15 minute read
Deli’s Dryers Zap Germs
The CHI facility includes 42 patient exam rooms and treatment spaces, pharmacy with retail, diagnostic imaging, and a laboratory. Physical therapy is incorporated into the space and shares an outdoor plaza adjacent to the citywide walking/biking trail. Photo: Kurt Johnson Photography
ings. “The traditional [medical offi ce building] model is not obsolete. There are still some independent practices that continue to be independent. There is a higher degree, however, of spaces being designed for multiple practices for convenience, effi ciency of operation, and effective use of space. St. Anthony North Health Campus, which will open in Westminster, CO, in March 2015, is a good example. The 58,000-sq.-ft., integrated physician’s offi ce building is connected to a new 282,000-sq.-ft. hospital for full integration and alignment of outpatient services and physician practices with inpatient services and the existing facility. The ambulatory-focused environment supports Centura Health’s ability to deliver health services across the full continuum of need,” said Robinson.
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Drivers in today’s healthcare-delivery world include shifting demographics and markets, new regulations, and changing business models, but the bottom line for all scenarios is cost containment and lean design. Clearly, all of these factors will continue to influence medical office design and construction for the foreseeable future.
CBP
ˆ DATA CACHE
Want more information? The resources below are linked in our digital magazine at cbpmagazine.com/digital/janfeb2015.
View Mayo Clinic’s SPARC program to improve the patient experience. experience.
Explore medical offi ce building real-estate trends.
View trends in MOB development.
Information on medical offi ce buildings and the ACA.
Ken’s View
Is there a doctor in the box? If not, is there an app for that? Probably, but if this is the future of healthcare, I’m not sure I’m on board.
Now, doc-in-a-box isn’t an especially flattering term, at least not according to one online definition that says it’s a “deprecating sobriquet.” Webster’s isn’t saying one way or another, although that esteemed lexicon does assure us that “sobriquet” is neither a fruit-flavored dessert nor a variety of charcoal briquette. Look it up.
Search algorithms, however, serve up no such deprecation regarding doc-in-a-box, aside from the aforementioned definition, and instead reveal under that term a healthy number of on-demand, immediate-care clinics, usually located in established, national pharmacy chains. I have my reservations about that, too. Flu shots in aisle 10 and colonoscopies in aisle 9 just doesn’t seem like an agreeable idea.
One well-known chain is taking it a step further by rolling out a new “telehealth” app to give users access to doctors through a smartphone. So how does that work? If you have a sore throat, you say, “ahh,” and insert your smartphone in your mouth? And if you have hemorrhoids? Never mind, I don’t want to know.
Anyway, for better or worse, healthcare is becoming more consumer centric, although consumer centric may well turn out to be the oxymoron that frequently describes customer service. For example, do waiting rooms really need TV sets? Do they, in fact, distract patients? The assumption must be that healthcare consumers will really like hearing about the latest Ebola outbreak or especially love listening to the drug commercials that enumerate possible side effects—nausea, muscle cramps, suicidal thoughts, and maybe even death. (Hey, doc, can you write me a prescription for some of those? Why be merely sick when you can be suicidal, too?)
If one can ignore the side effects, the imagery of those commercials suggests the drugs will make those who ingest them live happy, ecstatic lives with days filled with sunlight, scenic vistas, butterflies, unicorns, over-the-top exhilaration, and perfect families. Really? I thought that’s what illegal hallucinogens were for.
And how about medical dress codes? Call me old fashioned, but what’s with everybody wearing scrubs when hanging out in the medical office? Scrubs were originally worn by operating-room personnel, designed to be simple, with minimal places for contaminants to hide, easy to launder, and cheap to replace. Outside the operating room, they either look like pajamas or like someone wants you to think he or she is a surgeon but isn’t. They give the illusion of being clean when, in fact, they can be as easily contaminated as other clothing.
