Building Healthy Hospitals

By Susan Casey | May 15, 2006
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An integrated building systems (IBS) approach combines different systems—electrical; security and camera systems; audio/video; heating, ventilating and air conditioning (HVAC); and lighting—over the same networked system. In an IBS format, each system is interdependent; they function together in supplying and gathering information and distributing power. It differs from the traditional approach, because integrated systems do not have dedicated wiring for each device or function.

“It’s more about the environment than the technology. It’s the same technology as you would use anywhere else but you usually don’t have all those systems packed together in such a tight spot,” said Matt Doell, vice president and division manager, Sachs Systems, a division of Sachs Electric, St. Louis. “In hospitals, there are lots more sources of data—telemetry from a patient’s vital sign monitoring or hospital patient information or cell phones for nurse call systems—more systems than you would usually find in a normal office environment.”

For electrical contractors (ECs), it is a growing area.

“A lot of our NECA contractors are being dragged into this area, kicking and screaming,” said Terry Coleman, director of telecommunications training, National Joint Apprenticeship and Training Committee (NJATC). “But technology is changing. Customers are noticing the new products. They want them installed and, since they are used to the relationship with their contractors, they look to them to do the job.”

Those who do so are benefiting.

“Everybody’s so worried about integrated systems,” said Bob Riel, vice president and division manager, Dynalectric, San Diego, Calif. “Other electrical contractors don’t understand them. While it does take some commitment to get into it, it’s not as hard as what everybody thinks it is ... the benefits far outweigh the disadvantages. We just kill competition that can’t provide the same services as we do.

“Being able to do integrated systems also allows us to up-sell other systems, including electrical, as well,” Riel continued. “There are a lot of advantages to getting into it. The industry is definitely going this way. We started a division for it in our company in 1998 and it’s now 40 percent of the total gross revenue of our firm, but returns about 60 percent of the profit.”

Some contractors have formed divisions to handle installation of integrated systems and some are focusing their IBS business on healthcare applications. One of those contractors is Sachs Electric, who combines the skills of both its electrical and its low-voltage group, Sachs Systems, in the installation of IBS. This company has a list of IBS healthcare projects including St. John’s Heart Hospital, St. Luke’s Hospital and Barnes Jewish Children’s Hospital System facilities, according to Rob Moeller, healthcare business unit manager of Sachs Electric.

“In the last two years, facility managers and engineering firms have become more interested in integrated systems,” Moeller said. “If a healthcare facility started the design process two years ago or longer, normally a plan for an integrated building system [that] was not included. We are now seeing it included in the design activity. There is now more prevalence within the specifications and scope of work describing the requirements of the integrated business-to-business systems. It’s still leading edge, though.”

The required functionality in a healthcare facility is particular to that type of facility. Handheld devices with various uses are prevalent. Doctors and nurses use them to send paperless prescriptions directly to a pharmacy, to get access to information from a patient’s chart, and to remotely monitor a patient’s vital signs. If a machine monitoring a patient’s condition notes a situation that needs attention, an alarm is sent to a handheld device, alerting the health professional. That person can either visit the patient or dispatch someone to the patient’s room.

“What we do is install a backbone distribution of cabling throughout the facility,” Moeller said. “It runs to a receiver or wireless repeater system that can communicate with a handheld device. It allows professionals to use their handheld devices to wirelessly access information from the hospital’s computer system, for example, chart data. It also allows people who are visiting friends or family within the hospital to be able to use their wireless phones or devices. You have some cell phone companies that are paying for the installation of the systems so that their devices will operate in the settings.”

Safe and secure

Patients and their families expect their hospitals to have state-of-the-art security systems, ensuring that they will be protected while undergoing a medical procedure or treatment. Many hospitals have a system called HUGS Infant Security System, essentially a wireless monitoring system, to protect infants and children in family health units. It involves FCC-approved advanced radio frequency technology that will not affect or be affected by other hospital equipment.

How does this system work? A baby or parent is outfitted with some type of identifier tag—be it a wristband or a lanyard worn around the neck. If that person leaves the floor, security is alerted. With the older systems, alerts were usually confined to a single floor and were usually filtered through a middleman—e.g., a nurse or other healthcare provider.

A warning was issued, for example, if someone got in an elevator with a child, triggering a nurse to dispatch security personnel. With the IBS implementation, the HUGS Infant Security System ties into a central security monitoring system. In the case of a security violation, the signal dispatches automatically to the central system, immediately alerting a guard while floor personnel—nurses and others—also get a warning signal.

