This page locks in a placeholder for content that may guide decision-making for leaders in the education and university-affiliated healthcare facility industry. It address two issues only:
- Temporary use of student dormitories for contagious patient care
- Sudden uptick in broadband demand for off-campus learning and working
At the moment, this page is a re-direct from the IEEE Education & Healthcare Facilities Committee until the content can be formatted for the IEEE content management systems. Time sensitive content informing the global COVID-19 response challenges the business models of many non-profit organizations. “Pardon Our Dust” as we are fond of saying.
We provide this information on this website temporarily until subject matter experts in the various IEEE Societies are drawn into the conversation. We place “lorem ipsum” in passages that will be receiving more detailed response in the near future.
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Q1. To what degree, if any, should now empty square-footage in student residence facilities be used for COVID-19 response?
A. (Mike Anthony). At the risk of discouraging anyone’s imagination and best intent I would steer decision-makers away from this option for inpatient contagious respiratory disease care. Such use would likely be more suited to housing healthcare support personnel; not direct patient care. Dormitories have facilities that can provide child care to front line caregivers.
Military-style “pop up” facilities are built quickly for the type of care needed for military injuries; not necessarily for influenza care (though military biohazard facilities would likely be tricked out in a manner needed for treating patients with less contagious forms influenza). Nothing is impossible, however. Where there is a will, there’s a way.
A. (Jim Harvey). Getting occupancy certification might be tricky. Conformity and inspection will likely be complicated. Lorem ipsum.
A. (Mike Anthony). To add to Jim’s point: We assume that conformity to the power system reliability criteria found in NFPA 99 and NEC Articles 517 and 701 would be relaxed. Some of the CMS K-TAG requirements might be worth revisiting; (www.iccsafe.org content) linked below:
KTAGS_Group-B_existing-hospitals3
The most knowledgeable people for a temporary conversion will likely be front-line healthcare facility engineering experts such as Jim Harvey, Matt Dozier and Jonathan Flannery. All of them are contributing content to this page.
A. (Robert G. Arno). The HVAC systems found in medical facilities have a distinctive design criteria to limit the spread of infectious disease. Included is the standard requirements, such as IEEE White Book requirements for emergency power, are specific requirements for a sustainable system. These are designed to limit the spread of disease while providing for the best care to the patient. Dormitories are not designed to these specific requirements and usually have HVAC systems common to the entire facility. Unless significant modifications are imposed the risk of spreading a air born disease is not curtailed. If dormitories have separate HVAC systems for each room similar to modern Hotels this maybe a consideration, but the common areas would need to be limited accessibility for medical personnel only.
A. (Richard Robben). Re-purposing a portion of a dormitory requires attention to air handling systems; notably air management system requirements for contagious diseases. Also, patient care settings have space set aside for staging patient care. Typical dormitory room arrangements do not have this; though workarounds are possible.
A. (Jonathan Flannery). The use of hotels for contagious patient care may be more appropriate than college and university dormitories. The American Society of Healthcare Engineers will soon have recommendation to facility leaders contemplating use of student dormitories for contagious patient care. CLICK HERE
Q2. How do we prepare for step function uptake in bandwidth demand (i.e. “internet pressure”) on curriculum and business operations?
A. (Mike Hiler). Campus environments differ (Choose wisely) in the way bandwidth is delivered. I know of one University who use infrastructure provided by others to facilitate between healthcare facilities. Others have developed a self-sufficient topology interconnecting their university-affiliated healthcare facilities. More detail to follow.
A. (Mike Anthony) I know of at least one Australian University (Monash University) that is measuring internet pressure that may guide decisions (i.e capitalization decisions) but, to the best of my knowledge, this simply identifies the current state of internet traffic. Recall the adage: “If you can measure it, you can improve it”.
The FCC has a measurement program for broadband performance which includes the performance of residential access but I do not know of any actionable information that would, for example, improve access speeds now. It is likely that data gathered from FCC and Monash University programs will inform capitalization decisions by internet service providers.
Keep in mind that many research universities run de-facto public utilities for information technology and “may” be able to steer away some educational communities away from global bandwidth stress. Since it is likely that off-site learning will be changed forever after this, please forward any anecdotal information to @IEEECampus so that the question may be re-directed to a subject matter expert.
Standards Michigan was aware of at least one educational unit that did not have access to teleconferencing facilities so it made its teleconferencing facility available to any educational unit 24/7 outside of its own daily 11 AM/EDT teleconferences. That offer still stands.
