An overview of a seminar on patient infections and drinking water management within healthcare buildings in the UK

Building Water Quality Commissioning in Healthcare Settings: Reducing Legionella and Water Contaminants Utilizing a Construction Scheduling Method

“…Rather, the temporary piping would be used for construction activity water access and terminated (i.e., abandoned and removed) later in the project. This allows water activation to be delayed as late as possible in the same project schedule of events [3]. Gantt chart schedule B illustrates a 4-month delay in water activation (Figure 5 on August 1).…”

“…The National Health Service of England has provided Health Technical Memorandum 04-01 Part A [19] as a more robust document with detailed descriptions for BWDS installation, testing, and commissioning. Yet, when disseminating this information at a water hygiene conference, the agency identified substantial challenges with resistance and a lack of awareness of the importance of water safety in healthcare settings [3]. This has led to a 'black hole' of governance emerging as to who is responsible for BWDS performance and testing for compliance [3].…”

“…Commissioning for building system performance standards focuses on verifying if the building system is working as designed. The current water commissioning process lacks accountability [3,20,26] and does not routinely validate if the building system is working to minimize water contaminants through the premise plumbing [37,38]. The general assumption has been that new building systems would not contain contaminants [39].…”

“…Public health agencies and healthcare organizations have reported case studies (n = 31) resulting in disease cases (n = 894) and deaths (n = 112) from waterborne pathogens associated with poorly executed construction and commissioning activities [2]. Outbreaks in healthcare settings continue to occur related to construction and commissioning activities and often go unreported [3]. These events are categorized as healthcare-associated infections, in which a patient acquires an infection while staying in a healthcare setting and undergoing observation or treatment [4,5].…”

“…Other authorities having jurisdiction (AHJ) over US healthcare operations for design, construction, or financial reimbursement have subsequently stated similar WMP requirements, inclusive of construction and commissioning phases of work [14][15][16]. Additionally, international countries require healthcare facilities to have a similar process (i.e., a water safety plan) in place [1,3,[17][18][19][20] to meet their specific country's public health policies to control Legionella and other waterborne pathogens such as nontuberculosis mycobacteria (NTM), Pseudomonas, or others.…”