroom without switching on overhead lights. Caregivers can also use the step lights to check on residents, using room lights only if needed.

The bottom line By creating a regular pattern of bright light and real darkness, the environments we create can promote more robust and stable circadian rhythms. The benefits of a stable circadian rhythm include longer and more restful sleep at night, and improved alertness and cognition during the day. Clinical trials using light to treat elderly patients have demonstrated this effect along with reduced aggression and reduced need for medication. These improved outcomes for residents also have implications for staff and the bottom line. It’s easier and less stressful to care for a patient that is alert and responsive than one who’s difficult to communicate with. Patients suffering from Alzheimer’s often wake during the night and wander from their beds, which requires supervision from caregivers. The risk of falls is also higher at night. However, if patients are asleep for longer periods during the night, caregivers’ workloads are reduced, as is the risk of falls. And reducing the risk of falls pays real dividends by avoiding potential liability. Improved mood could also have an effect on cost: If patients experience fewer aggressive episodes, the risk

of injury to themselves and to staff is reduced, lessening the cost of care by avoiding staff sick leave and liability. While all of this makes good logical sense, there aren’t yet solid numbers to back it up, which presents an opportunity. In fact, efforts are underway to quantify these potential benefits through research in real-world situations. Michael David White, EDAC, LC, LEED AP, is a senior lighting designer at Schuler Shook (Minneapolis). His current focus is evidence-based architectural lighting for a variety of project types including long-term care facilities. He can be reached at mwhite@schulershook.com

References • Increased Light Exposure Consolidates Sleep and Strengthens Circadian Rhythms in Severe Alzheimer’s Disease Patients. Ancoli-Israel, S., Gehrman, P., Martin, J. L., Shochat, T., Marler, M., Corey-Bloom, J., & Levi, L. Behavioral Sleep Medicine, 1(1), 22–36. doi:10.1207/S15402010BSM0101_4 •B right light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Lieverse, R., Van Someren, E. J. W., Nielen, M., Uitdehaag, B. M. J., Smit, J. H., & Hoogendijk, W. J. G. Archives of General Psychiatry, 68(1), 61. • Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities. Riemersma-van der Lek, R. F., Swaab, D. F., Twisk, J., Hol, E. M., Hoogendijk, W. J. G., & Van Someren, E. J. W. JAMA: The Journal of the American Medical Association, 299(22), 2642–2655. • Senior Living Environments: Evidence-Based Lighting Design Strategies. White, M. D., Ancoli-Israel, S., & Wilson, R. R. HERDFall-2013. rainard, G. C., Hanifin, J. P., Greeson, J. M., Byrne, B., Glickman, •B G., Gerner, E., & Rollag, M. D. (2001). Action Spectrum for Melatonin Regulation in Humans: Evidence for a Novel Circadian Photoreceptor. The Journal of Neuroscience, 21(16), 6405–6412. • F or an in-depth discussion on colour of light and circadian response: www.lrc.rpi.edu/programs/lightHealth/pdf/spectralsensitivity.pdf

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TECHNICAL PAPERS

Roof anchor safety alert: an engineer’s survival guide Carl Sachs I managing director, Workplace Access & Safety

“Catastrophic” roof anchor failures during testing to a 2013 Australian Standard have big implications for hospital engineers.

n June, the peak body of Australia’s working at height sector, the Working At Heights Association (WAHA), issued a safety alert urging affected manufacturers to recall non-compliant products. Hundreds of thousands of roof anchors are installed on large government and commercial buildings across the country and are used by people wearing harnesses at height to connect their lanyards to the building. The anchors that sparked the safety alert were tested in accordance with an Australian Standard, AS/NZS5532, published in 2013. WAHA chairman

Independent certification offers workplaces certainty in the wake of anchor failures.

Michael Biddle says the standard’s requirements established an important baseline for the performance of height safety equipment. “It’s important to uphold AS/NZS5532, since there are so many anchors out there,” he says. “Workplaces and PCBUs needs a simple, yet robust criteria against which they can gauge their equipment. A worker who attaches to an anchor trusts their life on it. “The nature of these devices is that they are saving people’s lives, so as a minimum it needs to perform to this standard.” WAHA’s advice for building owners and facility managers is to: “(1) C ontact the installer of the anchor points on your facility and ask them to provide documented evidence that the products installed meet the testing requirement of AS/ NZS5532 and are certified for use on your specific roof profile;” “(2) I f evidence cannot be provided, obtain information from the manufacturer or regulator on appropriate advice for rectifying the situation; “(3) S eek advice from a manufacturer or installer of anchor points that can provide the evidence of compliance to AS/NSZS5532 for your roof profile.”

So, what makes a roof safety anchor truly safe? Until now, nobody knew for sure and suppliers of roof safety anchors were able to devise their own performance tests for this life-saving equipment. All that changed with the release of AS/NZS 5532:2013 Manufacturing requirements for single-point anchor device used for harness-based work at height. Sponsored by the Working At Heights Association with the participation of WorkCover NSW, AS/NZS5532 is part of the AS/NZS1891 suite of standards, which deal with fall arrest devices. In fact, the only requirement had been that anchor points were rated to 15kN for one person and 21kN for twoperson use. AS/NZS5532 introduced a number of new requirements and set a uniform national benchmark for testing and certification.

Dynamic testing Traditionally, manufacturers applied a static load to the anchor, which placed the least amount of stress on the product. A dynamic test replicates a person suddenly falling and being jerked to a halt. Accordingly, AS/NZS5532 prescribes: • for 15kN, or single-person fall arrest use, drop a 100kg load through 2 metres.

TECHNICAL PAPERS AS/NZS5532: a new benchmark to guide workplaces Unfortunately, the WAHA safety alert reveals that the faith users place in this equipment to save their lives in an emergency has often been abused. The good news is that people are now demanding greater certainty; within hours of the safety alert’s publication, Workplace Access & Safety was inundated with requests to have anchors tested in its NATA facility. AS/NZS5532 brings new rigour to the inherent safety of roof anchors but its effectiveness depends on the vigilance of the people who purchase, install, inspect and use them. • for 21kN or two-person use, drop 150kg through 2 metres. Both tests demand anchors hold the load for three minutes after the sudden drop, without showing any sign of breaking or cracking. The anchors may of course deform, provided there is no sign of permanent damage. Because an anchor is only as good as the substrate that it’s attached to, the anchors must be tested on the surface and using the same fixings and underlying structure that will be used in real workplaces. To ensure the results are correct and the testing procedure is applied to the minimum standards AS/NZS17025, these tests should be carried out in a NATA (National Association of Testing Authorities) laboratory and certified accordingly.

Compliance and certification When it comes to such lifesaving equipment, it’s essential to ensure that the product is capable of doing what it’s meant to do. Accepting assurances from the installer is fraught with danger, since there is no licensing or recognised training

for the installation. Check references, accreditations and the installer’s familiarity with the Australian Standards and regulations as well as the manufacturer’s instructions. Independent certification of the product by an association that is a member of JAS-ANZ, the government-appointed accreditation body for Australia and New Zealand, such as SAI Global. The “five ticks” StandardsMark on a product guarantees the manufacturer has been independently audited to ensure consistent quality, traceability and testing.

For more information, contact Workplace Access & Safety via www.workplaceaccess.com or phone 1300 552 984. *About the author: Carl Sachs is the managing director of fall prevention company, Workplace Access & Safety, and a director of the Working At Heights Association. Mr Sachs was also a member of the committee that drafted AS/NZS5532. WAHA safety alert in full: http://www.waha.org.au/waha-news-blog Video footage of anchor failures: http://www.waha.org.au/articles.html

Inspection and testing Ongoing testing, inspection and maintenance requirements are to be included with the handover documentation and user information detailed by AS/NZS5532. Inspection regimes vary from state to state. Some states reference the AS/ NZS1891 requirement for 12 monthly inspections as a minimum, but most states have mandated more frequent six-monthly inspections due to the LFHQ (low frequency, high consequence) nature of anchors.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

AS 1851-2012 and your Hospital Derek Hendry I Managing Director, Hendry Group

Introduction

s building owners, property managers, facility managers and hospital engineers are well aware, safety measures in buildings such as fire protection systems and equipment need to be tested, serviced and maintained in order to ensure they are able to function as designed when they are needed. AS 1851 is the Standard available to address the routine servicing of fire protection systems and equipment in Australia, and most building owners are required to comply with AS 1851 – 2005 or the newest Standard, AS 1851-2012. What are the features of the new 2012 Standard, and will the Standard apply to your building? Geoff Vick from Essential Property Services (a Hendry Group company), investigates.

History of AS 1851 AS 1851 in its various forms, has a long and chequered history, appearing first around 1939 and expanding to multiple sections through the 1980’s and 1990’s. The 2005 version (currently used in a majority of instances) was completely rewritten and appeared as one document in September 2005 as “AS 1851-2005 Maintenance of fire protection systems and equipment”. This version has since had amendments in July 2006 and again in May 2008. In theory, the stages introduced in AS 1851-2005 represented a logical progression in the evolution of the Standard but in practice, regulators in the States and Territories had serious issues with the complex and costly operational requirements interpreted with the Standard. The second round of amendments released in May 2008

saw the removal of some of these requirements. Since further amendments were deemed too substantial however, the Standard had a major revision, and AS 18512012 was released in December 2012, as “AS 1851-2012 Routine service of fire protection systems and equipment”.

