Presented by Anto Thilak, Senior Mechanical Engineer-ASTAD Jamil Qassim, Senior Electrical Engineer – ASTAD Haitham Al Dali, Construction Manager ASTAD Seenu S Pillai,Senior Mechanical Engineer – ASTAD
3rd HVAC Contracting Conference “Evolution
of HVAC Industry” Intercontinental Hotel
Doha - The City Monday, November 26, 2018
PANEL DISCUSSION 12PM to 1 PM
Topic:
HEALTHCARE FACILITY – Knowledge Sharing
Anto Thilak Mariyados BE, MBA, CHFM, LEED AP, HFDP, PMP,
MGPS AP
Senior Mechanical Engineer – ASTAD
Jamil Qassim –
BSEE | MBA | PMP| LEED GA| CHFM |
MGPS AP,
Senior Electrical Engineer – ASTAD
Haitham Al Dali M.E. | CCNA| MGPS AP | MME Grade A |
Member- Jordanian Engineers Association
Senior Mechanical Engineer – ASTAD
Seenu S Pillai B.E. | LEED AP BD + C| CPMP (Ashrae) |
MGPS AP
Senior Mechanical Engineer - ASTAD
Daniel Dmitri Sverdlov Canadian Professional Engineer, LEED AP BD + C
Senior Mechanical Engineer – ASTAD
Haitham Al Dali
is currently working for ASTAD as a Construction
Manager for HMC project.
has more than 28 years of experience in total in the MEP
field, out of which MEP manager for 10 years in
healthcare facilities projects.
is responsible for Projects and Construction
Management of all aspects of design, construction and
coordination of multidisciplinary systems and teams.
is an Authorized Person for comprehensive management
of Medical Gas Pipeline System (MGPS AP) in line with
Heath Technical Memorandum (HTM 02-01)
Anto Thilak Mariyados
IS a Mechanical Engineer, an MBA, LEED AP -Leadership in
energy and environmental design ,and MGPS AP- Authorized Person
of Medical Gas Pipeline System in line HTM 02-01.
IS an ASHRAE Certified Healthcare Facility Design
Professional (HFDP) and American Hospital Association
Certified Healthcare Facility Manager (CHFM) with
extensive experience in design supervision, construction
management and delivery of healthcare projects
HAS an overall 20 plus years of exposure and experience in
various types of projects ranging from healthcare, pharmaceuticals,
commercial, residential, educational, mixed use development and
district cooling plants,
Jamil Qassim –
is a Professional Certified Healthcare Facility Manager (CHFM) by
American Society for Healthcare Engineers. US.A.
had completed his Under Graduation from the University of Oklahoma
with a Bachelors of Science in Electrical Engineering and Master of
Business administration from University of Garland, U.S.A.
has 17 years of experience in various types of projects including,
mixed use development, residential, commercial, stadium with a focus in
Healthcare development and construction management.
is a certified PMP and a LEED GA Certified & an Authorized Person for
comprehensive management of Medical Gas Pipeline System (MGPS
AP) in line with HTM 02-01.
is currently working for ASTAD as a Senior Mechanical
Engineer.
has worked in the Gulf for 24 years with the last 14 years
in Qatar.
is an Accredited Green Building Professional and has a
passion towards sustainability. He has held various
technical workshops and seminars on Green building
Practices in Qatar and UAE.
is an Authorized Person for comprehensive management
of Medical Gas Pipeline System (MGPS AP) in line with
Heath Technical Memorandum (HTM 02-01)
Seenu S Pillai
Daniel Dmitri Sverdlov
Was a Lead Plumbing and Fire Protection Engineer working for the
KEEN Green Consultancy in Canada that had the largest number of
LEED APs (160 people out of total of 250 people) in North America
working for one company.
He delivered the first LEED Platinum Residential building in Calgary.
And also developed a concept and design all of the plumbing systems for
the Water Center in Calgary, which was the first office building in Alberta
to receive LEED Gold Certification.
holds the following Certifications and Accreditations:
Canadian Professional Engineer; Certified Plumbing Designer (USA);
LEED AP and LEED AP BD+C;Certified Project Management Associate
(UK).
IS a member of ASHRAE, ASPE and APEGA.
