Innovative Healthcare Trends – The Barn Operating Theatre

With the current drive towards improving efficiency and saving costs across hospitals, barn operating theatres have become a new and innovative way to use theatres.

The term ‘barn theatre’ refers to the open-plan design of the main surgical area, where each patient is treated in a dedicated space alongside the next patient, with a specialised air canopy over each station to prevent the spread of infection. The barn theatres have adjoining anaesthetic rooms and traditional recovery areas. Benefits of barn theatres include lower infection rates, improved safety and enhanced team working.

However, for multiple operations to take place in a single open space, it is essential that the ventilation system provides the protection against cross-contamination that would normally be provided by the intervening theatre walls. It’s also essential that the correct doors are specified to maintain the correct room pressures and prevent the spread of infection.

The open plan design of the barn theatre can offer lots of potential and numerous benefits, including:

– Opportunities for enhanced team working
– Greater peer awareness of contemporary surgical practice and standards
– Improved supervision for non-consultant surgeons
– Opportunities to develop non-doctor anaesthetists in a safe environment
– Efficient space utilization
– Reduced infection rates through improved theatre discipline.

Although the concept of the barn theatre is still relatively new, there have been an increasing number of barn theatres completed within the past few years; including Wrightington Hospital in Lancashire, Broadgreen Hospital in Liverpool and Chase Farm Hospital in London. There are a few other similar projects, including those at Salford Royal Hospital and the Royal Orthopaedic Hospital in Birmingham.

Dortek have supplied specialist doors to a number of these theatres, with Wrightington hospital and Chase Farm Hospital being the most recent. Dortek hermetic sealing sliding doors were specified on the recent Chase Farm project to provide maximum hygiene, ease of access and control of air leakage. Our hermetic doors have a 99% air tight seal, which helps prevent air leakage and reduce the risk of cross contamination in these areas. The doors and privacy vision panels were also supplied with lead and laser protection and touchless automations. The hygienic GRP construction of our hospital doors gives them a smooth, non porous and easy to clean surface which is ideal for infection control areas. Unlike timber doors, Dortek hygienic GRP doors have no natural seams, voids or crevices which can harbour bacteria. They are also free from hard to clean lips, joins and ledges (even around vision panels).

barn operating theatre doors
Dortek Hygienic GRP Hermetic Doors at Chase Farm Hospital

In essence barn theatres have numerous benefits, for orthopaedics surgery in particular and are designed to help hospitals treat more people more quickly, safely and cost-effectively. The unique concept means that more operating theatres can be put into smaller spaces with reduced members of operating staff. With multiple surgeons working alongside each other it’s also an ideal opportunity to share best practice and standards.

In the following video, Dr Alan McGlennan, medical director at Chase Farm Hospital, talks through the benefits of the new barn theatres in more detail. https://vimeo.com/281403947

Basic requirements for cleanroom doors

Choosing the correct door system is a major factor in ensuring the delicate balance of a cleanroom. If the doors do not function properly, the cleanroom could fail to meet relevant cleanroom standards and be exposed to a higher risk of contamination. Here are some of the most basic but essential factors to consider when selecting a cleanroom door.

Hygienic & Flush Fitting

It’s vital that doors and frames are completely flush with the wall panels in order to meet compliance standards and be easy to keep clean. The door surface should also be a smooth flat surface that is free from ledges, recesses or anywhere that bacteria or dust particles that can be trapped and grow. Vision panels within the doors should also be completely flush to the door to maintain hygiene. As ISO-1464 44-4 2001 states: “Doors should present as few horizontal ledges as possible with particular attention being paid to the minimisation of steps or ledges.”

Flush cleanroom doors Dortek
Design of hygienic and flush fitting cleanroom doors

Easy to integrate

Door systems which are designed to be compatible to any type of wall system should be chosen. It is essential that the complete door and frame system can be integrated seamlessly to create a flush finish on both sides of the wall. If the door system does not integrate into any wall structure then it can be difficult to change parameters within the facility without the cleanroom door integrity being compromised.

Resistant to cleaning chemicals

Cleanrooms are exposed to intense cleaning every day with a variety of strong chemicals to assure high levels of hygiene. Cleanroom doors, as any other cleanroom surfaces, need to be resistant to the regular usage of any cleaning products and any reaction between the door and the chemicals need to be avoided. Most reputable companies carry out tests to make sure doors resist common cleaning chemicals, Chlorine and VHP (vaporised hydrogen peroxide).

