President ZORG.tech. Eddy De Coster

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2 ZORG.tech more than 400 technical responsibles in the Dutch speaking part (6 mio people) of Belgium (10 mio people), which is part of Western Europe Member of IFHE since 1976, and IFHE Europe Eddy De Coster President ZORG.tech

3 Key figures Care beds hospitalizations day-care admissions surgery interventions consultations emergencies Staff Patient care (7.770 fte) Research & Education (1.501 fte) Education Biomedical sciences students University Hospitals Leuven (UZ Leuven) as an autonomous organisation for healthcare within KU Leuven

4 UZ Leuven and technical services Challenges Increasing need for health care: ageing, technology, Scarcity of resources: staff, funding, Health care strategy of UZ Leuven Efficiency Quality Innovation Integration of KU Leuven and UZ Leuven

5 History of UZ Leuven 1426 Medical education 1928 Foundation of St. Rafael hospital 1967 Masterplan integration hospitals 1975 Phase I Gasthuisberg 1985 Phase II UZ Leuven 1993 Phase III 2004 Masterplan UZ Leuven

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7 Spatial ordening area planning needs INFRASTRUCTURAL Evacuation & move of the city-campus m² still in use as clinical space (>600 employees) Ageing of the infrastructure Gasthuisberg m² > 30 years old, m² > 20 years old SUBSTANTIVE-STRATEGIC Implementation of the (care)strategic plan: Gasthuisberg acute campus / Pellenberg rehabilitation campus Downsizing number of beds shifts in care profile: More intensive care / increase of ambulatory care Incorporated strategy group Biomedical KUL - UZ Leuven Health-Science Campus: magnet site open for third parties: Red Cross, KHL college (nurseryschool), VIB (Flemish research institute for biotechnolgy),

8 Trends / evolutions Shift in case-mix More ambulantory care Integration KUL-UZ / partners Networking Vlaams Ziekenhuisnetwerk K.U.Leuven Sint-Lucas Brugge Sint-Blasius Dendermonde Sint-Jozef Turnhout Sint-Elisabeth Turnhout Mariaziekenhuis Noord-Limburg Damiaan Oostende Sint-Franciskus Heusden Zolder Groeninge Kortrijk AZ ZvB Ronse OLV Aalst Imelda Bonheiden AZ Sint-Maarten Duffel UZ Leuven ZOL Genk Salvator Hasselt Virga Jesse Hasselt Sint-Trudo Sint-Truiden

9 ir Eddy De Coster Head of the technical department

10 Masterplan Health-science campus: Heart metaphor Research Education General hospital Poly clinic Urban functions awg architecten Antwerp

11 Masterplan. clear circulations. Segmentation. streets/squares/ - care - research - education - support area. increased density. urban patterns. conserve open space. green patio s. clear tracks (separation in-ward patients/public circulation/logistics)

12 Projects Health Sciences Campus Gasthuisberg double surface Existing hospital 2003 New building hospital Existing Univ 2003 New building Univ

13 University Education & Research Project O&N 4 K.U.Leuven O&N 2 K.U.Leuven & KHL KHL Rega Institute

14 General Hospital: Patient care Entrance Hall O&N4: Biotech Building Fase VII Oncology Adult Hospital Wards Child Mental Health Fase Ivb: Mother & Child Fase VI: Mental Health Fase IVa: Critical Care Services Fase II Surgical Theatres

15 Campus Gasthuisberg Parking Mobility Logistics Catering Energy Health-mall Care-Hotel Catering Building intelligent cities

16 Mobility Future parkings Parkings - Actual parkings: Under construction: Total future parkings: West Beltway around campus East

17 Masterplan Energy Electricity Heat (natural gas) Water (kwh) (kwh) (m³) consumption # residences

18 Patient safety JCI accreditation since 2010 Last survey JCI 2016

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20 Technical Services and patient safety 1. Keep technical areas tidy, always close the door. 2. Prevent risk of falling, keep corridors free of ceiling panels, loose cables, etc. 3. Keep the working environment organized and clean, avoid spreading of dust and debris in the hospital. 4. Restrict access to the construction site for unauthorized people, take care of the signalization. 5. Request a ceiling permission when the ceiling will be opened for more than one day.

21 Technical Services and patient safety 6. Request a fire permission when grinding, welding, flame cutting, burning off of paint, etc (except in workshops). 7. What to do in case of fire? 8. Be recognizable, wear your badge and uniform, register yourself at the services. 9. Keep dangerous tools and products away from children and other vulnerable patients. Keep your work cart locked. 10. In doubt, ask for advice of your supervisor.

