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Report: Inova Fairfax Hospital Tour

The lead-up to the briefing by David Marra, the Director of Engineering at Inova Fairfax Hospital, the largest in the region, was stressful, due to the two postponements. As a result, instead of 20+ attendees, we had just 9, but what a presentation it was, and we are indebted to Dave Marra for the time he spent with us.

During the course of his excellent and informative briefing, Dave explained that the reason for the delays was the sudden arrival of a Joint Commission that spent seven days going over every inch of the hospital with a top to bottom inspection to assure that Inova was meeting all of its requirements for patient safety.

Dave pointed out the hospital covers some 42 acres, has 42 operating rooms, is four times the size of any of its sister hospitals in the region, and is now in the process of adding a brand new 440,000 square foot tower to the complex started in 1960 that now houses 938 beds, so as to provide private rooms for over 90% of patients.

From an engineering point of view he pointed out that they use 2000 tons of energy a day, 50,000 gallons of water pr hour, $ 3 million of gas pr year to provide safe and comfortable air for their 1.8 million square feet of controlled space. There are some rooms that require positive air flow and others negative, depending upon the needs of the patients, whether they are infectious or have heart problems, or whatever.

Dave administers a $ 40 million budget to do all this, including the care and maintenance of 3.5 miles of sidewalks that his staff have to keep free of snow, ice and cracks, and 5.5 miles of roads. With his staff of 80, they manage 55,000 work orders a year to maintain not just the roads, but also healing gardens, HVAC, fire suppression, sewage disposal, medical gas plants, an electrical distribution system – both for normal usage and emergencies.

They have to provide for 90 babies in the NICU, the neonatal care unit; 40% of the 9000 patients require oxygen, vacuum or gas, all of which require water to move them, as well as 4500 toilets and 1200 urinals. When the temperature is 100 degrees they need 7100 tons of water, most of which they get from Fairfax, and 8 emergency generators provide 8 MW of power.

Before taking us on a tour of the power plant, at the end of his 4 hour briefing, Dave pointed out that one their biggest challenges is finding able young staff to replace aging, retiring staff, since most schools have cancelled vocational course, replacing “dirty manual labor” with computer skills. This is an area, which, I think, we as engineers in IIE, SME and other members of the DC Council of Engineers and Architects, can try to influence through our participation on technology advisory boards of local schools and community colleges.

For those of you who couldn’t make it, I hope this provides you with some useful information (and I hope all the stats are correct.)

One more hospital vignette

Dave Marra told about the couple who had brought their son to the ER and afterward complained that the door to the bathroom was not wide enough to accommodate his wheelchair. So, Dave, who admittedly is overweight compared to his days in the Navy (about 300 pounds,) got into a wide wheelchair in the ER and wheeled himself to the bathroom. He had no problem getting into the door in one of the oversized wheelchairs the hospital has had to acquire to accommodate the 30% of patients who are overweight or obese. The door, which rules demand must click shut, did so as required.

He used the facility from his wheelchair and managed to wash up at the sink without banging his legs on the pipes underneath (another regulation). (granted, there are some extra-wide wheelchairs that can seat 2 to 3 normal sized people, that would not fit into the door, just as there are now double wide beds.)

The family also complained that there was no push button to open the toilet door to permit direct access, but Dave noted that would require an 8-foot deep passage, which would interfere with people walking along the walkway. (Hope I’ve explained this properly.)

At any rate, this gives us engineers some idea of the complexities involved in handling spaces and people at a hospital. En passant, he also noted that if someone orders a special meal, it has to be delivered within 30 minutes from the basement kitchen, and that, to reduce the known effects of salt, the kitchen was supplying packets of oregano and other spices to the otherwise “bland” food. Again people objected, so that, except for heart patients, the tray now includes packets of salt. Aren’t you glad you’re not responsible for stuff like that?

We are truly indebted to Dave for his comprehensive and thoughtful briefing.

– Submitted by John Baer, Chapter Member

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