A Summary of key changes to AS 1851-2012 Key changes in the redesign of the new Standard AS 1851-2012 were: • a simplification of the Standard structure, making it easier for stakeholders to understand • Restructured documentation requirements for reporting. • A more concisely defined relationship between initial installation, routine service and annual regulatory compliance. • A critical appraisal and refinement of routine service technical requirements. • An overhaul of the general requirements of Section 1. • Easier to interpret tables in Sections 2 to 14 (tables changed from type based to frequency based, and yearly service separated from supportive routine service schedules). • The clarification of the requirements for system interface testing. • A clarification of the role of commissioning and baseline data as part of the approved design. • A distinction made between critical defects, non-critical defects and nonconformances. • Extensively revised records (logbooks, tags, labels and summary records) and reporting requirements.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

• The removal of the ambiguity relating to current design Standards versus the design Standards applicable at the time of original approved systems installation, (that is, the approved design). • Several new appendices have been included to expand on Section 1 content— baseline data. The Standard establishes a systematic basis for minimum routine service activities, and as such, it may be used to form the basis for developing specific routine servicing regimes. The Standard requires evidence in the form of records and reports, with the documentary evidence intended to support responsible entities in satisfying regulatory obligations.

Regulatory requirements in States and Territories Currently each Australian State and Territory Government is responsible for establishing the requirements for the servicing of fire protection systems and equipment for buildings and land under their control, or for privately owned buildings and land. The Federal Government is responsible for Commonwealth land and buildings, regardless of which State or Territory the land is located. Each State or Territory establishes this control through an Act of Parliament (Act), and this is their primary form of legislation. These Acts in turn, can authorise the making of Regulations to administer the Act. Put simply, the Act established the principles and objectives for compliance, while the Regulations detail how these objectives are achieved.

TECHNICAL PAPERS Regulations in turn, can reference external documents such as Codes or Standards in whole, in part or in modified form, and this allows for documents such as the National Construction Code (Building Code of Australia) and Australian Standards to form part of the regulatory regime of State or Territory governments. An Act can “reference” Regulations, which in turn can “reference” Codes or Standards. Where Regulations, Codes or Standards are referenced, (or partly referenced), there is a lawful requirement to comply with the provisions, or with those provisions that are referenced. Where Codes or Standards are not specifically referenced, they are not compulsory. This is commonly referred to as the hierarchy of legislation. Since each State and Territory have their own legislative and regulatory framework governing safety measures (of which Fire Protection Systems and Equipment

State or Territory

Defined Term for Fire Protection Systems and Equipment

Commonwealth – National Construction Code (Building Code of Australia)

Safety Measures

Australian Capital Territory

Active Fire Safety Systems

New South Wales

Essential Fire Safety Measures

Northern Territory

Safety Measures

Queensland

Fire Safety Installations & Special Fire Services

South Australia

Essential Safety Provisions

Tasmania

Essential Safety and Health Features/Measures

Victoria

Essential Safety Measures

Western Australia

(No specifically defined term)

form a part) they also have their own terminology. The requirement to use a particular edition of AS 1851 in each State or Territory jurisdiction may be enacted through: • A direct reference to a specific edition in their legislation • A variation or addition to I Volume 1 Part I of the Building Code of Australia

• Regulation referencing a Code, Standard, Practice Note, Policy or other document specifying maintenance provisions, or • A reference to a specific edition in an Occupancy Permit or Certificate, (which specifies safety measures maintenance requirements and makes the use of the edition mandatory).

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TECHNICAL PAPERS Implementation of AS 1851-2012 in your State or Territory The following provides a summary on the adoption and use of AS 1851-2012 in your State or Territory based on the primary legislation operating in your jurisdiction. Note: This is basic information only – for full details refer to the relevant regulatory authority in your State or Territory AUSTRALIAN CAPITAL TERRITORY Testing may be carried out to the previous suite of AS 1851 Standards, AS 1851-2005 or AS 1851-2012. Currently there is no mandatory requirement to test to any particular AS 1851 Standard. NEW SOUTH WALES Testing may be carried out to the previous suite of AS 1851 Standards, AS 1851-2005 or AS 1851-2012 providing documentation is provided in accordance with EPA 2000. Currently, there is no mandatory requirement to test to any particular AS 1851 Standard, as emphasis on annual certification is system capability based, not maintenance based.

NORTHERN TERRITORY While not directly prescribed within the Northern Territory Fire and Emergency Act or Regulations, the Northern Territory has a variation to Part I Equipment and Safety Installations of the BCA, which details the maintenance to be carried out to safety installations within a building. These generally nominate earlier versions of the Standard. QUEENSLAND MP 6.1 states it is mandatory for testing be carried out to AS 1851-2005 or older versions as appropriate. Queensland Development Code and Regulations would need to be changed to nominate AS 1851-2012. SOUTH AUSTRALIA Buildings are required to be maintained in accordance with Minister’s Specification SA 76 in force at the time of Building Rules consent. The current version of SA 76 lists pre-1851-2005 editions. TASMANIA Tasmania has adopted AS 1851-2012 by way of an amendment to the Director of Building Control’s Specified List. The Building Act 2000 and its Regulations provide for the Director to prescribe certain matters including time periods and documents to be provided with applications. They are contained in the Director’s Specified List. The newly amended list applies from 1 September 2013. VICTORIA Testing to AS 1851-2005 may only be used if this Standard is nominated on the building Occupancy Permit or Certificate of Final Inspection (building approval documents), or for buildings constructed before 1994. It is expected that testing to AS 18512012 would require amendment to existing building approval documents to permit testing to the new Standard. WESTERN AUSTRALIA There are currently no restrictions on which version to use. In summary, the body charged with the responsibility of ensuring AS 1851-2012 meets community and stakeholder expectations has made the necessary improvements to ensure that the key objectives of the revision were met, while the revised testing, servicing and maintenance frequencies, and the clarified fit for purpose as designed requirements have made it easier to understand and implement the requirements of the Standard. Integral to the successful uptake of AS1851-2012 will be how readily the States and Territories formally adopt the new Standard. For now Tasmania leads the way, and time will tell if this Standard achieves acceptance across the nation. Jurisdictional differences in the adoption and implementation of regulatory compliance regimes costs the property industry millions of dollars each year, and the time for national harmonisation in regulatory compliance is long overdue. http://www.hendrygroup.com.au

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

Modern Active Water Management in Hospitals Guenter Hauber-Davidson I Managing Director, WaterGroup

Should you really worry about water use in your facility? Yes, writes Guenter Hauber Davidson, Managing Director of WaterGroup Pty Ltd a company specifically set up to help large water users like hospitals save water and money.

ow, would be the next question. Easy says Guenter. A key component nowadays for modern smart water management system is to have regular consumption data available online, instead of the old-fashioned way of waiting for your bills to arrive every month or quarter just to find it has doubled over the previous period (“bill shock”). He calls it the evolution of data management.

Figure: Evolution of data management Now that most places have implemented at least the basic water efficiency measures such as water efficient taps, low flow shower heads to flush toilets and maybe a rainwater tank, it is all the more important to keep a close eye on the facility’s water consumption.

In a recent review for a large facility manager WaterGroup found 7% worth of savings just through a systematic analysis and comparison of the water use between various facilities. The cost of realising these savings was so low that the payback was in the order of eight months. If you say “I’d like to have some of that, thank you”, read on.

Six Step Process STEP 1: Understand and collate your data. Make sure you have a resource in house that diligently without fail at least once a month looks at the data coming in. If you do not have those resources, contract it out to a specialist service provider. STEP 2: Obtain the data. Even if you’re still in the dark ages and just get

your monthly or quarterly water utility bills, at least put those into a system and analyse them. If you are stuck in the 90’s and you’re taking manual readings, that’s better but again, it will only create value if you collate the data in a centrally accessible storage repository. The ideal would be if you acquire the data through live online monitoring, also called smart metering. It will deliver 15 minute consumption data directly to your portal so you can see day in day out what your consumption is. STEP 3: Analyse the data. If you can, compare water use within your own organisation between similar facilities. Use simple water use key performance indicators (KPI’s). It allows you to normalise water consumption based on the size and type of your facility.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS Analysing the data also includes comparing the rates between different sites. Surprisingly often discrepancies in the charging regime can be found that may have been related to former agreements, changes in site use or new developments. In a recent review, just reviewing the sewer discharge factors (SDF) identified $65,000 worth of savings for one client. Trade waste charges are another element can often identify worthwhile savings opportunities.

A word oN KPIs Care must be taken when interpreting KPIs. Unless things are exactly the same, and they never are, there may be good reasons why KPIs between different sites are different. A good KPI may not necessarily mean that this site is water efficient nor does a bad KPI mean that this site is a water waster.

What it does mean though, is that further investigation is warranted to identify if there is a good reason why the KPI is what it is. A high level review across various sites is a good way to establish this. It could then allow a “normalised” KPI for a particular site. Thus, when management looks at these numbers a high KPI should then mean unnecessarily high water use just as much as a low KPI should mean: “Leave this site alone it manages its water well”. STEP 4: Alarm it. Set corresponding trigger points. When the data is collected manually or automatically there has to be levels that force you to take action. Remember: No action, no result.

STEP 5: Set up corresponding procedures and workflow diagrams. It needs to be clear what needs to be done when things are out of the norm. This ensures that the right corrective action is taken to realise the potential savings. It also minimises the number of false alarms because nothing reduces the effectiveness of a program more than too many alarms for trivial items. Alarms should come with a clear work instruction and an indication of the size of the problem. STEP 6: Record the actions taken and the resulting outcomes. This is a simple process at the time but will prove invaluable in years to come. It will allow you to demonstrate the actual savings achieved and support the business case at the press of a finger tip. It will also highlight further efficiencies for you. By following this six step process you will be able to lock in perpetual savings ensuring your water bill always stays as low as it can be, and maximise your water savings.