22 Medical gasses Technical risks in hospital exploitation Electricity Heating Water Fire detection and control Hospital signaling nurse calling PTS HVAC ICT & network! Elevators

23 Masterplan Energy Electrical and data center -> timing and implementation - Start sept In use end 2010 new energy plant Connection distribution net

24 electricity plant

25 Roostervloer Roostervloer Roostervloer Roostervloer Roostervloer Electricity plant TWO in ONE Gang Kopstation A 2,98 Lift Gang 250 kva 250 kva Gang Gang Trappenhuis M G M G M G M G M G 250 kva 250 kva Kopstation B GEN 1 GEN 2 GEN 3 GEN 4 GEN 5 NORMAL EMERGENCY

26 Masterplan Energy datacenter electricity plant

27 Electricity plant and Datacenter Faraday cage

28 Electricity: Technical risks in hospital exploitation Double net on V: NORMAL=normaal nood=emergency Peak use NORMAL > 12 MW EMERGENCY: 4 diesel-alternator-groups of 2 MW - max. use of emergency net is lower than the use of 3 emergency-groups safety N+1 - yearly control bij asking the energy supplier to turn off the hospital for 5 min at 7 am on a working day.

29 Technical risks in hospital exploitation Electricity Grid: high & low tension

30 Medical gasses Technical risks in hospital exploitation Electricity Heating Water Fire detection and control Hospital signaling nurse calling PTS HVAC ICT & network! Elevators

31 UZ Leuven Network (UZ Net) Data en voice Local outlets: RJ45 Local cabling: UTP Cat5E 41 Satelite Equipment Rooms (SER)-GHB=30 - Patchpanels & Switches, - Local Equipment Vertical cabling (Backbone) - Fiber Optic - Redundant links with 2 MERs Main Equipment Rooms (MER) - Central Backbone nodes - Central Office Equipment - Central Server Equipment - Active redundancy

32 2 Dispatch security

33 3 Security IP Based Technology Alarm Server (Mobicall) 5 units Personal protection system (aggression) Emergency call (assistant, doctor): call 2580 Fire detection (VSK Systems) 17 fire units fire detection points (optical, thermal) Access Control Technical alarm system (Sauter/Siemens) HVAC Camera for monitoring system

34 Technical risks in hospital exploitation Heating Centralized boiler-room with 4 boilers (with a total of 40MJ heating capacity) Mixed-burners oil and gas Medical gasses: compressed air, oxygen - crucial for life support of some patients - medical gasses regulated by pharmaceutical laws in Belgium and Europe - most important rules : - assure supplying the right gas - deliver from 3 separate sources under pharmaceutical conditions

35 Water Technical risks in hospital exploitation - very extended net of water supply by the government - our challenge is to deliver water in good condition towards the patient: - very important for haemodialysis, sterilization: treatment in the hospital by reverse osmosis - drinking water: the law is very strict In our hospital only patients with reduced immunity get water in bottles, all the rest is coming from external supply.

36 Water Technical risks in hospital exploitation - Sufficient water supply at all times: reservoir controlled by the external supplier for several days. supply to our hospital comes in by three separated ways. - Quality: All the new water pipes for both cold and hot water are insulated so the temperature is correct and can be measured and alarmed. We do water tests every month at 100 points chosen by our experts as the most critical points.

37 Air quality Technical risks in hospital exploitation Special applications, in operating theatres, cleanrooms for pharmaceutical use - clean air coming from hygienic groups and use of absolute filtering guarantees the quality of the air - particle counting every year on air samples

38 Incident Management System UZ Leuven RISKS Fire Explosion Collapse Distortions energy Vital processes Nature Extreme climate Distortions internal order Important Lack of personal Contamination Disturbance supply Victims incident Pre-incidentplanning: Preventive measures,... Internal cause INCIDENT External cause Emergency situations: emergency procedures disaster: emergency plan per nursing unit - department - hospital Reception plan Evacuation plan Isolation plan Relocation plan

39 Emergency procedures training Plan Do testing adjust Act Check

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44 Measures:

45 Healthcare construction Examples

46 Healthcare construction Admission of contractors:

47 Healthcare construction Examples

48 Healthcare construction

49 Healthcare construction

50 Near-incidents Registration of nearincidents Analyzing near incidents

51 Last Minute Risk Analyse

52 Last Minute Risk Analyse

53 Thank you for your attention Eddy De Coster, ir. head of department, Technical facilities UZ Leuven Chairman organization of technics in care Belgium: Zorg.tech Belgium