New Central Sterilization Services Facility
One of the least know, but most critical, functions of a healthcare system is the Central Sterilization Services (CSS) department. This department, it’s processes and it’s functions have a direct impact on patient care and safety. IMEG had the opportunity to be a part of the University of Iowa Hospital & Clinics (UIHC) Central Sterilization project as the Prime Consultant.
IMEG’s services began with a design team (engineer, architect, CSS consultant, logistics consultant) comprehensive study of the existing CSS site conditions, workflow, tray volumes and annual procedures. This phase included IMEG site investigation to fully understand existing MEPT infrastructure, constraints and challenges. Using this information, the design team developed two options for the Owner to consider a) Evaluation of an on-site renovation solution, and b) Evaluation of an off-site solution. Renovation of the existing CSS presented several challenges including extensive phasing, significant disruption, failing infrastructure, limited floor-to-ceiling structure, and a limited footprint that did not allow for efficient process workflow. Based on the study results and options presented, UIHC pursued a new greenfield, off-site facility.
In addition to avoiding issues associated with renovation, a centralized off-site facility provided flexibility to serve the main campus and several satellite campuses. IMEG’s Medical Equipment (MEQ) Planners worked closely with the CSS Consultant to eliminate Ethelyn Oxide (ETO) sterilization equipment and coordinate medical equipment requirements, capacities and specifications. This collaborative effort allowed a MEQ pre-purchase package to be issued to reduce lead times, reduce cost, consolidate construction schedule, and identify site-specific equipment MEPT requirements. Design of a greenfield facility allowed IMEG’s structural services to work closely with the architect and CSS Consultant to strategically place columns within the decontamination area to coordinate with workstation locations and process workflow.
One of the biggest challenges associated with the proposed site was poor domestic water quality. Given the facilities significant water consumption and stringent water quality requirements, a complex water treatment system was required that included an iron filtration system, water softening system and an underground brink storage tank. The facility design also contains an advanced pure water system including redundant reverse osmosis (RO) systems with a side-stream deionized (DI) side stream system.
With the exception of chilled water and steam service from a campus central plant, the building contains a complete MEPT design similar to a traditional stand-alone facility. A local generator was provided and sized to handle critical loads during a power outage. The building design includes provisions for redundancy including two steam services, two fiber services, emergency chiller connection, emergency steam boiler connection and emergency (trailer mounted) generator connection. The HVAC system was designed with sub-cooling capability to achieve ranges defined in AAMI Standards and ASHRAE-170; this allows each of the process space to achieve lower temperatures while maintaining acceptable humidity levels.
The collaborative approach by UIHC staff, design team and IMEG led to a future-proofed, state-of-the-art facility with MEPT infrastructure sized for additional equipment and expansion. Owner and user preferences were fundamental to the design of all system and infrastructure throughout the design process. The new space included special attention
to finishes and healthcare lighting, resulting in a work atmosphere promoting a positive and productive environment that will contribute to employee retention and reduced attrition.