Benefits of an automatic system Whilst the above process can work based on manual billing and data collection, this is clearly where automatic metering (smart metering) comes into a league of its own. This is also the Snapshot from Coles water management database

Obviously, if you only get quarterly data the soonest you can react to abnormal use is on a quarterly basis. If you take weekly or monthly readings you can shorten the time. The ideal, of course is an online smart metering system. Then you will automatically get notified of abnormal use within 24 hours. This will allow you to maximise the savings available to you and reduce unnecessary money literally wasted down the drain.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

process that needs to be attached to smart metering to get real value from it. Otherwise it will remain just an expense for a fancy graphic interface and display but will not provide you great return on investment. A state-of-the-art smart metering system will have a web-based central repository for all this information. For starters, it will mean that the data is all stored in one place, accessible by everybody within the organisation who needs to access it, based on a hierarchical login. It is completely independent of whether a facility manager is in a metropolitan or rural area or whichever State. No more looking for spreadsheets stored of individual desktops or an obscure location on the network. Everything is right there on the web based water management interface. Better than that, much of the analysis, alarming and triggering of initial corrective action is all done automatically. All your data is regularly charted to give you a clear visual overview. You can readily zoom in or zoom out to select whatever period you may wish to view. A good system should allow you to easily compare your facility with any other one you wish to. Water use across sites can readily be compared with each other. KPIs as explained above are automatically calculated and put into a separate KPI chart, showing your facility compared against others and best, average or fair industry standards.

TECHNICAL PAPERS Part of the initial alarming is done automatically by sending emails or SMSs to corresponding contact details. As part of Step 5 Work Procedures, an automatic system is put in place such that the person responsible for ensuring sustainable water use (which may be an outside service provider) will follow up an alarm if corrective action has been taken within a preagreed time and the abnormal water use has not been addressed. This makes sure nothing falls between the cracks and potential savings are realised. The best part is that such a system also allows automatically recording the savings achieved. It can do that by providing a savings time series that clearly show the achievements to date. This is a wonderful tool to maintain the buy-in of staff and keep everybody motivated in the continuous use of the system for ongoing savings.

Coles for example have implemented a system like that across a select number of their supermarkets all over Australia. It has helped them achieve $20,000 worth of savings every month since the project was conceived in 2012. Smart health care providers are now not only realising how to best extract value from data they already possess, but are decisively acting on it. The secret is to put in place an effective system that allows this kind of “data mining” without placing undue stress on already stretched resources. By recognising the potential savings a budget can be identified to support a business case for either additional internal resources or to justify contracting out (some of) these services. Because as times are getting tougher and tougher, no facility can afford to waste even just $10,000, especially if it is across such

WHO WHEN WHERE

is entering...

an emotionally charged and sensitive topic as precious potable water. Are you on board with a modern water management system or could you be one of the organisations who may not even be aware of how much water and money you might be wasting?

Are you ready for the next El Niño? The CSIRO is now predicting a 70% likelihood of another El Niño recurring. All main indicators such as mean sea surface temperatures and currents are pointing towards that. Is your organisation ready to come under renewed scrutiny for any water wasted? (Remember what it was like during the drought in 2006 to 2010?). Now is a good time to plan for this and put in place a good water management structure so you can stand up to the focus that may soon be placed back on water.

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Engineering for Health & Hygiene

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

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IHEA Healthcare Facilities Management Conference 2014

TECHNICAL PAPERS

15 - 18 OCTOBER 2014 | BRISBANE CONVENTION & EXHIBITION CENTRE

COMPLIANCE: GOVERNANCE IN HEALTHCARE FACILITIES

REGISTRATION FORM

CONTACT DETAILS

Title (Mr/Mrs/Ms)

One form per person please. Please write clearly.

First Name

Surname

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Division

Organisation Address

State

Postcode

Phone

Mobile

Email Address (for confirmation/tax invoice) Delegate’s Email Address Special Dietary Requirements (if applicable) Special Needs (eg. wheelchair) Accompanying Person’s Name REGISTRATION OPTIONS

Fee

Notes

Full Conference Registration (inc GST) IHEA (Financial) Member Only Earlybird Rate (before 9/8/14)

$780

Full Rate (on or after 9/8/14)

$880

Retired IHEA Member

$350

Non Member Earlybird Rate (before 9/8/14)

Full Conference Registration includes attendance to all conference sessions (including technical tours) and the trade area, daytime catering from Wednesday - Friday and a conference satchel containing the conference handbook. It also includes attendance at the Welcome Reception and Trade Evening on Wednesday 15th October and the Conference Dinner on Thursday 16th October. Registration does not include attendance at the Optional Social Dinner on Friday 17th October.

$930 $1,030

Full Rate (on or after 9/8/14)

Day Only Conference Registration (inc GST) IHEA (Financial) Member Day Only

$450

Non Member Day Only

$500

Day Only Registration includes attendance to all conference sessions and the trade area on the day of registration, daytime catering on the day of registration, technical tours (for Friday registrants only), and the conference handbook. Registration does not include attendance at the Welcome Reception and Trade Evening on Wednesday 15th October, the Conference Dinner on Thursday 16th October or the Optional Social Dinner on Friday 17th October. I wish to attend this day: Thursday 16 Oct Friday 17 Oct

Optional Technical Tours - Friday 17 October 2014 (inc GST) Brisbane City Hall

Free

Lady Cilento Children’s Hospital

Free

Technical Tours will run from 1.30pm on Friday 17 October 2014. Please select only one option. Places on each of the tours may be limited and will be allocated on a ‘first in, first served’ basis.

Optional Social Dinner: The Jetty, South Bank - Friday 17 October 2014 (inc GST) Dinner

$50pp x Qty [

Includes two course meal.

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EventENGINEER hashtag: #HFMC14 THE AUSTRALIAN HOSPITAL I JUNE 2014

IHEA Healthcare Facilities Management Conference 2014

TECHNICAL PAPERS 15 - 18 OCTOBER 2014 | BRISBANE CONVENTION & EXHIBITION CENTRE COMPLIANCE: GOVERNANCE IN HEALTHCARE FACILITIES

REGISTRATION FORM (CONTINUED) Partners Registration (FREE REGISTRATION) FREE

Partners Registration

Name: Includes complimentary attendance at delegate afternoon tea on Wednesday 15th October 2014

Optional Partners Program Activities (inc GST) Thursday 16 October 2014

$65pp

Queensland Performing Arts Centre and Brisbane Powerhouse

Friday 17 October 2014

$50pp

Gallery of Modern Art and High Tea

Additional Social Program Tickets (inc GST) Additional Welcome Reception Tickets $60pp x Qty [

Additional Conference Dinner Tickets $150pp x Qty [

Welcome Reception & Conference Dinner tickets are included in all full conference registrations. Additional tickets for partners or those registered as Day Only delegates can be purchased here.

Optional Social Outing: A Day Out in the Lockyer Valley - Saturday 18 October 2014 (inc GST) Lockyer Valley

$130pp x Qty [

The Optional Social Outing includes a trip to the Handmade Expo Markets and Bundamba (including steam train ride), morning tea at Queens Park, lunch at Woodlands at Marburg (including croquet, wine and cheese) and a trip to the iconic Mt Coot-tha Lookout.

Accommodation: Rydges South Bank (9 Glenelg Street, South Brisbane) (inc GST) Queen Room (room only)

$279p/n

Queen Room (+b/fast for 1)

$309p/n

Queen Room (+b/fast for 2)

$339p/n

Superior Queen Room (room only)

$299p/n

Check-in Date:

Superior Queen Room (+b/fast for 1)

$329p/n

Special Requirements:

Superior Queen Room (+b/fast for 2)

$359p/n

TOTAL PAYABLE

Full payment is required to secure your accommodation booking. This payment will be forwarded to the hotel. Accommodation cancellations may or may not incur fees, it is dependent on the hotel’s policies.

Check-out Date:

AUD $

PAYMENT DETAILS A receipt will be emailed to you once payment is received.

ICEBERG EVENTS ABN 84 084 581 153

Direct Deposit: Account Name: Iceberg Events | BSB No: 484 799 | Account Number: 201007319 Please use ‘IHEA’ & your company name as the reference. Email the payment confirmation / remittance advice to krysty@icebergevents.com.au so that a receipt can be issued.

Cheque (made payable to ‘Iceberg Events’) Credit Card

Mastercard

Visa

Card No. Name on Card

Email me a Tax Invoice with payment options Amex

Security Code (3-4 digits) Expiry Date

Signature

TO SECURE YOUR PLACE COMPLETE FORM (2 PAGES) & SEND TO: 1 Scan/Email: krysty@icebergevents.com.au 3 Fax: 07 3367 0032 2 Post: IHEA 2014, c/- Iceberg Events, PO Box 1179, Milton QLD 4064

Enquiries to the organisers: Iceberg Events Phone: 07 3876 4988 krysty@icebergevents.com.au

Terms and Conditions: Cancellations and refunds: All cancellations must be made in writing to Iceberg Events. A refund on conference registration fees and social functions will be made on all cancellations received before 15 September 2014 less a $55 administration fee. Accommodation cancellations may or may not incur fees, it is dependent on the hotel’s policy. There will be no refunds on or after 15 September 2014 although substitute delegates are welcome. Privacy Policy: For networking purposes IHEA may make the name, position and company name of each attendee available to the delegates in the form of a delegate list given to each attendee. In addition your contact information may be given to the sponsors/supporters of the conference. I do not wish my details to be shared.

52 www.HFMC2014.org.au THE AUSTRALIAN HOSPITAL ENGINEER

I JUNE 2014

Event hashtag: #HFMC14

TECHNICAL PAPERS

How compliant is your building? Derek Hendry I Managing Director, Hendry Group

Building owners, managers, and hospital engineers need to be aware that a majority of buildings do not comply with the current Building Code of Australia (BCA).

ach year various aspects of the BCA are enhanced or amended according to industry and community consultation and feedback, and also according to the agenda and direction identified and adopted by the Council of Australian Governments (COAG). Recent examples of these are the enhancements to Bush Fire protection requirements, the adoption of the Disability Access provisions within the BCA, and the inclusion of energy efficiency provisions for commercial and residential buildings. Since premises are designed and constructed to comply with the BCA applicable at the time (as an absolute minimum), it stands to reason that as each new edition of the BCA is published, there will be a growing list of building elements that will, in compliance terms, become outdated. As these buildings become increasingly non-compliant with the current BCA, factors such as whether the building still serves the original designed-intent, and whether the building elements in question are still ‘fit for purpose’ and still provide for the health, amenity, and safety of the building occupants sufficiently enough, come into question. These questions are generally considered when a particular trigger initiates the review process, culminating in the need for either, or all of, an update to the building itself, a change of building classification, or an update to the procedures practiced within the building.

