Renovation in Hospitals: Pressurization Strategies by Healthcare Contractors in the United States

Abstract

Objective: The objective of the study was to identify current practices utilized by contractors in healthcare renovation projects. Background: Renovation in healthcare facilities comprises nearly half of all healthcare construction. Since a complete shutdown of the healthcare facility during renovation is typically not feasible, efforts must be taken to isolate ongoing functions of the hospital from activities in the construction zone. There are numerous documented cases of morbidity and mortality related to construction activities in the hospital. Hence, guidelines recommend negative pressurization of the construction zone to prevent the migration of dust and potential pathogenic agents into the functioning zone. Method: To accomplish the paper objective, a questionnaire was developed to address pressurization strategies, the use of backup systems and anterooms, and workforce training for healthcare projects. One hundred twenty-nine project managers and superintendents from top healthcare construction companies in the United States participated in the study. Results: Results show that owners influence pressurization strategy, but contractors typically assume a primary role in establishing pressurization levels, monitoring conformance, and training construction personnel. However, without solid evidence of effectiveness, pressurization levels often vary from Center for Disease Control standards. Conclusion: Further research is needed to establish evidence-based practices and to develop training modules for construction crews to support these best practices. Promoting evidence-based training can improve patient safety and minimize adverse patient outcomes.