When Credit Valley Hospital (CVH) in Mississauga, Ontario was originally commissioned in 1985, drinking fountains were not viewed as a threatening source of communicable diseases. However, several years ago, faced with growing concerns after a deadly infectious outbreak of C. difficile in an Ontario hospital, the 365-bed CVH needed to pursue new infection control measures.
Farrow Partnership Architects (FPA), a firm located in Toronto, saw that CVH’s drinking fountains, which had been decommissioned but still had an existing built-in source of water, could be converted into a hand washing units as a positive force for infection control.
According to Health Canada, hospital-acquired infections kill some 8,000 to 12,000 patients across that country every year, and cost the health system millions of dollars. The Canadian Health Network points out that hands spread an estimated 80% of common infectious diseases, yet studies show less than half of hospital nurses and physicians clean their hands between patients.
In 2008, working with CVH’s infection control and maintenance managers, FPA developed and implemented 15 hand washing units in the corridor of an inpatient care area over a one-month period. Aimed primarily at reducing the spread of infection, it was also recognized that improvements in hand washing facilities would reduce the risk of legal action resulting from infection disease outbreaks.
These hand washing units were designed in the absence of any government performance guidelines, specifications, or industry standards. At the start of this initiative, FPA and CVH created the following criteria for success that was realized through the ultimate design:
- Convenience and ease of use: reduced the significant time loss incurred by busy doctors and nurses walking to a distant location many times a day
- Minimal spread of contaminated water: deep basin reduces splashing of soiled water
- Minimal amount of physical contact: faucet with hands-free operation
- Rapid prototyping: off theshelf components were used where possible to reduce implementation time (e.g., regular paper towel dispenser and disposal)
- Ease of installation: developed a self contained unit for ease of installation into new or existing plumbing
- Warm and inviting materials: selected solid surface material over the more clinical standard stainless steel products
- Supportive of maintenance programs: solid surface material conducive to low maintenance and ease of cleaning
Diverse participants contributed to the success of the hand washing units including the hospital’s infection control committee, various doctors and nurses, and the maintenance staff. FPA worked with a subcontractor and Wilsonart to develop the prototypes and final product. Nurses and infection control committee members commented on the first prototype and minor adjustments were made, which included a curved front to facilitate cleaning and to create a more elegant looking shape. A second prototype, complete with plumbing and antiseptic gel, was developed and put into use over a two-week period.
Ultimately 15 final versions of the hand washing units were installed in 2008, and more will be added as funding becomes available.