Following are some of the most common triggers and outcomes for building updates:

provisions that can trigger an upgrade of an existing building.

COUNCIL NOTICES, BUILDING NOTICES OR BUILDING ORDERS

Where alterations to a building exceed more than 50 per cent by volume (within a three year time-frame in the case of Victoria), the event can trigger a requirement for the whole building to comply with all the current regulations ( the whole BCA). Other states have no time limits applicable, and calculations may vary in the interpretation of the volume. For example, some building surveyors include simple partition changes in the volume calculations, while others only calculate the volume associated with a refurbishment which includes significant modifications to services.

Building notices or building orders can cover the broad aspect of public health and safety such as dangerous buildings, fire report matters, and closure of unsafe public assembly buildings, and only a local authority (because of the restrictions in legislation)can serve building notices or building orders in relation to public safety measures provided in an existing building. Building notices provide the means by which the municipal building surveyor can require the building owner to show cause as to why an existing building should not be subject to building work in order to provide a level of public safety which meets with community expectations. An existing building does not have to be upgraded to the same standard as is required for new buildings under building orders or building notices. If the owners do not respond satisfactorily to building orders or building notices by undertaking the required works, then the municipal building surveyor/council can proceed to issue building orders or take court action which, if not complied with, will ultimately incur penalties, or even closure of the building.

EXTENSIVE ALTERATIONS While most building control legislation is not retrospective for existing buildings, some State legislation does contain

An upgrade to fire safety and/or structural capacity may also be determined because the modifications to services may compromise the essential safety measures contained in the building, and may be determined to be inadequate to protect persons using the building. Upgrades may be determined to facilitate egress from the building in the event of a fire, and/or to restrict the spread of fire from the building to other buildings nearby.

DISABILITY ACCESS Recent moves to improve the commonality of the disability access provisions for buildings in the Building Code of Australia (BCA) and the Disability (Access to Premises – Buildings) Standards 20I0 have substantially harmonised the BCA with the Disability Discrimination Act. As a result, the integration of the disability access code with the BCA carries significant implications for building

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS owners, tenants, property managers and hospital engineers.

hotels, motels, and common areas of new apartment buildings.

The Premises Standards contain detailed disability access information specifying the circumstances and types of building where the Standards apply, and they apply to a new building, a new part of an existing building, and the affected part of an existing building.

ENERGY EFFICIENCY COMPLIANCE

For disability access, the affected part of a building means: • the principal pedestrian entrance of an existing building that contains a new part and • any part of an existing building that contains a new part, that is necessary to provide a continuous accessible path of travel from the entrance to the new part. Generally speaking, the affected part of a building must comply with the new access requirements where alterations and/or additions are proposed to an existing building, and the proposed work is subject to a building permit/complying development certificate or a construction certificate/building permit. The affected part of the building, relative to disability access, does not apply to: • existing parts of buildings outside the area of the new work and the affected part upgrade • an accessway from the allotment boundary, from any accessible car parking space on the allotment or between other buildings on the allotment Upgrading works for an affected part may include the following disability access works: • accessibility of upper floors to new work • providing lift access features such as Braille or tactile buttons • signage • removing a step at a building entrance • upgrading handrails on a ramp • minimum width requirements of doorways or passageways, including passing and turning spaces As a consequence of the new disability access provisions, the BCA more extensively covers features such as lifts, stairs, ramps, toilets and corridors in buildings such as office blocks, shops,

Energy efficiency requirements, as detailed in Section J of Volume One of the Building Code of Australia (and applicable to all building Classes 2-9, unless otherwise stated), apply to the construction of all new buildings, as well as the refurbishment, alteration or extension of any existing building. The energy efficiency requirements allow commercial and public buildings to achieve minimum levels of energy efficiency compliance through the performance-based provisions of the BCA. In essence, these measures are designed to reduce the use of artificial heating and cooling, improve the energy efficiency of lighting, air conditioning and ventilation and reduce energy loss through air leakage. Assessments generally cover building elements such as the building fabric, external glazing, building sealing, air movement, air conditioning and ventilation systems, artificial lighting and power, and access for maintenance. Energy efficiency compliance with the BCA can be achieved by complying with the deemed to satisfy requirements of the BCA or by developing an energy efficiency alternative solution that demonstrates that the proposal meets the relevant BCA performance requirements. Where energy efficiency alternative solutions are sought or additional information is needed, softwarebased energy efficiency analysis can also be deployed to assess the energy contribution of various building components such as building fabric, air filtration and natural ventilation, internal heat sources, air conditioning systems and vertical transport systems.

EMERGENCY PLANNING Emergency plan development, Emergency response procedures, evacuation diagrams, emergency procedures training, and emergency response exercise program implementation are

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

just some of the requirements of the emergency planning obligations under AS 3745-2010 Planning for emergencies in facilities. When a building undergoes alterations, some or all of these requirements can be impacted by the changes in the building, and building owners need to give due consideration to ensuring their emergency planning remains effective, up to date and AS 3745 – 2010 compliant in order to provide a safe work environment for staff, building occupants and visitors alike. While the basic intent of the BCA is to ensure the provision of safe buildings for occupancy that provide a level of amenity commensurate with community expectations, the application of the BCA can be open to interpretation. Building Surveyors are quite often called upon to provide expert advice or witness, and to provide sound planning advice in maximising your building asset. Where possible, ensure you receive sound and professional advice before calling in the builders.

About the HENDRY Group Derek Hendry is the Managing Director of the HENDRY Group of consulting companies that Include HENDRY Building Surveying Consultants, HENDRY Disability Access Consultants, Essential Property Services and Emergency Plan. HENDRY pioneered the private certification system of building approvals in Australia, and the consultancy assists clients nationally in all facets of building control and disability access compliance, essential safety measures audits and emergency planning requirements. HENDRY publish a monthly e-newsletter entitled ‘Essential Matters” as a free subscription service, to keep property and building managers, facility managers and hospital engineers up to date with the latest developments in building compliance and building control. http://www.hendrygroup.com.au

TECHNICAL PAPERS

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST

Filter Selection for Hospitals In Australia, about 6% of patients acquire an infection in hospital, and the incidence of hospital-acquired infections may be increasing. Common hospital-acquired infections are respiratory and urinary tract infections, surgical wound infections and infections associated with intravascular cannulas. (MJA Practice Essentials: Infectious Diseases)

ne third of hospital-acquired infections are judged preventable. The Committee to Reduce Infection Deaths (US) – RID – reports that as many as 92 percent of deaths from hospital infections could have been prevented.

air filter, having an efficiency of F8 when rated under EN779:2012 or MERV 14 when rated under ASHRAE Standard 52.2 will remove more than 90% of this contaminant. Aspergillus is also easily removed by F8/MERV14 level filtration.

Pneumonia is the most costly of all hospital-acquired infections. Fortunately it is among the most preventable, where proper levels of air filtration, and the appropriate number of air changes per hour of ventilation air, are in place. Camfil can provide a more comfortable environment for patients and staff, while lowering the total life cycle costs of filtration as well. Camfil’s premium air filters are recognised for top-level performance in four critical areas important to health care facilities: energy savings, air quality, waste reduction, and environmental impact.

Application and Selection of Air Filters

Staphylococcus aureus has a diameter of 0.8 micron to 1.0 micron. An

Microorganisms carried this way can be dispersed widely by air currents and may be inhaled by a susceptible host within the same room or over a longer distance, depending on environmental factors. Therefore, special air handling and ventilation are required to prevent airborne transmission. Legionella, Mycobacterium tuberculosis and the rubeola and varicella viruses are also of concern.

Tuberculosis has a diameter of 0.2 micron to 0.5 micron and a rod length of 1.0 micron to 4.0 microns. Although an F8/MERV 14 filter should, in all probability, remove at least 90% of this contaminant. Tuberculosis contaminant that approaches the media on a perpendicular may penetrate the filter based upon its diameter of 0.2 to 0.5 micron. HEPA filtration should be strongly considered in areas servicing tuberculosis patients. Filter selection should always include consideration of the size and type of contaminant to be captured. Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue 5-micron or smaller in size of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time), or dust particles containing the infectious agent.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Room air cleanliness is always a function of filter efficiency and the number of air changes. Many nosocomial maladies are easily removed with a F8/MERV 14 filter. Viruses and other sub-micron contaminants cluster and often adhere to larger items that easily become airborne such as skin flakes. Many are removed from the airstream when the larger particles are captured by the filter. How can air filters generally improve the IAQ? • Keeping the system clean – the projected airflow is maintained

TOPICS OF INTEREST • Influence Temperature and RH by keeping sensors clean • Maintain the efficiency of equipment. (Fan, Heating, Cooling) • Reduce indoor contaminants from humans, building materials and equipment. • Remove outdoor contaminants, which could cause allergies, cancer and lung-diseases • Avoid micro-organisms in the system Efficient air filters contribute to a better indoor air quality for humans and a better production result in the industry. This is very important to consider when selecting the right type of filter. It is necessary to first of all conclude which type of particle collecting efficiency (or adsorption efficiency and capacity for molecular filters) one need to achieve a healthy and productive environment. A F9-filter has a 80% separation of 0.4 µm particles, a F8-filter has about 70%, a F7-filter has about 50% while an M6(F6)filter has about 20%. The concentration of 0.4 µm particles downstream of an F7filter will be reduced by a factor of two compared with the M6-filter. An F9-filter will reduce the downstream concentration further by a factor of two. This means that the F9-filter is twice as good as the F7-filters, which is twice as good as the F6-filter.” (Air Filtration in HVAC Systems – REHVA Guidebook No.11)

Eurovent Air Filter Certification

Eurovent’s certification of our fine-dust filters means our products live up to the performance requirements and the data we print in our official documentation. Our fine-dust filters are tested by independent laboratories selected by Eurovent and that means security for you. The key elements of the program are that: • Published data must be correct • The products must comply with the EN 779:2002 standard

The above photo shows coarse fibre/electret media magnified 400 times. Coarse/electret fibres, because of their large size, are easier and less expensive to produce. Their primary effect of particle capture requires a charge imparted on the fibre during the manufacturing process. As the charge dissipates because of particulate loading, so does the efficiency of the filter. This is a critical condition, as 99% of all particles are under 1 micron in size — the range where these types of filters suffer critical loss of efficiency

The above photo shows fine fibre media magnified 400 times. Fine fibre media operates under a mechanical removal principle, and fibres do not lose efficiency over time. Their initial efficiency is indistinguishable from their actual efficiency over life, providing the user with the particle removal performance they have specified.