If there are bandwidth bottlenecks, instructors should consider rationing video conferencing and move at least some instruction time on telephone conferences. Virtual private networks may be a partial solution.
A. William McCoy (Verizon). What should be considered is equipment and technology should be evolved not revolved and managing to lifecycle cost and not first cost should be the approach. Wireless and the 5G technology is the basis of the future for IoT which should more than address the needs of the healthcare industry.
A. (IEEE Communications Society). Lorem ipsum
Q3. How do we configure the virtual private network to reduce bottlenecks in internet use for instructional purposes?
A. (Mike Hiler). The switching equipment found on Major Universities can be configured to accomplish this. More detail to follow.
Q4. What type of power system modifications would be involved re-purposing dormitories for direct patient care?
A. (
Matt Dozier). There are a couple of scenarios, one being a long term renovation/conversion of a facility to provide health care. Under this scenario, system modifications as you mention will be somewhat extensive to conform with standards and codes.
A second scenario is a temporary use conversion of a facility to provide care response following or during a catastrophic event or crisis. In this case, compromises are knowingly accepted in conformance with practice standards to address urgent needs. We have done this following catastrophic events (hurricanes, flooding). Under these circumstances, temporary generators can be connected through transfer means to provide back-up power for entire buildings or wings of buildings. Think “whole house” generators. The response is driven by the urgent nature of the crisis and code compliance is temporarily suspended by choice due to the crisis.
This second scenario is only considered as a temporary measure and can only be entered into with full knowledge of the risk-reward aspects of the decisions and cooperation of authorities.
Regarding the first question, similar concerns exist relative to the nature of the crisis and duration of the event. Granted the HVAC systems can not support infectious isolation but we (IEEE) should not be rendering directions/recommendation as we are not experts; ASHRAE and others should address any possible temporary uses in a catastrophic circumstance. I don’t disagree we can offer caution but we should direct any of those questions to others. We should stick to our knowledge/experience base.
Q5. What would workarounds for reconfiguring fairly standard residential class electric service (in a typical dormitory) to meet an elevated requirement for reliability of outlets at patient bedside?
A. (Robert G. Arno). I have no doubt that the USACE can configure dormitories into make shift hospitals but will the electrical infrastructure support the necessary load?. These facilities were not build to Hospital standards especially for emergency power. What medical equipment will be necessary to support infected patients to ensure that the correct treatment is being applied. What is a typical load requirements. Article 517 of the NFPA has a series of requirements for health care facilities that dormitories do not. For example in Part II of 517 it identifies requirements for wiring and protection in patient care areas (defined in 516.2). It does not apply to business offices, corridors, waiting rooms or similar areas in clinics, medical and dental offices, and outpatient facilities, nursing home and limited care facility areas used exclusively for patient sleeping. A major goal of Part II is to prevent electrical shock. In healthcare applications, people’s bodies are often in direct contact with energized equipment. Thus, Part II provides extensive grounding and bonding requirements-even for something as ordinary as a receptacle. The bottom line is Article 517 identifies a completely different power infrastructure that what is required for dormitories. Mike Holt Industries has published a summary that goes into more detail and some of there comments are referenced here.
Anytime you visit a hospital you will notice the red receptacles. These are emergency power receptacle designed to maintain power the medical equipment even during a power outage. These emergency power systems have a high Reliability requirement to not only provide emergency power but also supply that power in a matter of seconds. In article 708 of the NEC code it describes the suggested requirements for Critical Operating Power systems. Reliability is a major consideration for critical systems and hospitals being part of that system.
Dormitories are just not built to these standards and unless the infrastructure is modified present a concern to the safety of the patients. In emergency situations you must do what is best for the population. But I think everyone should be aware of the issues as pointed out.
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IEEE Education & Healthcare Facilities Committee
@IEEECampus
NIST Cloud Computing Standards Roadmap
IEEE On the impact of MOOCs on engineering education
FCC Report on Consumer Fixed Broadband Performance in the United States
Bibliography: Note that some content originates at a single source and is distributed to local subscribers with some local modifications.
Colleges offering dorms as hospital overflow for virus cases
The University Libraries increases sanitization of facilities in response to COVID-19
Cuomo Proposes Converting SUNY Dorm Beds into Hospital Beds
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Open for Comment
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AAMI ST79-2017/A.3 and 4-202X, Comprehensive guide to steam sterilization and sterility assurance in health care facilities [Comments due March 22nd]
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