All Hands On Deck - Washington DC VA Medical Center
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Washington DC VA Medical Center

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All Hands On Deck

FMS staff members install a plexiglass shield for the Renal Center's check-in counter.

FMS staff members install a plexiglass shield for the Renal Center's check-in counter.

Wednesday, May 6, 2020
FMS: Together, We Are Frontline Heroes

As the nation gains a newly found appreciation for grocery store workers and restaurant personnel, the Washington DC Veterans Affairs Medical Center team is shining the spotlight on Facilities Management Service staff members, who are some of the many faces working on the frontlines during the era of COVID-19. FMS is an integrated service of skilled craftsmen, journeymen, technicians, engineers, designers, equipment operators, and administrative staff who support the total patient care environment.

The Washington DC Veterans Affairs Medical Center’s FMS workshops are a buzz of activity as the team is busy making plexiglass barriers for clinics and customer service areas, converting inpatient rooms to negative pressure rooms, as well as completing a number of COVID-19 infrastructure projects. The team has been working consistently since March to ensure the safety of staff and Veterans. These projects are in addition to the day-to-day operations that keep the 55-year-old main hospital and other buildings running smoothly.

Converting Inpatient Rooms to Negative Pressure
According to Todd Williams, Chief of FMS, a negative pressure room uses lower air pressure to allow air to flow into the segregated environment and be safely exhausted outside of the building; thus, protecting those outside the patient’s room from potential exposure.

“There is more work than one may think needed to make a room conversion. It requires teamwork with the staff from FMS’ HVAC (heating, ventilation, air conditioning), Carpentry Shop, Electrical Shop, Engineering and other trades staff,” said Williams. These conversions are not necessarily easy. “They take engineering, ingenuity, and technical field expertise which we are fortunate to have in our FMS shops.”

Because the inpatient rooms have to be empty and terminally cleaned prior to conversion, the team has to be available on short notice and ready to jump into action as soon as a room becomes available. “The team had to be able to begin the process and finish quickly so the room would be available for another Veteran as soon as possible,” Williams said.

The conversion process presented numerous challenges including equipment and material shortages. The team worked closely with VA Contracting Service and select vendors who make the procurement process more efficient.

The FMS team’s work is not complete when an inpatient room is converted to negative pressure, the staff must continually monitor the equipment and room pressure daily. The team is also working to upgrade its older negative pressure rooms with new equipment and stands ready to convert more rooms if necessary. Future renovations of inpatient units 4B and 4E already have design plans to make more rooms negative on-demand and will add to the number of permanent negative pressure isolation rooms.

FMS’s initial effort to double the number of negative pressure rooms on Units 4B and 4C from 14 to 28 rooms in short time was shared with VISN-5 and Veterans Health Administration (VHA) leaders as a best practice back in March. With the project essentially complete, the medical center has 35 total negative pressure rooms which expands our health team’s capacity to care for more Veterans during the COVID-19 pandemic and beyond.

Plexiglass: Transparent Protection
Visitors will notice the medical center looks a little different now with numerous plexiglass shields installed at check-in counters, desks, and other areas throughout the medical center. The shields are designed to be transparent physical barriers to block virus-containing droplets released by coughing, sneezing and speaking. The Primary Care Clinics and the Emergency Department were the first areas to receive the shields that were crafted in-house in the FMS workshop. Plexiglass shields for laboratory, MRI, Oncology and the retail store and cafeteria quickly followed.

The FMS team has also created plexiglass protectors for use in direct patient care areas including the Dental, Dialysis, Interventional Radiology and Eye Clinics. FMS interior designers are working on procurements for more-permanent, modular shielding solutions for future use.

FMS staff members are also making shields to be used in direct patient care such as optometry.

COVID-19 Infrastructure Updates
Besides creating the negative pressure rooms and plexiglass protectors, FMS staff members have been working on a number of other projects in support of the COVID-19 effort.

The first few weeks in March were a blur of activity as the FMS team helped modify the DECON trailer and set up the Respiratory Evaluation Center (REC) in the Research Building. The REC allows staff to evaluate and test Veterans for COVID-19 in a separate location and has reduced wait times in the Emergency Department.

FMS staff has added view panes to the doors of inpatient rooms and will soon be doing the same for select Community Living Center resident rooms. “Many of the patient rooms needed to have view panes installed in the doors to allow clinicians to safely monitor patients without always having to go inside the room,” Williams said.

While not on the frontlines like nurses or physicians, FMS’s teamwork is vital to safe patient care. The service will continue to be busy as it monitors equipment and room pressures and stands ready to modify existing infrastructure as necessary to support frontline COVID-19 operations. We are all in this together, and we will get through this together as a health care team committed to caring for Veterans and one another.

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