• Filters must be tested by independent laboratories – SP in Sweden and VTT in Finland

When selecting an HVAC filter, you should keep these differences between mechanical and electrostatic filters in mind because they will have an impact on your filter’s performance (collection efficiency over time), as well as on maintenance requirements (changeout schedules).

• The test laboratories must be ISO 17025 certified • We as manufacturers must be quality certified to ISO 9000 or a corresponding standard • Each year, Eurovent selects four new filters from our range for inspection Select Camfil air filters with Eurovent certification – it’s guaranteed

Principles of Filtration As mechanical filters load with particles over time, their collection efficiency and pressure drop typically increase. Eventually, the increased pressure drop significantly inhibits airflow, and the filters must be replaced. For this reason, pressure drop across mechanical filters is often monitored because it indicates when to replace filters. Conversely, electrostatic filters, which are composed of polarised fibres, may lose their collection efficiency over time or when exposed to certain chemicals, aerosols, or high, relative humidity. Pressure drop in an electrostatic filter generally increases at a slower rate than it does in a mechanical filter of similar efficiency. Thus, unlike the mechanical filter, pressure drop for the electrostatic filter is a poor indicator of the need to change filters.

Optimising the operational cost for clean air handling system Energy consumption today and tomorrow Higher cost of energy together with the increased focus on global climate has raised the demands on lower energy consumption worldwide. Sustainability has increased the focus on energy saving, so every new system needs to be optimised. An equally important, and maybe in the short term, even more important, question is what to do with the existing systems we have today. Air handling units (AHU) supplying clean air to buildings in the industry, offices and dwellings are important to create a good indoor air quality for both humans and production processes. An air handling system normally consists of many subsystems or components like: fans, heat exchangers, sound reduction, air filters etc.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS THE HOSPITAL SENSOR

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

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TOPICS OF INTEREST Life Cycle Cost (LCC) of Air filters

The energy losses in an AHU-system consist typically from pressure losses due to ducting and equipment like heat exchangers, cooling coils, the specific performance of fans and air filters. A large part of this comes from the pressure drop over the air filters, and therefore it is important to minimise the energy consumption. The ‘typical’ energy cost of filters as a percentage of the total system is approximately 30%. Selecting the correct filter, i.e. F8 filter efficiency and lowest average pressure drop, can create significant savings on energy while maintaining healthy Indoor Air Quality (IAQ). This is an opportunity since the filters are the most inexpensive part of the system to improve.

Considering the total operational cost for air filters in a system the vast majority of installations have a large share of the cost coming from the energy consumption (typically 60-70 %). The energy consumption is directly proportional to the average pressure drop over the life of the filter.

town environment with a Moderate AQI (PM2.5): 16-35 µg/m3. The airflow per filter in the AHU is 3400 m3/hr (944 l/s). The fan efficiency is set to 60% and the airflow is the same during the entire operation. The LCC period is 10 years and the final pressure drop is 250 Pa.

Since air filters normally are replaced many times in a buildings life span, it is from this perspective that by decreasing the pressure loss over the filters for the same given efficiency, a significant reduction in energy use can be obtained.

The table below highlight by increasing the surface area of the filter, this will in turn decrease the initial pressure drop. By lowering the average pressure drop of the filters, this can represent savings of up to 30% in the total cost of ownership.

Conducting an LCCanalysis

HEPA Filters for Critical Areas

Camfil was the first filter manufacturer to develop a sophisticated program that calculates the Life Cycle Cost of air filters. Over many years the program has been improved. The program is based on numerous real life measures of filters. This allows us to predict the filter’s pressure drop and lifetime in an actual installation rather than relying on theoretical calculations.

HEPA filters are specified for air supplies serving operating theatres, protective environment rooms for treatment of patients with high susceptibility to infection and exhaust systems from isolation rooms.

Having selected the required filter class, we can calculate LCC for 1-, 2- or 3-step filtration based on either change outs after time or after final pressure drop. The program can be adjusted according to the characteristics of your outdoor air and your specific costs for filters, labour, disposal, cleaning and energy. In the example below three filters are compared, both of the same filter class, F7 and used as single stage filters in an AHU operating continuously in a

HEPA filters are also specified for discharge air from fume hoods or safety cabinets in which infectious or radioactive materials are processed. The filter system should be designed to permit safe removal, disposal, and replacement of contaminated filters. A HEPA filter, by definition, has an efficiency of at least 99.97% when tested on particles 0.3 micron in size. The key word is “tested”. A HEPA filter must be tested and certified by the manufacturer as to efficiency, rated airflow and resistance to airflow.

The LCC for a filter is the cost of the: • Filters • Labour (installing and replacing) • Energy consumption • Cleaning of ventilation system • Disposal of used filters

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

Kleenduct Australia delivers outstanding duct cleaning services to existing and prospective customers throughout Australia. Our company offers 24 hour, 7 day a week servicing 363 days of the year. This ensures that we are in a position to promptly and efficiently meet the demands of our customers.

ATTRIBUTES 

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State of the art reporting

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Up to date with Industry Standards, regulations and best practices

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TYPE OF CUSTOMER 

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Hotels

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Mining

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Aged care facilities

Kleenduct Australia has the depth and expertise to fully service all duct cleaning requirements on a national basis, and we hold many national contracts with key organisations in Australia. In utilising Kleenduct as a maintenance provider our customer has the opportunity to draw from the extensive experience and comprehensive range of services we provide.

DUCT INSPECTION 

Advanced camera system has a articulating eye with a full colour camera head and lets you take a closer look at horizontal and vertical ductwork…

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We offer a wide range of services to an even wider variety of customers. We are extending our operations to include Fiji and New Zealand and will be an international company by mid 2014.

SERVICES 

Duct cleaning

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1300 438 287

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

info@kleenduct.com.au

TECHNICAL PAPERS A Certificate of Conformance should be included with each HEPA before it is installed in your facility. This certificate includes complete testing data and ensures that the manufacturer has built the product to the required specifications and tested each individual filter before leaving the manufacturing facility. Some vendors do not test or may “batch test”, rather than individually testing each filter. Certificates of Conformance for each filter should be filed with the onsite scanning report for evidence should problems arise and as support documentation for facility audits. Unidirectional Flow The CamHosp 2 System offers the following advantages

SOME THINGS ARE HARDER TO GET THROUGH THAN OTHERS

1. Unidirectional flow, according to EN ISO 14644. 2. H14 standard gasket or gel seal terminal HEPA filters.

Absolute™ C

Absolute™ D-G

Absolute™ V-G XL

ABSOLUTE ™ – the most reliable HEPA filter • Each Absolute™ filter is rigorously tested

before dispatch to ensure greater reliability

• Our filter media is developed and tested

3. G uaranteed airtight plenum which is assembled using a system of flanges and bolts and complies with class B of the EN1886 standard (completely airtight casing). The plenum area and the structural elements are made of electrogalvanised steel with an oven-baked epoxy coating, which is highly abrasion resistant, perfectly smooth and can easily be decontaminated. The materials are also resistant to the standard disinfectants used in hospitals.

according to our own precise specifications to provide a maximum life span

• Media is pleated with our superior CMS (Control Media Spacing) technology to promote optimal airflow with the lowest possible pressure drop

4. T he clamping system, which has a compression limiter with captive stops ensures excessive compression of the gasket is prevented. This allows for an easy, safe and quick filter assembly. 5. Protective Screentek screen to ensure maximum usage of the theatre by providing individual protection for the HEPA filters. These are protective screens made of monofilament polyester fabric on a clip-on frame a few centimetres away from the HEPA filter. If a Screentek screen becomes contaminated during the course of an operation, the individual screen can easily be replaced by a clean one in only a few minutes. This ensures that the ceiling is hygienic and that the next operation can take place. The major benefit of this protective system is that the HEPA filters do not need to be replaced, which would require the operating theatre to be closed down for maintenance, cleaning and re-testing. Sealing of HEPA Filters Gasketing of the HEPA filter should be aligned properly, assuring that the gasketing, when compressed, will seal all surfaces from air bypass. The filter sealing mechanism should compress the

www.camfil.com CLEAN AIR SOLUTIONS

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST gasketing material to 50% of its original depth. HEPA filters should include the latest poured-in-place seamless gasket that prevents leaks through gasketing junctures found in traditional HEPA filters. Where a fluid sealing method is used, the knife edge should uniformly penetrate the sealant but not fully to the base of the channel.

of the HEPA filter have an operating fibre diameter of 0.67 micron. Large particles can block a relatively expansive area of the filter, increasing pressure drop prematurely and reducing the effectiveness and life of the filter. This chart shows the increase in life with various selected pre-filters. If a total cost of ownership maintenance program is implemented, this methodology can also produce substantial energy savings

HEPA Filter Service Life Initial considerations concerning the service of HEPA filtration relate to minimising pressure drop within the HVAC system for energy conservation, and extending the life of the HEPA filters. The chart here shows the typical life extensions of HEPA filtration when various levels of pre-filtration are used. When the Life Cycle Cost of the HEPA cost is considered, F7 (MERV 13) or F8 (MERV 14) pre-filtration is the norm. A 5-micron size particle looks like a boulder to HEPA filtration media. The microfine glass fibres that make up the media

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TECHNICAL PAPERS

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST

Fenestration...