Contents
1. Overview of HVAC and MEP in Health Facility
2. Evolving ASHRAE Standard 170 for Health Facility
3. Cherry picking from different codes is a concern – Examples
4. Ventilation for isolation rooms
5. Black Building Test / IPS
6. Open discussion
Overview of HVAC and MEP in Healthcare Facility
Overview of HVAC and MEP in Health facility Reducing hospital-acquired infections (HAIs; also called nosocomial infections) has become a focus of the health care industry
Air
Water
Contact
As per information in ASHRAE Design
Manual…
Air borne transmission represent up to
1 % of nosocomial infection
Overview of HVAC and MEP in Health facility
Three main medium/routes of infection transmission are;
HVAC : Reducing hospital-acquired infections
Overview of HVAC and MEP in Health facility
A well-designed HVAC system affects indoor
environmental quality and asepsis integrity through
specific HVAC-related factors e.g.,
• Thermal comfort,
• Acoustics
• Odor control
Room noise levels
And
Cross Talk
Overview of HVAC and MEP in Health facility
• Differential pressure relationships between spaces
• Directional Airflow
• Air Filtration
• Overall Building Pressurization, etc.
HVAC engineering controls directly contribute to maintaining asepsis
Overview of HVAC and MEP in Health facility
HVAC system effectiveness can also lead to an..
• improved healing environment for the patient,
• contributing to shorter patient stays
• and thereby minimizing the patient exposure to
HAIs.
MEP OTHER THAN HVAC
Plumbing in General..
• Cold water
• Hot water supply
Hospital includes…
• Cooled Cold water
• Hot water return
• Reverse Osmosis water
• Deionized water
• Clean steam for CSSD
• Steam for laundry /
kitchen
Overview of HVAC and MEP in Health facility
Drainage in general..
• Waste drain
• Soil Drain
• Storm Drain
Hospital includes…
• Laboratory drain
• CSSD drain
• Mortuary drain
• Radiation treatment
drain
• Decontamination drain
• Laundry Drain
• Fuel drain collection
MEP OTHER THAN HVAC
Overview of HVAC and MEP in Health facility
MECH
Medical gases
Fuel oil for boilers /
generator
LPG for kitchen
Elevators and
patient lifts
Pneumatic Tube
system
Biological waste
management
systems etc….
Overview of HVAC and MEP in Health facility
MEP OTHER THAN HVAC
Electrical:
• Isolated power supply
• Uninterrupted Power Supply (UPS)
• Emergency / Generator power
MEP OTHER THAN HVAC
Overview of HVAC and MEP in Health facility
Extra Low Voltage Systems:
• Nurse call
• Patient Management
• Fire alarm
• Supervisory Control And Data Acquisition
(SCADA)
• Tele Medicine
• Picture Archiving And Communication
System (PACS)
• Laboratory Information System
• Integrated building management system
HVAC and MEP in Healthcare Facility
Proper planning &
coordination gets you
better installation
Lack of planning &
coordination gets you
delicious spaghetti
Relax
Which male engineer do you find more attractive as a husband? Options: A. Mechanical B. Electrical C. Software D. Civil E. Architect
Following was a question to ladies; can you guess the answer?
Source:
University of WhatsApp
Evolving ASHRAE Standard 170 for Health Facility
Evolving ASHRAE/ASHE Standard 170 for health facility
Standard 170 originated with an agreement between
ASHRAE and the Facility Guidelines Institute(FGI)
The first standard jointly sponsored by ASHRAE & ASHE
(2008 edition)
Updated on a 4 year cycle in concert with documents
published by FGI.
This standard does not constitute a design guide.
Comprises a set of minimum requirements intended for
adoption by code-enforcing agencies.
Evolving ANSI/ASHRAE/ASHE Standard 170
for health facility
Evolving ANSI/ASHRAE/ASHE Standard 170
Best practices are provided by
other ASHRAE publications,
such as ASHRAE Handbook—
HVAC Applications and HVAC
Design Manual for Hospitals
and Clinics.
Cherry picking from codes is a concern –Examples
Example 1 –
Operating Theater
differential pressure
Source - https://www.tandfonline.com/doi/pdf/10.1080/19942060.2010.11015295
Example 2 – Central
Sterile Supplies
Department (CSSD)
ventilation
ASHRAE & HTM Widely Used Ventilation Standards For Healthcare Facility In
Middle East
Cherry picking from codes is a concern
Widely referred Tables from ASHRAE & HTM
HTM 03-01 ASHRAE 170 Table 7.1
Cherry picking from codes is a concern
ASHRAE & HTM
Parameters ASHRAE HTM
Total Air Changes Per Hour 20 25
Fresh Air Changes Per Hour 4 25*
Temperature (deg. C) 18-25 20-24
Differential Pressure Min 2.5 Pascal 25 Pascal
Cherry picking from codes is a concern
Max or Min? *based on typical OT AHU drawing in HTM
HTM-03 01
Note:
a. Nominal room pressures are
given to facilitate setting up of
pressure-relief dampers,
the calculation process, and the
sizing of transfer devices. In
practice, the resultant pressures
are not critical, provided the
desired air-flow rates and
movement are achieved.