One medical-office worker, assistant, technician, or whatever they’re called these days, recently was observed sporting scrubs decorated in what looked to be a paisley pattern, making the scrubs appear all the more like the aforementioned pajamas. A doctor, either attempting medical humor or showing off his high-school biology mastery, observed that her outfit appeared to be decorated with paramecium—rather to the assistant’s puzzled embarrassment, I think. Para what?
Another thing. Why are magazines in doctors’ waiting rooms always so cheesy and old? That was the question posed by a recent study and reported in a BMJ medical journal, whose editors apparently were in a jocose mood.
The reason: patients steal the interesting ones. Copies of Time and The Economist were more or less left behind, but the more “gossipy” titles disappeared. However, bear in mind, the study was done in a single New Zealand medical office and, as we all know, that country is said to have a large hobbit population, so the results were perhaps skewed. I don’t know if the findings would be similar in, say, New York or Los Angeles. More research is needed.
As an antidote to the paucity of compelling reading materials in waiting rooms, it has been suggested patients bring with them a book they have really, really been meaning to read and settle down to enjoy and savor it. That way, the receptionist will surely call them in seconds, or so the theory goes.
In some ways, waiting rooms with cheesy magazines are representative of, and even a warm and fuzzy connection to, the healthcare system to which we’ve become accustomed, a remnant to hold on to even as the medical landscape is beset by inevitable change. And change is the only thing of which we can be certain.
— Kenneth W. Betz, Senior Editor, CBP
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Zingerman’s Community of Businesses, a collection of food specialty businesses in Ann Arbor, MI, recently installed Livonia, MI-based American Dryer hand dryers at several of its facilities.
Deli’s Dryers Zap Germs
Cold Plasma Clean hand-dryer technology eliminates microbes and paper waste at Zingerman’s food specialty businesses.
Zingerman’s continues to expand from its modest deli and mail-order businesses to food, travel, and business-training enterprises.
By installing hand dryers with CPC technology, customers like Zingerman’s are not only drying their patrons’ hands, they are eliminating harmful microbes in the air. Sustainability and hygiene were two important factors in the decision to upgrade hand dryers.
Zingerman’s Community of Businesses, a collection of food specialty businesses in Ann Arbor, MI, that grew out of the original Zingerman’s Deli, is committed to sustainable building, energy efficiency, efficient water usage, and green practices. As part of that commitment, Zingerman’s recently installed Livonia, MI-based American Dryer hand dryers at three of its facilities. The dryers incorporate American Dryer’s Cold Plasma Clean (CPC) technology, which eliminates microbes while drying hands.
CPC’s environmental benefits align with Planet Zingerman’s, an initiative launched by the company in 2011, the company said. As part of the program, the company recently achieved LEED Gold status for the addition at the original Zingerman’s Delicatessen. The company’s growth plan, released in 2006, stated: “When we talk about great service we refer not only to our customers, our community, and each other, but also to our planet; we push ourselves to go beyond basic compliance on environmental issues.”
Managing partner Grace Singleton first encountered the American Dryer brand at a National Restaurant Association show in Chicago. Singleton compared several dryers and found the appearance, strength, flexibility, and warm air of American Dryer’s hand dryers to be the most compelling choice. “Another thing that excited me was that you could moderate the volume,” she said. “The dryers also look sanitary.”
The company’s initial decision to purchase and later upgrade American Dryer’s hand dryers was also influenced by Singleton’s extensive travel through Europe. “You don’t see paper towels in any restrooms. There are just hand dryers everywhere,” she said. “And so once you get used to that, you think, wow, why should we be dealing with paper products? They’re left on the floor. You have to clean them up. They definitely use more resources than hand dryers. Once you get immersed in that culture, it’s hard coming back and seeing all that paper.”