Your Building’s Cornea Ramiz Gabrial I Managing Director, Beehive Consulting Group

Over the years, I have learnt to look at buildings as “Living Structures”. Accordingly building systems and elements are the Living Structure’s organs. The air conditioning and ventilation system can resemble our respiratory system, building envelope resembles our skin, different piped services resemble the circulation system. The BMS could resemble our central nervous system, where all other systems report to and/or take orders from.

y burden this time is to focus on Fenestration. A very important, yet could well be ignored, organ of the Living Structure body. Fenestration to a building is like the eyes to the human body. It also resembles the sensitive part of our skin that needs to be looked after and protected or otherwise it could affect other important body organs. Dehydration, infection and even kidney failure can take place if our skin is not in perfect condition. Similarly, energy loss, moisture problems, filtration issues, structural deterioration, etc of the building can take place when the fenestration and other elements of the building envelope are not design, installed or maintained in proper manners. The two main important components of the building fenestration system are the frames and glazing. Frames can be, mainly, manufactured from: • Timber: Timber has much better thermal properties (very good insulator), however it requires maintenance and generally speaking has a shorter life span. • Metal: The most common metal that we use is aluminium, however, steel is also used. Metals have the lowest thermal properties as they are good heat conductors. However they are structurally very strong and aluminium requires no maintenance. Good aluminium sections are constructed with

thermal breaks to improve their overall thermal properties and reduce the heat transfer effect of the metal frame. • Polymers: Polymer sections are still less common than timber and metal frames however they are becoming more popular as more resilient sections are developed. Polymers have lower U-values (i.e. better heat transfer properties) in comparison with metal sections. While some transparent plastic materials are used as glazing elements of fenestration systems, we can confidently say that glass is used in almost 100% of building fenestration. From the architectural perspective, fenestrations could come in the form of windows, skylights, sky domes or doors. The percentage of the transparent (fenestration) part of the building envelop varies from one building design to the other. Fenestration serve as the only physical and/or visual connection between the building occupants and the ambient (nature or life). Connectivity and views are major factors in boosting building occupant productivity and morale. Fenestration can be designed to be either fixed or operable type. Operable type can be utilised to introduce natural ventilation into the building. In low rise buildings, operable fenestration can be utilised as emergency exit paths.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

Glass is the second components of the fenestration system of the building (after frames). It is a building material that can be taken for granted during the design and selection process. When selecting suitable glass for a building project, there are three aspects that need to be addressed. These are: • Architectural • Structural • Thermal & Day Light The first two aspects (Architectural and Structural) are traditionally looked after. The Architectural aspect include glass colour, reflectivity (mirror glass, etc) and coating or tinting. The Structural aspect include selecting the required glass panel thicknesses and toughness that satisfies the applicable constriction standards, this is particularly important in high rise buildings. Historically, the thermal and day lighting aspect of the glass selection process was not given great attentions by designers and engineers. It was until energy conservation became a major focus, followed by the adoption of Green Building designs, that the importance of the glass thermal properties rose up in the list of importance. Yet, similar to any other issue, building professional and public awareness take time. When analysing the thermal properties of any glass material, there few factors that need to be studied. In this article, I will

TOPICS OF INTEREST refer to three very important factors. These are; • The coefficient of heat transfer, which refers to as the U-value and measured in W/m2°C • The Solar Heat Gain Coefficient (SHGC), which refers to the proportion of the total solar radiation that is transferred through the glass at normal incidence. • The Shading Coefficient, which is the ratio of the solar heat gain through the glass relative to that of a 3mm clear glass. Glass manufacturers produce glass panels in different colours, tinting, reflective material coatings and thicknesses. Glass panels are generally manufactured on panel; thicknesses that range between 3 to 13 mm. Glass material and thickness affect its overall U-value and glass colour, tinting and reflectivity all affect its solar heat gain coefficient and shading factor. All three factors (U-value, SHGC and Shading Coeff.) affect the building

energy use and day lighting. Note that clear glass can transmit more than 75% of the incident solar radiation and more that 85% of the visible light that passes through it. Today, single, double and triple panel fenestrations are used in buildings throughout the world. Multiple panel fenestrations (double and triple) have a gap between the glass panel. This gap can either contain air or an inert gas (Argon or Krypton). Double and triple panel fenestrations with inert gas filled gaps have lower heat transfer coefficient (lower U-value). Fenestration can affect building energy use through four mechanisms; • Day lighting • Air leakage • Solar heat gain • Thermal heat transfer Each of the above listed mechanisms is a field by itself that could be studied to

understand its impact on the building. The common factor that all four mechanisms share is that they all affect the building energy consumption, which is the main issue that I want to address through this article. • Day Lighting: As it indicated earlier, day light in buildings is considered very important to factor that affect the occupants’ productivity and morale. Buildings with good level of day lighting attract and retain better tenants and higher business rate of return. The important question that needs to be asked though, is... How much day lighting is enough? How can we tell if the amount of day lighting is costing the building owner or occupier more that the benefit that it offers them? Day light is directly affected by fenestrations. Their size, location, orientation and glass type affect the

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST amount of day light entering the building and hence the amount of energy used and/or saved. Building spaces with adequate day light will require less or no artificial lighting during the day hours (or part of these hours). This involve energy saving on two levels. The first is the reduced energy saving as a result of not using the artificial lighting. The second is the energy saved as less (or no) heat is emitted by the artificial lighting system that need to be removed by the building’s air conditioning system. Day light modelling softwares are used to determine the optimum level of day light that the building’s architectural design achieves. One important aspect of the day light modelling is determining and eliminating glare of becoming an issue inside the building as a result of excessive day light. On the energy side, building computer energy consumption modelling softwares enable building architects and mechanical engineers to minimise building energy use. The softwares enable the energy modeller to alter any building components (fenestration is one of them) to determine its positive (or negative) impact on the building’s overall annual energy consumption. The analysis and dialogue that happen between the day light and energy consumption modelling help to arrive at the optimum glass type selection and fenestration size and location that provide the best day light scenario for the building and causes the lowest possible heat transfer (inwards in summer and outward in winter). • Air Leakage: Air leakage is considered a bad situation that take place in buildings where air enters (or exists) the building through construction cracks, openings and fenestration frames and operable fenestration panels. Building air leakages (in summer and winter) increase the building energy consumption since this uncontrolled amount of cold or hot air is entering the building and adding to its cooling (or heating) load. Air leakage can have more damaging effects on buildings as it introduce uncontrolled amounts of humidity and dust into the building which can contribute to generate mould and fungal growth in the building. In addition, air leakages from building fenestration affect the level of comfort inside certain affected spaces of the building that could fall beyond the HVAC system’s capability to achieve space comfort. It is important to seek higher fenestration manufacturer specifications to reduce or eliminate air leakages. • Solar Heat Gain: Solar heat gain is the component that is directly related to the selected glass type. Apart from the architectural decision to use certain glass type, colour, shading, tinting or shading coefficient, the computer energy modeller for the project can work closely with the architect to test different possible glass selections and determine the type that result in the lowest overall energy consumption.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

• Thermal Heat Transfer: Similar discussion applies to the fenestration thermal heat transfer as that for solar heat gain. The difference is that thermal heat transfer takes place through the window frame and glass. It also takes place during the day light and night hours of the day. So computer energy modelling softwares are the analysis tool that we have today to help us in making educated decisions about the most suitable glass type for the building we analyse based on minimising the building’s annual energy consumption. It is important to shed some light on the hourly building load estimation and energy modelling softwares. The softwares have detailed weather data for different cities in the world. Accordingly when executed it can estimate the required building energy consumption based on hour-by-hour, 24 hour a day, 365 days a year. Ideally, the Owner should engage a mechanical consulting engineer who is experienced to perform detailed energy modelling for the building. The reason is; a. T he same computer software that is used to estimate the required air conditioning capacity is used to perform the annual energy model for the building. b. The air conditioning system is the highest energy consuming system in almost any commercial building and it is very important to engage energy aware mechanical consulting engineer, as the selected type of air conditioning system could mean a lot when it comes to evaluating the building’s energy performance. As an example, for the same building envelope and glass type, a building that is served with split type air conditioning systems will use much more energy than an identical building that is equipped with air handling system with economiser cycles. A person may suggest, instead of going through the path of running computer energy models to determine the optimum glass type, why can’t we use a highly insulated, high reflective glass and we can be sure that we will save energy. The answer to the above argument is “there is such thing as over insulating the building”. In other words, you could use highly insulated or reflective glass that the building starts using more energy. This can particularly happen in mild weather conditions such as Melbourne. The technical explanation for this condition is that over insulating the glass or the whole building envelope could trap heat inside the building that can be lost naturally through the building glass and other envelope components at certain times of the day. Of course this also depends on the building’s use and hours of occupancy. Another example, using highly reflective glass in a building is considered a definite positive move to reduce it’s cooling load as reflective glass reduces the amount of direct sun light entering the building in summer. However, depending on the building size, usage and geographical location, the reflective glass would well reduce the amount of sun entering the building in winter too, resulting in a higher heating energy bill. Again the only way to determine the economical benefit of using high