Cherry picking from codes is a concern
Operating Room Pressure Regime ASHRAE & HTM
ASHRAE=2.5 Pa
No mention of
pressure relief
HTM
25 Pa – Pressure
relief
Cherry picking from codes is a concern
CHERRY PICKING FROM CODES IS A CONCERN
Central Sterile Supplies Department (CSSD)
Ventilation - ASHRAE
Decontamination
(Dirty)
Prep & Pack
(Clean)
Storage
(Sterile)
Work flow
Air flow
CHERRY PICKING FROM CODES IS A CONCERN
CSSD Ventilation - ASHARE
Source - HVAC Design Manual for Hospitals and Clinics
CSSD Ventilation – Health
Building Note(HBN 13)
Wash
(Dirty)
Inspection assembly and packing(IAP)
ISO-8 ; 20 ACH; 10 Pascal
Storage
(Clean)
Work flow
Air flow – Two directions
CHERRY PICKING FROM CODES IS A CONCERN
TYPES OF ISOLATION ROOMS
1. Protective Environment (PE) room – Positive Pressure
2. Airborne infection isolation (AII) room – Negative Pressure
3. Combination PE / AII room
Picture source: https://www.priceindustries.com/library/engineeringupdates/volume/21/roompressuremonitors
ISOLATION ROOMS
Protective Environment (PE) room – Positive Pressure
Picture source: https://www.priceindustries.com/library/engineeringupdates/volume/21/roompressuremonitors
POSITIVE
PROTECTIVE ENVIRONMENT (PE) ROOM
ISOLATION ROOMS
Source - HVAC Design Manual for Hospitals and Clinics
Airborne infection isolation (AII) room Negative Pressure
Picture source: https://www.priceindustries.com/library/engineeringupdates/volume/21/roompressuremonitors
Exhaust grill above
patient bed or wall
Supply Air
NEGATIVE
ISOLATION ROOMS
AIRBORNE INFECTION ISOLATION (AII) ROOMS
ISOLATION ROOMS
Source - HVAC Design Manual for Hospitals and Clinics
COMBINATION AIRBORNE INFECTIOUS ISOLATION/PROTECTIVE ENVIRONMENT (AII/PE) ROOMS
Picture source: https://www.priceindustries.com/library/engineeringupdates/volume/21/roompressuremonitors
Supply Air
POSITIVE
ISOLATION ROOMS
Negative
COMBINATION AIRBORNE INFECTIOUS ISOLATION/PROTECTIVE ENVIRONMENT (AII/PE) ROOMS
Source - Centers for Disease Control and Prevention
Evolution of Combination Isolation rooms
Rooms with reversible airflow provisions
for the purpose of switching between
protective environment and AII functions
shall not be permitted
Source – Extract from ASHRAE Standard 170 - FOREWORD
Black Building Test & Isolated Power Supply for Healthcare Facilities
Content
1. Black Building Test
What is Black Building Test
Importance of Black Building Test in Healthcare Facility
Essential and Non Essential Electrical Systems / Loads
Lesson Learned from past experiences of fault findings
Question for Audience
2. Isolated Power Supply System (IPS)
Overview of IPS System in Healthcare Facility
IPS importance in Healthcare Facility (HTM 06-01)
Black Building Test
Black Building Test OR Integrated System Test :
Simulating total power failure, monitoring, re-verification, documenting the building systems and components behavior and how these systems should react to the loss of power.
Importance in healthcare facility
Not only an Electrical Test rather an Integrated System Test
Not a load driven test
Loss of Power - Risk
1. Understanding the risk from Loss of Supply – HTM 06-01
Source of above risk assessment chart is from HTM 06-01 - 2017
Planning & Execution Stages
1) Roles and Responsibility Matrix
2) Response Matrix – Understanding systems configuration
3) System Integration Matrix
4) Stockholders involvement
5) Utilities Service Provider
6) Conducting the BBT
7) Recording fault findings and observations
8) Corrective measures & Lesson’s learned
9) Producing final report
Response Matrix
System Circuit
no.
