11/16/2011 01:02 EST | Updated 01/16/2012 05:12 EST

New standards for hospital construction should cut patient infections

TORONTO - A new made-in-Canada standard for the construction of new hospitals and the renovation of existing ones was unveiled Wednesday.

A key recommendation is that single-bed rooms become the norm, unless there is a good rationale for housing patients in semi-private rooms.

Many studies have shown that single rooms cut down on the spread of hospital infections like C. difficile and drug-resistant Staph or MRSA, infections that add substantially to patients' time in hospital and the cost of treating them.

The standard was developed by CSA Standards, a not-for-profit association that crafts standards for a variety of sectors. The health-care facility standard was written with input from people who work in hospitals, including nurses and other health-care professionals.

The 400-page document covers myriad facets of a hospital's physical features and its operations, said Bonnie Rose, president of CSA Standards.

Adoption of the standard should help hospitals safeguard newborn babies, while helping them meet the challenges of caring for obese patients and for the elderly.

"Health-care facilities are very complex structures," Rose said at a news conference heralding the completion of the project.

"They have security and notification systems, complicated ventilation, backup power, medical gas and other sophisticated systems that exceed the requirements of typical building and construction planning."

What does that mean in terms of what kind of ground the recommendations had to cover? Rose enumerated a few examples.

"How wide doors are. How doors open. Where the lighting is. How you move patients through the facilities. How you ensure security of newborns. All of that was considered in the development of the standard," she said.

The news conference was held at Toronto's St. Michael's Hospital, where a demonstration took place in a simulation room to show how some of the guidance might be used.

The room, used for training, is a stand-in for an operating theatre. The door is ultra-wide, to accommodate a gurney. Complex medical equipment is suspended from the ceiling, to reduce tripping hazards in a setting where a large number of staff might be moving about in close proximity.

All the surfaces were cleanable and the room was built to specifications that would allow for future change to accommodate new equipment coming on line.

Dr. Antoine Pronovost, medical director for the trauma-neuro intensive care unit at St. Michael's, said that the way the standard was devised — with input from practising medical personnel and the public — is part of what makes the document important.

And he noted that the standard will be revised on a cyclical basis, as medical evidence points to new ways to improve the functioning of hospitals or cut down on the risk of hospital-acquired infections.

Reducing the risk that patients will pick up infections in hospital is a key thrust of the standard.

It is estimated that between 220,000 and 250,000 new hospital infections are acquired every year in Canada, and 8,500 people die as a result of those hospital-acquired infections, Rose said, adding it is believed between 30 per cent and 50 per cent of those infections are preventable.

Hospital infections add to the time patients spend in hospital and the cost of treating them. Rose noted that a hospital in Michigan that moved to a single-rooms-only system found it made back the added investment within three years.

Funding for the writing of the standard came from provincial and territorial governments, which were involved in the process. Although the standard is not mandatory, Rose said it is expected provinces and territories will want to adopt it.

But change will not be an overnight phenomenon.

"I expect the change will be incremental and it will be over the longer term, as new facilities are built, as existing facilities are modified or renovated," Rose said.

This is the first Canadian hospital standard for health-care facilities as a whole, though CSA has previously issued standards for particular parts of facilities or particular functions within hospitals.