TOPICS OF INTEREST reflective glass is by running a computer energy model for the building to determine its overall annual energy consumption with different glass reflectivity levels. On the other hand, detailed computer energy models can provide very good indication of the economical rate of return of the added investment as a result of using higher glass thermal properties (or other building elements) in comparison with using glass that satisfies the Building Code requirements. It is important to note that computer energy modelling is as good as the amount and accuracy of the information that is fed into the software and the level of energy modelling experience by the energy modeller. The more detailed and accurate the information, the more meaningful and informative the results. It is of interest to mention that almost 40% of the energy used in commercial buildings is consumed by their air conditioning systems. Also over an average building life span of 50 years, the building’s initial cost represents about 10% of its total life cycle cost. This reflects the importance of two issues: a. Optimising the actual system capacity b. M aximising the air conditioning system operation efficiency (Coefficient of Performance – COP). A major factor in optimising the air conditioning system capacity is optimising the thermal properties of the selected building glass and other building envelope components. This optimisation process would normally include added capital investment. However this added investment is compensated in two ways. The first is through the reduced air conditioning system capacity and hence its initial cost. And second through the reduced system energy consumption and hence life cycle cost. Computer energy modelling is the tool that helps quantifying the actual financial rate of return of the added capital investment. Discussing building fenestration and glass without mentioning building shading can be identified as an incomplete discussion. Shadings are architectural elements that are directly related to fenestration. Shadings are architectural elements that are used to reduce the building’s solar heat gain and reduce glare as a result of excessive day light entering the building. Building shading can be external to the building or internal. Building computer energy modelling takes into consideration the effect of all fixed type building shading. Movable shading elements (e.g. curtains) can be considered as part of the building energy model, however most energy modellers elect to ignore their effect since the use of such elements greatly depends on the preference of the specific space occupants. In summary, building fenestrations and glass selection can positively or negatively affect the stability of the internal building environment. It could also affect the building’s energy consumption. In many cases it worth exceeding the minimum required glass thermal specifications by the Building Codes to achieve smaller capacity air conditioning system and reduce the building’s annual energy consumption. However it is important to build a computer energy model for the building to estimate its overall annual energy use and hence enable proper evaluation

of anticipated financial rate of return of the added first cost investment. While computer energy modelling is great tool to evaluate the building’s energy consumption, they are as good as the accuracy and detail of the information that is fed into the model. Evaluation of the building energy use through computer energy models should be comprehensive to include other building factors such as walls, other system building systems, building shading devices and any element that affect building energy use.

About the writer Ramiz Gabrial, P.E., M-ASHRAE, LEED AP is the Managing Director of Beehive Consulting Group. He is a Building Services Consulting Engineer with 25 years of experience in the design management of variety of building types and major interest on sustainability, building envelop, integrated building design and computer energy modelling. Ramiz is a technical public speaker who has participated in multiple sustainability awareness raising programs for professionals and the public. A registered Professional Engineer in Virginia – USA. He has worked with major consulting firms and client bodies in the United States, New Zealand, Qatar, UAE, Jordan and Iraq. He is the founding member and the immediate past President of the Qatar Chapter of ASHRAE. Ramiz welcomes any interaction/feedback from likeminded professionals on Gabrial@beehivecg.com.au

Wireless data logging Measures and records temperature and/or humidity, or milliAmps One or two sensors Operational up to 350 meters from Gateway Over 100,000 logs Graphs, statistics, out of range values: all are available at your fingertips. Alarms via PC, SMS and email Automatic updates and download of files

Come and see us Security settings (user at stand G2 at access control) foodpro 2014 in Relay option Melbourne

Temperature Technology

263 Gilbert Street Adelaide SA 5000 www.t-tec.com.au

Ph: 08 8231 1266 Fax: 08 8231 1212 sales@t-tec.com.au

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST

Heat Exchangers Kendall Ciraldo I Air Change Australia

1. Heat Exchangers

ut simply, a heat exchanger is a device used to transfer energy from one medium to another. HVAC applications are wide and varied, as they transfer energy (mostly in the form of heat) through working fluids such as air, water and refrigerant. Most heat exchangers consists of two working fluids, a primary stream that either absorbs or rejects energy and a secondary stream that conversely rejects or absorbs the energy from the primary stream. This energy is seen in the form of temperature only (heat). In some ‘air to air’ examples, latent energy (temperature and moisture) can also be transferred. The amount of energy that is transferred by the heat exchanger is known as its ‘effectiveness’ or ‘efficiency’. If a heat exchanger were to be able to transfer the entire energy from one medium to another, it would be rated at 100% efficiency. Other important properties of heat exchanger performance include • Pressure Drop – the amount of energy lost in pushing the working fluid through the heat exchanger at a given velocity • Fluid Velocity – dictates the overall required size of the heat exchanger required for a given flow rate

Exhaust Air Outside Air

HVAC Supply Air Return Air

Figure 1 Complete Assembled Air-Air Heat Exchanger Figure 3 Cross Flow Heat Exchanger 3D (courtesy of http://www.sciencedirect.com)

2.1 Plate type A plate type heat exchanger comprises numerous air guiding passages which are separated by a ‘transfer media’ such as aluminium, plastic or cellulose. The orientation and direction of flow of adjacent air passages can be used to describe the type of plate heat exchanger. 2.1.1 Cross Flow Cross flow heat exchangers have their primary and secondary streams operating in a perpendicular orientation to each other. This provides a convenient means of attaching inlet and outlet connections to the heat exchanger; however it inhibits the overall efficiency. As primary air travels through the heat exchanger, it transfers with weaker secondary air that has already lost some of its energy.

2. Air-Air Heat Exchangers Each year, building owners spend thousands of dollars on heating and cooling the interior and outdoor air required for optimal indoor air quality. Much of that energy is wasted when it is exhausted from the building. By implementing heat recovery technology to capture the energy embodied in heated or cooled exhaust air, HVAC plant size and running costs can be significantly reduced. An air to air heat exchanger can be used to perform this function, of which there are various types.

2.1.2 Counter Flow A counter flow heat exchanger has the primary and secondary air streams directly opposing each other. This leads to a higher efficiency as primary air progressively transfers with ‘stronger’ secondary air that holds more of the energy of its initial state.

Figure 4 Counter Flow Heat Exchanger

Figure 2 Cross Flow Heat Exchanger 2D

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

2.1.3 Mixed Counter/ Flow A mixed counter/cross flow heat exchanger provides the high efficiency of a counter flow type with the ability of easily separating the inlet and outlet connections. The arrangement shown below is a ‘Z’ style heat exchanger, where the majority of transfer is counter flow with some cross flow regions at the inlet and outlets.

TOPICS OF INTEREST

Figure 5 ‘Z’ Flow Heat Exchanger 2D

Figure 7 Thermal Wheel Figure 6 ‘Z’ Flow Heat Exchanger 3D

2.1.4 Enthalpy and Sensible Only Air to air plate heat exchangers can also be divided into ‘sensible only’ or ‘enthalpy’ types. Sensible systems transfer temperature only. In an enthalpy system the heat exchanger is able to transfer moisture in addition to temperature. To achieve this, a cellulose transfer media is used (similar to paper) which allows moisture to pass through in the form of vapour. The enthalpy type heat exchanger can be particularly useful in hot humid climates. For drier climates and in heating applications, a sensible only heat exchanger is more advantageous. Utilising a transfer media of aluminium, steel or plastic, this heat exchanger will only transfer temperature. 2.2 Thermal Wheel A thermal wheel looks very different to the plate heat exchanger, yet its concept of transferring energy from one path to another remains the same. Primary air is directed into one section of the wheel through a solid ‘heat storage matrix’ which absorbs some of the energy. The wheel is continuously rotating and as the heat storage matrix travels to the opposing side, a secondary air stream passes through it and the energy in the storage matrix is then transferred into the secondary air stream. The thermal wheel can have high efficiencies comparable to a counter flow

plate heat exchanger; however some of this is lost in the power input required to rotate the wheel. As it is a moving component, the additional maintenance costs also need to be considered. 2.2.1 Enthalpy and Sensible Only An aluminium heat storage matrix will normally be used in sensible only transfer. The aluminium surface can be applied with a hygroscopic coating which will allows for adsorption and release of water vapour providing both sensible and latent transfer. 2.2.2 Desiccant The thermal wheel can also have a desiccant coating (typically silica gel) applied for the purpose of dehumidifying the air stream. Moisture in the primary air is absorbed into the desiccant, and then the secondary air stream is used to ‘regenerate’ the moisture filled desiccant. The secondary air needs to be at an elevated temperature, normally heated by a water or refrigerant coil.

3 Applications 3.1 Tempering Outside Air The majority of applications in a building HVAC system use air to air heat exchangers to pre cool or preheat outside air. The minimum amount of outside air required is dictated by AS1668 ventilation rates, however to improve indoor air quality designers often recommend higher amounts of outside air.

In addition, accreditation services such as GBCA Green Star and NABERS IEQ promote greater amounts of outside air. There are also special applications such as pools, gyms and laboratories, where high outside air change rates lead to the use of heat exchangers. The majority of heat exchangers are not sold on their own and instead are factory installed into a packaged air handling system with the required fans, electrics, controls, casing, and heating/ cooling mechanism. 3.2 Ventilation Only Units Ventilation only units comprise of the heat exchanger as well as supply and exhaust fan (primary and secondary) and are commonly known as ‘Energy Recovery Ventilators’ (ERV’s) or ‘Heat Recovery Ventilators (HRV’s). They are used to precondition the outside air before supplying into another air conditioning system. This can be achieved by using the energy recovery ventilator in series or parallel 3.2.1 Series Operation Tempered outside air from the ERV is supplied directly into a separate air conditioning system. This is more often used when low volumes of outside air are required. The ERV can handle all of the required outside air on a project, and then supply this into a larger AHU, which does the remainder of the cooling or heating.

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST

Figure 8 Ventilator in Series Operation

3.2.2 Parallel The ERV will supply pre-conditioned outside air directly into the space. This will then mix with the already conditioned internal air (handled by a separate system). This can sometimes be easier to install, particularly on retrofits. Care must be taken to ensure there is adequate air distribution to allow the outside air and indoor air to mix. This can be particularly important in high humidity climates, where humid outside air may be directed towards cold supply air grilles resulting in condensation.