Feed To Location Type of
Power
Electrical
Transfer
Test
result
Remarks
AHU01 MDB-03 MCC- 01 Plant
Room A
N Auto Pass OK
AHU02 MDB-03 MCC- 04 Plant
Room B
E Auto Fail Wrong
wiring
DDC11 SMDB 04 DB-07
Electrical
Room 5th
floor - C
E Auto /
BMS
Fail No
Essential
supply to
area
VAV 32 MCC 23 DB-08 Electrical
Room 6th
floor - B
N Auto
Pass OK
Essential and Non-essential systems
Typical Essential Systems Typical non-essential
Fire Alarm System General Power Sockets
Life safety and support systems Normal Lighting System
IT Servers AHUs serving common areas, offices, etc.
Fire Fighting Pumps Toilet Exhaust Fans
AHUs serving critical areas Non-Essential Lifts
Isolated Power Supply System Kitchen equipment
Nurse Call System Etc…
Fire fighting lifts
Medical Equipment in OR’s, ICUs
Etc…
Conducting the BBT - continued
NORMALIZATION
PERIOD &
BACK TO UTILITY
POWER
BBT– Fault Finding Example
AHU
MCC Normal
Supply
Essential
Supply
DDC
Essential AHU
VAV MSFD
Controlled
air supply
Essential AHU - Normal Operation
OK
Black Building Test – Fault Finding Example
AHU
MCC Normal
Supply
Essential
Supply
DDC
Essential AHU
VAV MSFD
Uncontrolled
air supply
Emergency Operation (Essential Supply)
What is
Wrong?
Black Building Test – Fault Finding Example
AHU
MCC Normal
Supply
Essential
Supply
DDC
Essential AHU
VAV MSFD
Uncontrolled
air supply
1. Emergency Operation (Essential Supply)
MSFD & DDC Panel NOT on
Emergency Power
BBT – Lesson Learned
1. Equipment not connected to Essential supply
2. Field devices ( VAV , DDC, MSFD, controllers , ..etc ) are not connected or wrongly wired
3. Rebooting issues of different software on essential but not on UPS supply.
4. Systems dependencies and integrations
5. Design issues / Change of design
6. Client's expectation
Black Building Test – Final Report
1. A proper GUIDE for end user operations and steps to be undertaken during loss of mains utility power outage.
2. The developed matrix will become a useful document
3. Electrical Distribution Circuitry re-validation of all systems and equipment
4. Hot spots can be identified.
5. Moreover, comfort to end user for a safe and secure facility
Isolated Power Supply (IPS)
Courtesy of
youtube
Isolated Power Supply (IPS)
Why we need it ?
Patient & Staff – Safety
In electrical systems IPS provides additional safety/security due to its ability to FUNCTION CONTINUOUSLY even with a single earth fault on the system or connected equipment.
Discontinuity (failure) of electrical power supply can cause danger to life
Normal Power Supply without Ground/Earth
When a faulty piece of equipment without an equipment ground wire is
plugged into an electrical outlet not containing a ground wire, the
instrument case becomes energized (“hot”). If an individual touches the
case (A), he or she will receive a shock (dashed line depicts path of
electrical current) because he or she is standing on the ground (B) and
completes the circuit
Normal Power Supply with Ground/Earth
When a faulty piece of equipment containing an equipment ground wire is
properly connected to an electrical outlet with grounding protection, the
electrical current (dashed line) will preferentially flow down the low-
resistance ground wire. An individual touching the instrument case (A) and
standing on the ground (B) still completes the circuit; however, only a small
part of the current flows through the individual.
Isolated Power Supply (IPS)
In an operating room, the isolation transformer converts the
grounded power on the primary side to an ungrounded power
system on the secondary side of the transformer. There is no direct
connection from the power on the secondary side to ground. The
equipment ground wire, however, is still present.
Isolated Power Supply (IPS)
A safety feature of the isolated power system is illustrated. An individual
contacting one side of the isolated power system (A) and standing on the
ground (B) will not receive a shock. In this instance, the individual is not
contacting the circuit at two points and thus is not completing the circuit.
Isolated Power Supply
Overview as per HTM 06-01
Also known as Medical IT System
Installed within Group Two Areas
Supplied from dedicated isolation transformer for patient safety.
Provides local and remote alarms for Insulation fault, transformer overload and over temperature alarm.
Isolates the earth fault by creating a separate ground for IPS panel via isolating transformer.
Group Two - HTM 06-01
