Our Hospital is in the process of design for building a new hospital. We were asked our requirements etc. and came up with size, equipment, locality and they came back with the idea of "satellite workshops" close to the areas of use. Does anyone work in this type of design and is it a good idea rather than a central workshop doing everything?

Hi Len, we are doing a major rebuild here at Coffs Harbour and have included a small workshop on the edge of the new theatre area and were also offered one in ICU which we decided we did not need.
I think satellite workshops are a good idea as it saves having to move things like anaesthetic machines over long distances and in our case, in and out of lifts.

Dave

First off, Len, I would say it depends on the size of the hospital (and therefore, hopefully, the number of biomed techs involved). As a "Rule of Thumb" I would suggest that it is probably not worth considering for less than a 100-bed hospital.

In one of my "previous lives" I was involved with Hospital Design Teams (aka keeping architects restrained within the bounds of reality), and - based on my own experiences of supporting equipment in-house at a number of 350-plus and 500-bedded hospitals - I always used to include a sub-workshop within the "clean zone" of the main theatres. Upon visiting one such site a year or so after completion, I was even thanked by the biomeds for my foresight (...a very rare event)!

My insistence was based upon the success I had some years earlier in keeping one of my guys in theatre greens (other colours may be, and indeed are, available). This was Good News as it meant that, not only was biomed assistance readily to hand in case of any "emergencies" (flapping) that occurred up in theatres (thereby saving me the pain of getting changed into theatre garb a couple of times each day myself), but servicing of all the theatre kit was done quietly (usually during the evenings) without having to drag it through the hospital and down to the basement where our main workshop was hidden away.

So I would say "yes" (and agree with Dave) - theatres are the prime candidate for a sub-workshop - plus a permanently assigned biomed tech (who could be on a roster system if no willing volunteer* can be found).

By the way, in well-designed hospitals the clean side of CSSD (TSSU, Sterilization ... whatever) should be adjacent to the main theatres - so "our guy" can also take take of kit in there as well.

In a large hospital, ICU may be another candidate - but probably not always manned; but there is often a "spare side room" available in such locations, anyway (such as where the blood-gas analyzer used to sit - a place where I must have spent hundreds of happy hours over the years). I have also seen "small workshops" tucked away (hidden?) in large Maternity Units and (or) Neonatal Units; but these were really small store rooms (not much larger than cupboards) where parts and a couple of special items of test kit were kept.

Off-site Mental Health Units (of the "secure" type) may be yet another possibility - for reasons of "security" mainly - of both tools and test equipment, as well as biomed staf. Dialysis units - especially if detached from the main hospital - could also be considered for a sub-workshop. Anywhere off-site really, where a biomed might have to spend relatively long periods on a regular basis - especially if special clothing is involved. Plus, of course, at any off-site - or remote - Clinic(s) or Outstation(s) that you may be responsible for; a small workshop (store room, broom cupboard) under your control (lock and key) can save you having to cart so much kit (tools, test equipment, spares, manuals) about in your vehicle. It can also serve as a place of respite ("safe space" in current UK terminology) where you can "take a breather" (and maybe even a cup of tea).

Another one I have used with success (at a large hospital) was attached to the clinical laboratory complex. It was a good place to store the special parts needed there, and also provided an "office" where visiting servicing engineers could "report" and base themselves (kettle essential) rather than having to go off and find the main biomed workshop. Luckily that site was large enough (and I had enough good blokes) to post a tech there permanently; he was yet another lucky guy, working on interesting kit. And don't forget that "Lab" is generally the largest department in the hospital (kit-wise, at least).

Finally, if you are a service contractor - and I'm assuming that you're not, Len - rather than in-house staff, be sure to include a clause when negotiating your contract that you shall have (sole) access to a suitable room somewhere handy at each location you are to be responsible for. This might seem seem like a small point (especially at a time when you're keen to get things agreed regardless), but you'll be glad later that you did (based on my own experiences, not all of which were good). But there again, as a contractor, you would also be well aware that duplicate test kit and what-have-you costs money! However, in [a country in West Africa] we justified such expenses by weighing them against the (very real) possibility of having our shiny kit "lifted" when on the road.

Lastly, if you are involved in a New Hospital Project that you shall also have to maintain after it is commissioned - make sure you get hold of a master key (one that fits every door in the building(s)). Then you can "claim" any spare room that takes your fancy once the hospital opens!

* It was a job that I used to relish, myself. If nothing else it gets you away from the "hospital politics" can can often develop in (main) biomed workshops.

Useful information Geoff.

Have you come across (or tried) the satellite workshop idea in your travels, Angus?

In Saudi, we had a biomed permanently based in the OR working from a satellite workshop. It proved to be well worth it as he was able to oversee the performance of the kit and rectify any problems before they became a significant issue. Also, from a PR view, it proved to be a winner as the theatre staff were happy that we dedicated resources to then and could respond to any problems immediately. I would always advocate for the provision of such satellite workshops within a new or existing facility.

Yes; that's a good point about PR.

I notice you have changed location, Angus. Good luck with that.

I think a satellite workshop in Theatres/ITU is a good idea, but not sure having someone permanently based there is a good idea, unless it is a massive theatre complex.

... or unless the guy is free to wander around the site in theatre greens (blues, or whatever) - albeit usually covered by a white coat - as I have sometimes seen.

Yes Geoff, I have often seen theatre greens being worn outside theatres. Not sure what the point is of changing into them, if they are going to be worn anywhere??

I have always put it down to "Do As I Say, Not As I Do" syndrome.

It's probably not so bad as long as they change footwear.

Mind you, in some places I have been (overseas), the biomeds have been the most prolific "offenders" (mea culpa).

But the nice thing about wearing theatre clothes all day (week) is that you can simply bung them into the hospital laundry and draw out a fresh set. You know it makes sense.

An added plus:- no ties in the theatres.

Very close to SDU for standardised decon prior to engineering actions. One pathway for all instrumentation and equipment. In Use->SDU->EBME->Use

When presented with the luxury of designing a new hospital (see Len's opening post) it's probably best to begin by blocking out sensible (rational, logical) clusters of functional departments:- Sterile Supplies adjacent to Theatres, ICU next to Theatres, NICU near to L&D, Radiology and CT next to A&E, Physio near to OPD etc., etc.

"Engineering" is often stuck out in a Services Building* - near to the generators and so forth. That is OK, but (as already mentioned) Biomed Services should be nearer to the users (that is, in the main clinical building), with satellite workshops scattered here and there as previously discussed.

I know that architects (especially) are usually in a hurry to develop their latest "beautiful creation", but they often need to be "managed" (restrained), and reminded by more down-to-earth (and to them, lesser) beings that we are essentially designing a place of work, rather than an art gallery.

By the way, when I say "adjacent", don't forget there may be various ways of achieving such "connectivity" - adjoining departments, corridors, and elevators (lifts) to name just a few ... as well as pneumatic tube systems (which seem to have made a bit of a comeback in recent years).

"Distribution" of supplies, patients' meals and what-have-you is another area that should be thought about early on (rather than literally being an after-thought); there are options there as well (does anyone else remember the subterranean roads with electric stores trains running around the basement at Northwick Park?).

Lastly, even at an early stage, don't forget compartmentalization of departments vis-à-vis fire protection (and regulations) - something else best incorporated into the overall design right from the start.

See also this ancient thread (some of the links no longer work, unfortunately).

* Also a good place to hide the Laundry, by the way.