3.2.4 DX Packaged Units The complete packaged solution is to have the heat exchanger coupled with a direct expansion heat pump system. In the schematic below, outside air enters the unit at A (35oC, 14.2g/kg). Simultaneously, the cool return air from the building enters at 1 (24oC, 9.2g/ kg) through a separate inlet. The return air will absorb up to 75% of heat and humidity from outside air. Thus, the outside air enters the refrigeration system at a much cooler and drier state B (26.8oC, 10.5g/kg) which later is cooled to a nominal temperature at C (130C).

xpin = moisture content of primary air before the heat exchanger (kg/kg) xpout = moisture content of primary air after the heat exchanger (kg/kg) xsin = moisture content of secondary air before the heat exchanger (kg/kg) The enthalpy transfer efficiency of a heat recovery unit can be expressed, in its simplest terms, as:

μh = enthalpy transfer efficiency hpin = enthalpy of primary air before the heat exchanger (kJ/kg) hpout = enthalpy of primary air after the heat exchanger (kJ/kg) hsin = enthalpy of secondary air before the heat exchanger (kJ/kg)

Figure 11 DX Packaged Unit with Heat Recovery

4.2 How to Calculate Total Heat Exchanger Capacity The sensible only heat exchanger capacity can be calculated from:

4. Helpful Calculations

Figure 9 Ventilator in Parallel Operation

3.2.3 Chilled Water Units This is a very common way of utilising the heat exchanger. Essentially chilled and/or hot water coils are installed into a ventilator system which will handle the supplementary cooling. Initially outside air passes through the heat exchanger, which cools and pre-conditions (summer) or preheats (winter) the air. The air then passes through inbuilt chilled and/or hot water coils and is further cooled to the required supply air temperature.

4.1 How to Calculate Heat Exchanger Efficiency The sensible transfer efficiency of a heat recovery unit can be expressed, in its simplest terms, as:

HXsensible = sensible capacity (w) tpin = temperature of primary air before the heat exchanger (DB) tpout = temperature of primary air after the heat exchanger (DB) Airflow = primary airflow rate (l/s)

μt = temperature transfer efficiency tpin = temperature of primary air before the heat exchanger (DB)

The latent heat exchanger capacity can be calculated from:

tpout = temperature of primary air after the heat exchanger (DB)

HXsensible = sensible capacity (w)

tsin= temperature secondary air before the heat exchanger (DB)

xpin = moisture of primary air before the heat exchanger (kg/kg)

The latent transfer efficiency of a heat recovery unit can be expressed, in its simplest terms, as:

xpout = moisture of primary air after the heat exchanger (kg/kg) Airflow = primary airflow rate (l/s) The enthalpy heat exchanger capacity can be calculated from:

Figure 10 Chilled Water Unit

μx = latent transfer efficiency

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

TOPICS OF INTEREST HXenthalpy = total capacity (W) hpin = temperature or primary air before the heat exchanger (kJ/kg) hpout = temperature or primary air after the heat exchanger (kJ/kg) Airflow = primary airflow rate (l/s) Further the enthalpy heat exchanger capacity should be the addition of the sensible plus latent portions.

5. Sizing a Total System with Heat Recovery

Sizing a system with heat recovery is not much different to the conventional process. The heat load just needs to be adjusted to take into account the heat exchanger energy saving. The flow chart opposite shows the general steps to sizing a system with heat recovery.

6. Which Heat Exchanger Type to Use? The below table provides a guide to the benefits of each heat exchanger. Heat Exchanger Type

Typical Transfer Media

Typical Efficiency

Typical Pressure Drop

Price

Relative Maintenance

Cross Flow Plate Sensible

Aluminium

60%

Low

Cross Flow Plate Enthalpy

Cellulose

60%

Low

Mixed Counter Flow Plate Sensible

Plastic Film

75%

Medium

Low

Mixed Counter Flow Plate Enthalpy

Cellulose

75%

Medium

Low

Thermal Wheel Sensible

Aluminium

80%

Medium

High

Thermal Wheel Enthalpy

Aluminium with hygroscopic coating

75%

Medium

High

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

THE AUSTRALIAN HOSPITAL ENGINEER I MARCH JUNE 2014 2014

PRODUCT NEWS

Product News Hurll Nu-Way Choosing dental & medical air compressors: think 10 years ahead and go oil free Of all compressor types, used in hospitals and dentistry, scroll compressors are the best choice meeting the toughest air quality requirements.

The capital cost of the compressor is ca. 15% of the total cost of the ownership, while electricity consumption makes up 75%. Thatâ&#x20AC;&#x2122;s why correct sizing and energy efficiency are of the highest importance. Hitachi scroll compressors are able to operate in multi-drive mode, automatically matching the air supply to the need of compressed air. As a result, a 15 kW unit, running at 50% capacity, will use 36% less energy compared to a load/unload style compressor.

H I Dental compressors must be oil free and water free, as the quality of air affects both the health of the patient and the quality/longevity of the dental work done. Choosing oil free compressors will guarantee oil free air, while desiccant compressed air dryers will lower the water content in the air to maximally decrease the probability of the bacterial growth.

Before investing in the equipment, think 10 years ahead and calculate energy costs and future maintenance costs of the equipment you consider. You may be surprised to discover that the cheaper options turn out to be not so affordable after all.

For advice on scroll compressors for medical and dental applications, contact Hurll Nu-Way Pty Ltd, Australian distributor of Hitachi air compressors, on 1300 556 380.

Hospital air systems should be versatile, and if needed, should be able to provide breathing air quality compressed air. Some compressors will include an integrated refrigerant dryer and/ or air receiver. While these packages have the advantage of offering a slightly smaller footprint, they limit the versatility and serviceability in comparison to stand alone units. Offering stand-alone dryers/ receivers gives the end-user the versatility to completely tailor the system to the requirements. In-built refrigerant dryers are often suitable for European conditions but may not be appropriate for Australian ambient temperatures or be able to offer the air-quality that a desiccant dryer system can.

Maintenance costs and downtime should also be considered. Scroll compressors require minimal maintenance. Hitachi scroll compressors require yearly filter replacement, with servicing and certain replacement parts every 4 to 8 years, depending on total operation hours. Servicing the dryer, located outside of the compressor, is also easier and quicker than servicing an in-built dryer. It also has the advantage of not having to take the compressor offline.

While oil-free compressors are prone to corrosion in comparison to lubricated compressors, the addition of pre-filters reduces any probability of rust. Certain models have added flexibility with multiple compressor heads, allowing the machine to continue operating with remaining heads in the event that one is taken offline. If the compressor is installed in the residential area or close to the customers, it should be quiet, and Hitachi, with noise levels comparable to whispers, is a great choice. When choosing the place to install the compressor, avoid humid areas with cold temperatures, like basement or boiler room, as it may affect the quality of the compressed air.

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THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

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PRODUCT NEWS

Product News Magellan Power The Magellan Power service includes preventative maintenance for the following Magellan products and batteries.

Magellan Power Steps up Service Effort

• Magellan Power MCRI and MCRII DC UPS systems.

Australian designer and manufacturer of AC and DC back-up power systems Magellan Power has boosted its team of Service Engineers, who work in-house – and on site.

• Magellan AC UPS system.

The new, larger team cover the repair and preventative maintenance of all Magellan Power products, including MCRII battery chargers, UPS and batteries.

•VRLA, Lithium and NiCad batteries.

• Inform UPS.

H I

Managing Director Masoud Abshar says the team is the biggest it has ever been.

“We now have an impressive number of experienced product electrical engineers, all trained in servicing Magellan power systems. In the past it was difficult to retain staff for Service because of the mining boom, but now that has slowed they can get to all of the other sectors who need them.”

We provide:

1. I n House Qualified and Certified Electrical Technicians, specialising in Magellan Power Products (from our manufacturing testing department).

2. F ull Service Report: Following a service, a full report is submitted to the customer, with details of repairs undertaken, recommendations of any action, and a quote for additional items if needed.

Service Procedure:

In addition to the team, Magellan has set a new service plan.

• Comprehensive visual and mechanical inspection.

The new service plan relates specifically to MCRI and MCR II battery chargers & associated equipment which are likely to be installed in hospitals all over Australia.

• Full battery health check including battery capacity test if feasible.

“It’s essential to have the correct servicing for your power equipment, and we believe many hospitals with our equipment will welcome the fact we now have a more available service department to cater to their needs,” he said.

For Service enquiries contact sales@magellan-power.com.au or (08) 9434 6621.

• Functional test.

ZETCO

ISO 9001 Certification Press Release

National energy and carbon management firm In March 2014 the quality management system of Zetco Valves was certified to ISO 9001:2008 as a demonstration of the commitment of the Management to further improve customer satisfaction and performance of business processes. The ISO 9001 standard is a world-class business growth framework adopted by more than one million organisations. The audit and certification was conducted SAI Global with the certificate displaying the following scope “The design, import, packaging and distribution of valves”. What distinguishes Zetco Valves from its competitors is its continued commitment to product innovation and the ISO certification of the design and development process is an additional enhancement of the respect for the customer’s quality expectations and regulatory requirements.”

Safe Work Awards

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Zetco Valves has been awarded the 2014 Award for the Best Workplace Health and Safety Practices in a Small Business by Safe Work Australia. Following from its success in the NSW awards, Zetco was nominated by WorkCover NSW for the National Awards.

Commenting on Zetco, the judges stated, “Demonstrating that business of all sizes can make a difference, Zetco took out the small business category for taking initiative to put in place technology solutions which larger organisations have failed to, achieving both safety and commercial benefits as result”.

Zetco is delighted to have its commitment to WHS recognised nationally. Since 2007, there has been a considerable focus on improving the health and safety of the working environment. This has not only delivered considerable gains in terms of reduced risk but there has also been substantial progress made in terms of worker comfort which has ultimately led to increased productivity.

For more information contact Zetco on 1300 659 639 or email info@zetco.com.au

THE AUSTRALIAN HOSPITAL ENGINEER I JUNE 2014

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G IE T a top Looking for N I E solution? IL C

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Delivering innovative valve solutions

Zetco’s T4 Top-Entry ball valve for medical gases has all the required features:

 Full bore entry design  Top allows service and maintenance of seals

Phone 1300 659 639 Email enquiries@zetco.com.au www.zetco.com.au

body is cleaned  Internal and ready for installation

 Sizes 15mm to 50mm 75