Designed, implemented and integrated

Electrical contractors bring knowledge of IBS to healthcare projects—to a team of integrators and designers. The ECs work alongside other professionals, including systems designers, manufacturer personnel of a specific data system or professionals from cell phone companies, who have knowledge and ability in wireless technology.

“They’re at the forefront,” Doell said. “There are systems designers out there that are testing new systems in hospitals and our position in the new technology is that of an installer. We certainly can go out with a Gauss meter and measure electrical field strength, but generally the systems designers are the ones in charge of mitigating interference issues and making systems that integrate better for those environments. In hospitals, ceilings are studded with all kinds of different antennas. Even 10 years ago, that wasn’t true. There weren’t so many wireless systems. It’s become complex for a couple of reasons.

“First, there’s only so much ceiling room and, when a hospital is operating, taking the ceiling apart in order to put in yet another cable and yet another antenna becomes a logistical problem. With so many different frequencies operating at the same time, the fear is that they’ll start interfering with one another. So we work to integrate these systems. We don’t integrate all of them—but use common antennas and common cabling systems,” Doell said. “We were doing a job in St. Louis and we used a lossy cable—a cable that intentionally leaks signals down the length of a cable instead of an antenna. Thereby, anywhere that the cables ran, those close to the cable would be able to pick up the signal. That results in fewer antennas sticking down through the ceiling in the hallways. We try to standardize the radio frequency distribution system so we don’t have so many different kinds of frequencies both from a physical, logistical and from a frequency-interference standpoint.”

In the next few years, many hospitals will want to upgrade and integrate their systems. The projects will present opportunities coupled with particular challenges for the electrical contractor. Besides the challenge of dealing with a large variety of systems, contractors also have to consider the regulations that apply to hospitals in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

“Hospitals have to be careful about the data that is transmitted and you have to take steps to safeguard that data,” Doell said.

Another concern is the care called for in retrofitting.

“You can retrofit,” Moeller said. “It’s just very difficult in an functional facility because you have to physically run raceway behind the walls but, in order to install the cable, you have to do a lot of barricading to protect the integrity of patients and your workers due to the prevalence of infectious disease.”

Getting trained and ready

Installing IBS involves some new skills for workers, so they must be properly trained to tackle the unique needs in IBS projects.

“If you’re just starting out, training your personnel can be costly,” Riel said. “We use the low-voltage apprenticeship as the basis of our training but other training is our responsibility. We send our technicians to regular manufacturers’ training every year. My best advice to contractors is that they start by hiring people who are leaders in the field. When we started, we hired some of the best telecommunications/data and security people in the business—people who knew the systems we wanted to sell.”

NJATC is also aware of the situation.

“We’re completely revising the installer technician apprenticeship program,” Coleman said. “An idea was hatched through the IBEW [International Brotherhood of Electrical Workers], NECA and NJATC to do VDV [voice/data/video] cross training in areas where there was no apprenticeship program, to take journeyman wireman electricians and train them in all the specific systems from the installer technician apprenticeship program.”

According to Coleman, the new approach differs from the three-ring binder concept—the NJATC now has individual workbooks for individual systems. A contractor who knows that he will be bidding a specific system can get his work force ready without having to invest in a full apprenticeship program. He can pull that lesson content and workbook information from NJATC and do targeted training.

“Any electrician with the proper mindset and training can do this work,” Coleman said.

Apprentices and journeymen, however, will ordinarily not be tackling the task of system integration, or tying all of these individual systems together to create an interoperable or integrated building system.

“That requires knowledge, not only of each individual system and hardware that is involved, but also of what is common between all of the systems and which parts need to communicate together to perform the desired functions or collect the required data,” Coleman said. “Educating a systems integrator usually falls on the shoulders of the contractor or facility owner. Any firm only needs one or two trained individuals who usually have experience in a variety of systems and [has] done product-specific training and manufacturer-specific training. They read manuals and specifications, and spend time talking to designers, engineers and manufacturers to stay current.”

Educating one’s work force and focusing company efforts is what’s needed to garner opportunities for installation of IBS in healthcare settings. It is a growing opportunity and a potentially lucrative one for interested electrical contractors.     EC

CASEY, author of "Kids Inventing! A Handbook for Young Inventors" and "Women Invent! Two Centuries of Discoveries that have Changed Our World," can be reached at [email protected] or





About The Author

CASEY, author of “Women Heroes of the American Revolution,” “Kids Inventing!” and “Women Invent!” can be reached at [email protected] and





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