In addition to finding a local source, Singleton found an environmentally conscious partner in American Dryer. By installing hand dryers with CPC technology, customers such as Zingerman’s are not only drying their patrons’ hands, they are eliminating harmful microbes in the air and saving as much as 98% of paper-towel costs. The dryers provide a maintenance-free solution without filters, chemicals, or labor.
Sustainability and hygiene were two important factors in Zingerman’s decisions to purchase and upgrade its hand dryers. However, like all company decisions, they were made by committee after many other considerations. Those most impacted by any decision, including staff from the kitchens or front offices, are consulted and asked to share feedback. This contributes to a better overall decision and less regret, according to Singleton. “We find getting more people involved up front helps us get to a better solution,” she added.
In the spirit of ongoing improvement, Zingerman’s now has 14 hand dryers in three of its facilities, all using CPC technology. Cold plasma, or bipolar ionization, is nature’s way of cleaning the air. High levels of ionization are found throughout nature. The cold-plasma generator,
American Dryer, Livonia, MI, recently turned to two microbiology labs for independent testing of the Cold Plasma Clean (CPC) technology used in its ExtremeAir CPC hand dryers. EMSL Analytical Inc. (EMSL), Chicago, is a Centers for Disease Control certifi ed lab with American Industrial Hygiene Association accreditation in industrial hygiene and environmental microbiology. Antimicrobial Test Labs (ATL), Eagan, MN, is an EPA Good Laboratory Practices Standards-compliant laboratory audited by the Environmental Protection Agency and the U.S. Food and Drug Administration. Independent studies from EMSL and ATL have shown CPC’s effectiveness against E. coli, staph, C. diff, MRSA, and salmonella with kill rates as high as 99.6%. CPC technology has also been independently tested for safety by Underwriters Laboratories, Northbrook, IL, passing the UL867 and California Resource Board standards.
In addition to its hygiene benefi ts, American Dryer’s ExtremeAir CPC provides universal voltage and adjustable sound and speed. An adjustment dial inside the dryer's tamper-resistant enclosure is as easy to use as the sound dial on a car radio. There is no need for a technician or special tools. The adjustment dial allows adjustments for sound from 83 to 69 dB (the level of normal conversation) with corresponding air speeds of 19,000 to 10,000 linear ft./ min. The dryer’s universal-voltage feature confi gures itself to operate on any standard voltage from 100 to 240 V, 50 to 60 Hz, making installation easy and preventing wiring mistakes. Customer preferences for the precise balance between sound and speed tend to vary by setting. Facility management at sites such as hospitals and restaurants want to keep noise at a minimal level, while schools, factories, sports stadiums, and industrial settings prefer the highest speed setting.
DATA CACHE
Want more information? The resources below are linked in our digital magazine at cbpmagazine.com/digital/janfeb2015.
Circle 6 on the Reader Service Card.
Specify a hand dryer. Specify a hand dryer.
Calculate operating costs. Calculate operating costs.
Download a catalog.
View a green guide.
Compare hand-dryer models. available only inside select American Dryer ExtremeAir models, uses steady-state positive and negative discharge points to split water molecules in the air into oppositely charged hydrogen and oxygen ions. These ions then break down gases to harmless compounds commonly found in the atmosphere, according to a company spokesperson.
Cold-plasma technology has been successfully used to clean the air in schools, hospitals, and other commercial buildings since the 1930s. More recently, cold plasma has been used in the medical industry to treat
surgical incisions and break down harmful microbes in the food-processing industry.
Aside from incorporating HEPA filters, conventional hand dryers make a lot of noise and don’t eliminate microbes, making them less sanitary, according to Singleton. “We’re concerned about the spread of disease, and anything we can do to help ensure Zingerman’s has a sanitary environment is a really good thing,” she said, adding that employees are very happy with the dryers and their added benefit of improved hygiene. CBP
EDITORS’ CHOICE
Lead-free brass ball valves ProPEX lead-free brass ball valves for PEX-to-PEX connections are available in sizes from 1/2 in. to 2 in. and are listed to ASTM F1960, NSF 14/61, NSF 359, and the Uniform Plumbing Code. Valves have blow-out-proof stems and are available with stem extension kits to accommodate as much as 2 in. of insulation in insulated piping applications.
