Hospital pharmacy modernization projects are some of the most difficult and complicated for healthcare providers due to extensive regulations, infrastructure constraints, and inevitable hiccups. On previous projects, we’ve encountered everything from changed code requirements that changed midway through the project, to mechanical, electrical, and plumbing (MEP) systems that unexpectedly needed to be replaced.
Upgrading a pharmacy to achieve USP 797-800 compliance requires flexibility while maintaining the highest level of quality. The safety of hospital staff and patients is at stake and there is no room for error. The approach to pharmacy design needs to focus on effectively dealing with a variety of different problems that may arise during the process.
Here are five ways to get it right:
Give regulators heads up early
It is not enough to get the names of the authorities that regulate pharmacy upgrades in your state. You also need to understand their specific strategies for approving these projects in order to anticipate and avert conflict. Are the supervisory authorities overwhelmed by staff shortages? Do you have a new management that is now enforcing a stricter approach on key points?
Your team should include project approval process veterans who can tell you what they saw. For example, in California, pharmacies must be approved by the Office of Statewide Health Planning and Development (OSHPD), soon to be renamed the Department of Health Care Access and Information (HCAI), which oversees the construction of the health system. They must also be licensed by the California Department of Public Health (CDPH) and the state’s Board of Pharmacy.
In order for the customer to fully understand the implications of the code requirements, it is important to have a code compliance log that is updated at each design phase. This type of documentation is particularly useful when regulations are expected to be updated or changed while working on a project. Another way to avoid problems is to create room data sheets (one sheet per room) that will capture all of the design requirements for each room being remodeled. After completion, the spatial data “book” can also be used as a valuable reference work to explain everything about the project, such as:
Many design firms may not care about this level of detail. We found that including the spatial data sheets in our OSHPD preliminary reviews helps give them a fuller understanding of how the project was put together and the scope of the incremental work that will take place about a year later.
Examine the existing infrastructure and make difficult calls
With any pharmacy upgrade, it is important to be pragmatic and realistic about whether the existing MEP systems can be retained. This is especially true for older hospitals where old file drawings may not reflect current conditions.
To address this situation, we believe the best strategy is to start with a comprehensive condition assessment of the facility and a feasibility study. Don’t be surprised if this process takes 5-8 weeks, but it will be time well spent. The goal is to identify and resolve any unforeseen conditions that can affect the project’s budget.
It is common to find systems that are old or improperly repaired or replaced. Be ready to have difficult conversations about systems that have expired and that need to be removed and replaced. Then you can plan the necessary changes right away instead of redesigning everything after discovering a problem.
Consider alternatives to temporary pharmacies
With many modernizations, hospitals build temporary pharmacies that can last for six months to a year. Hospital administrations recognize that this can be a complicated, labor-intensive and expensive process; The same rules apply to temporary and permanent pharmacies. But alternatives can allow you to keep your existing pharmacy staff and equipment until the new facility is ready to move into. An important consideration is determining which departments do not need to be housed in the hospital where space is scarce. Can they be moved to an off-site location instead?
For example, if you could move the administration to a different location, e.g. B. in an office building on campus or down the street, you can recapture this space for the permanent pharmacy. Administrative areas are much cheaper to move. You could even put them on a trailer outside until a permanent home is found. These strategies can shorten the duration of the project and be less disruptive to pharmacy staff.
Prepare for new technological demands
An upgraded pharmacy may not immediately need an additional data port or space for wiring, but the future may look different. New devices may be added that need to be accommodated. Will you have the option to add bandwidth? Will you be able to offer enough connectivity? Always keep these questions in mind and allow as much flexibility as possible for the future.
One approach is to plan additional expansion areas within the IT rooms in order to cope with more capacity downstream. This kind of thinking ahead goes beyond an extra socket here or there. Think about what you will need for the entire space in 5-10 years and even beyond.
Facilitate the way for future renovations
In the course of construction, things often change. As we’ve seen in our pharmacy projects, a mixing room can be removed or a refrigerator can be added. You need to imagine how things will change and when a renovation will be needed. We need to act now to make this process as smooth as possible.
The best strategy is to fully document the construction process, especially changes to the original plans. By creating a BIM model, we can provide digital documentation for every archivable asset. Taking full advantage of the model allows builders not only to simplify the build sequence, but also to export a project inventory that lists all installed doors, fixings and sockets that may require maintenance.
Photo: LPA Design Studios