Staff training and awareness campaigns with patients and visitors are vital to keep hospital drains clear, says Richard Leigh
21 April 2016 | By Richard Leigh
Modern hospitals are among the most complicated buildings in the world. They are designed to be used intensively, for different types of patients, in different care settings, using different treatments and equipment.
Drainage systems are, therefore, also complex, and health facilities managers know what a headache it is when they break down. Sewage backing up behind a blockage and flooding a hospital ward is not uncommon - and it can mean having to move patients to other busy wards while the area is cleaned.
So what can estates managers do to mitigate the risks inherent in hospital drainage? Here are five key elements of an effective drainage management strategy.
1. Know your drainage system
Most hospital sites have been developed ad hoc over years and mapping of drainage systems often does not keep up with this process. Plans are often inaccurate or incomplete. Misconnections and even illegal connections in hospital pipework are not uncommon.
Identifying the source of drainage problems - such as blockages, seepage or ground contamination - can be harder, and planning solutions harder still. Responding quickly to service-critical emergencies may be impossible.
The only answer is to map the entire system to identify connections, water flows, system capacities and asset condition.
We do this using a range of tools, including robotic CCTV drainage cameras, which provide HD-quality video footage of the inside of pipes. Pipes and chambers can also be laser scanned to create 3D point cloud images for assessing capacity and structural integrity. This highly accurate plan is the starting point of a drainage maintenance strategy - identifying what needs to be done as a matter of urgency, and what can be left until later.
2. Make sure of sufficient capacity
It is all the more alarming that an effective drainage capacity survey may not be carried out when new facilities are built. We responded to a sewage flood in a treatment area in a new hospital unit. Our CCTV survey identified a pinch-point in the drainage system. With the new unit in place, it did not have enough capacity to handle peak flow rates. The likely solution is the installation of a larger-diameter foul water downpipe. The cost of this work will be much greater than installing a pipe with adequate capacity in the first place.
3. Establish effective maintenance
Preventative maintenance is essential, especially because of the unique demands placed on drainage systems. In older hospital buildings, many downpipes are cast iron, so their capacity can be reduced by oxidisation. Caustic chemicals can accelerate this process. Sanitation gels and detergents can build up in pipes. We regularly find downpipes with diameters reduced to as little as two centimetres by this process. The pipes then have to be descaled using a specialist electro-mechanical cleaning device.
Blockage problems outside buildings can affect patient services too. Tree root infestation and drain collapses are a common cause of sewer blockages. The good news is that there are many techniques for rectifying such problems cost-effectively and quickly. Lanes Group is a pioneer in the use of no-dig drain repair techniques such as patch lining and full pipe lining to minimise the impact on patient care.
4. Build good drainage access
It is important for facilities teams to ensure that hospital drainage systems can be accessed quickly and as easily as possible. This does not always happen. Pipework can be installed without any access points. Manholes can be covered over during refurbishment work. Pipe access plates can seize up because they are not adequately maintained. Internal drainage systems may be suspended from ceilings, making finding and dealing with blockages difficult without disrupting patient care.
Our teams have had to excavate pipes to gain access to them, or cut new access points in high-level pipes. In emergencies, when patient care is threatened, this can cause critical delays.
5. Control what goes down the drains
What patients and healthcare workers do at home, they will do in hospital. So thousands of sanitary products and wet wipes will be disposed wrongly down hospital toilets every day. In hospital canteens and kitchens, fats and oils will find their way into drains, either in residual amounts or through irresponsible disposal. These can combine and congeal to cause 'fatbergs' in hospital drain lines.
With macerated waste already disposed of down drains in ward sluice rooms, hospital drainage systems are under particular pressure. This makes it important to do everything possible to control what is put down drains. Train your staff, and try to maintain awareness campaigns with patients and visitors.
Essentially, it will help hospital FMs greatly if they know the full scope of the drainage risks they face. This will help them prevent problems before they can affect patient care. And chronic drainage problems, managed on hospital sites over many years, can be cured with the right expertise and technology.
Richard Leigh is business development director at Lanes Group plc