Uponor Inc., Apple Valley, MN Circle 87
Ver tical, packaged heat pump
RetroAire RQTH:
• Single-package vertical heat pump • Drop-in replacement for Carrier 50QT • Applications include apartments, hotels, dorms
RetroAire RQTH single-package vertical heat pump provides cooling and heating to multiple rooms. A drop-in replacement for the Carrier 50QT discontinued in the late 1980s, the unit is installed in a closet which allows ducting to adjacent rooms. Controls, power, and drain connections are in the same general area as the 50QT. e unit has externally mounted louvers for balcony applications and internally mounted louvers for applications where external unit access is not feasible. Panel-mounted refrigerant service ports are on the indoor side. Applications include condominiums, apartments, dormitories, and hotels/motels.
ECR International Inc., Utica, NY Circle 86
Gas unit heaters Expanse gas unit heaters use a tubular heat exchanger, said to be more reliable and effi cient than older clamshell-style heaters. The tubular design reportedly provides uniform, maximized heat transfer for increased effi ciency and has a low-pressure drop, enabling heated air to be evenly distributed. The design is said to provide operating effi ciencies to 82% for duct furnaces and to 83% for unit heaters.
Trane, Davidson, NC Circle 88
Sensor faucet system Z6950 Aqua-Fit faucet system retrofi ts a new spout onto an existing electronic base. A concealed sensor lens and aerators prevent damage from vandalism or cleaning chemicals. System electronics are located in-line with the spout shank below deck. The system is available with low-fl ow outlets to 0.35 gal./min. and an adjustable time-out activation.
Zurn Industries, Erie, PA Circle 89
Rooftop units York Prestige rooftop units are said to match the footprints of other manufacturers’ units. The design reportedly reduces installation complexities and saves time by eliminating the need for a curb adapter. The 3- to 12 1/2-ton units use microprocessor-control technology with an LCD display, and have a programmable USB interface and digital diagnostic readouts. Units available include 13 SEER, 15 SEER, and 11.5 to 12.2 EER.
Johnson Controls, Milwaukee Circle 90
FEMA-compliant louver AFG501 louver is a 5 1/2-in.-deep, severe-duty aluminum louver that protects exterior wall penetrations on FEMA 361- or 320-compliant storm shelters or safe rooms. Inverted V-style blades provide a high free area, resistance to water penetration, and low airflow resistance, while providing protection against extremely high wind loads and wind-borne debris. Louvers can be specified with a variety of options in a wide range of finishes.
Airolite, Schofield, WI Circle 91
Vertical two-stage geothermal system YT multi-positional, vertical packaged geothermal system has an all-aluminum microchannel air coil, and is said to provide improved heat transfer, higher efficiencies, and less weight compared to traditional copper/aluminum tube-and-fin coils. Elastomeric compressor isolation pads separate the Copeland UltraTech two-stage scroll compressor from the unit. The pads isolate and dissipate vibration at one source. High-density, closed-cell foam insulation is used throughout the unit. Digital controls mount on the top or side of the unit.
Enertech Global, Greenville, IL Circle 92
Undermount basins HS-series Terreon solid-surface undermount basins are ADA compliant and have a flat-bottom design. Basins can be specified either as a seamless, prefabricated Omnideck lavatory system or basin only with solid-surface countertops for field fabrication. Basin shapes include rectangular, square, and oval in 32 colors.
Bradley Corp., Menomonee Falls, WI Circle 93
Custom bases Custom bases for rooftop equipment mounting have all-welded construction and are shipped in one piece, if possible. Options include a built-in roof pitch, extra height for installation of sound traps beneath the unit, and a pressure-treated wood nailer.
