Mott MacDonald | Confidential | Antimicrobial Resistance Prevention Engineering and Facilities Management Perspective
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2 Operation Stage AMR Prevention Measures After the construction phase, the healthcare buildings will be occupied by the healthcare personnel to provide health services and by Facility Management personnel to provide Hard and Soft FM services. Typically a service agreement will be signed with the Facility Management (FM) Company. The counterpart of this agreement will vary depending on the Healthcare contracting model (PPP, Public, private). The service agreement will detail the scope of the work undertaken by the FM company. It is important to have adequate provisions in regard to Antimicrobial resistance in the service agreement as the FM Company staff would typically be involved from MEP equipment maintenance/ replacement to Soft FM services such cleaning, disinfection, waste, etc. The Service agreement should contain specific requirements or KPIs in regard to AMR or antibiotic stewardship. Environmental and Social Action Plans (ESAP) and Environmental Social Managements Systems (ESMS) might be available in some projects where such plan and systems is annexed to the Service Agreement. Provisions in regard to AMR could be introduced to the ESAP. It is also important to have an Infection Control Committee (ICC) established in the healthcare building to control and monitor the work, trainings and activities provided by the FM company staff and the Administration staff during the Operation phase. To minimise the risk of infection in the hospitals, it is acknowledged that there needs to be systems in place to manage and monitor the prevention and control of infection during the operation phase. These systems may use risk assessments which consider the susceptibility of service users as well as any risks that both their environment and other users may pose to them. It is recommended that the risk assessments, management and monitoring of the systems should be carried out by both the Healthcare personnel and by Facility management. Contractually, it is not usual to assign performance parameters to healthcare personnel such as doctors, nurses and administration personnel. However, performance parameters can be put on the facility management personnel to address AMR. The Table below shows some requirements that could be required from the Facility Management Service staff. Table 2: Recommendations (KPI) for Operations Phase No
Subject
KPI
1
Maintenance frequency of Ventilation system components.
Facility Management Company would be usually responsible to keep Air vents, grilles and other ventilation outlets unblocked and keep it free of dust, grit, soil, film, cobwebs, scuffs and any other marks. A schedule/frequency for cleaning or maintenance associated with the requirement should be introduced. This is typically carried out on a annual basis.
2
Maintenance frequency of HEPA filters.
24 January 2020
Filtration performance may affect Indoor Air Quality (IAQ) in several ways. Poorly maintained filters with inadequate seals and breaches in the filter media promote the passage of contaminants into occupied spaces. This seriously affects IAQ in critical areas where clean environments are needed. Severely occluded particulate filters increase the resistance of airflow through the filters, affecting air