Easy to keep clean

Door surfaces in a cleanroom should be smooth in order to remain impervious to microorganisms. The design of cleanroom doors should be kept as simple as possible, avoiding the use of elements that are difficult to clean like ledges or complex mechanisms. Both sides of the door and frame should be completely flush to the wall, to avoid uneven surfaces which are difficult to keep clean.

Impact resistant and durable

Doors in cleanrooms can be subject to high amounts of traffic and exposure to hazardous chemicals on a daily basis. Selecting the right door solutions can help save time and money over the longer term. Strong, lightweight doors should be chosen to improve durability, ease of maintenance and low lifecycle costs.

Vision panels with safety glazing

In a cleanroom, safety comes first. Therefore, every part of the product should be designed to meet the highest safety requirements. Vision panels in doors should be safety glazing and shatter proof to prevent any risk of glass scattering if the panel breaks.

Dortek Door Fiberglass Systems

FRP cleanroom doors

Dortek’s range of door sizes and thicknesses are designed to integrate into all cleanroom modular panels. Our unique frame design offers a completely flush finish to any cleanroom wall panel of choice.

Considerable care and quality control goes into every Dortek door blade to ensure the smoothest possible finish. The fiberglass door blade is designed to have no sharp edges or 90-degree angles for ease of cleaning. Our frames are seamless, smooth, with round edges and seamless mitres with no crevice or dirt gathering areas.

We are constantly developing innovations to our product offerings to enhance the hygienic performance of our products. Small, but critical, features including flush fitting frames, recessed hinges, vision panels, lock keeps and receivers have all been continuously re-designed to minimise and eliminate dirt gathering areas in cleanrooms.

Oxford Biomedica Expansion Project

Dortek has recently completed a project for a new state of the art cleanroom facility which will enable a leading international gene and cell therapy company to expand its bioprocessing operations and manufacturing capabilities.

From the outset Dortek were appointed to work alongside the project team to design, manufacture and install specialist hygienic GRP doors for the facility. Dortek doors were installed into GMP cleanroom suites, production areas and quality control laboratories.

The specialist areas have been designed in full compliance with MHRA regulations and conform to ISO cleanroom standards. This includes the use of zoned HVAC systems to maintain the segregation, cleanliness, air pressures and other environmental controls.

Choosing the correct door system is a critical part of the design within these facilities as the doors will dictate compliance with standards, ease of traffic movement, hygiene, fire regulations and balance of air movement. As well as this, doors must be seamless, waterproof, resistant to cleaning regimes and free of voids and organic material such as wood where bacteria could multiply.

Dortek supplied 160+ hygienic door systems, some doors had hermetic sealing for air pressure differential and VHP fumigation control. Doors were also supplied with fire and smoke test certifications. More than 60% of the hinged and sliding doors are automated and interlocked, actuated by touchless sensors for greater facility control against cross contamination.

Dortek hygienic GRP doors are completely free from cracks and joints making them the most hygienic solution. The moulded seamless construction of a Dortek door makes it easy to clean, non-absorbent and able to withstand the intensive cleaning regimes which are often used in cleanrooms and research laboratories.

Dortek’s Marketing Manager, Sheree Headspith, said: ‘We have built a strong reputation for supplying our specialist hygienic GRP doors to the biotechnology industry and the number and quality of projects we are being specified on continues to grow. We are delighted to be able to offer our expertise and knowledge on doors for these highly specialist facilities which are required to meet strict regulations and high standards of cleanliness.’

clearoom doors

Reasons why Dortek Hygienic GRP Doors are specified in Bioscience and Research facilities:

  • Smooth, seamless hygienic door construction
  • Door and frame completely void free – nowhere that moisture and bacteria can gather undetected
  • Ledges minimised (windows are completely flush to both sides of the door)
  • Hardware options – hinges, locks and closers can fit virtually any GRP door panel.
  • Resistant to the commonly used cleaning and fumigation agents used in research facilities
  • Lightweight yet very strong – increased widths and heights available, all easy to operate
  • High hygiene, hermetic sealing and fire rating in one door
  • Fire certificated to UL, BS, EN, China, Singapore, Australia and NZ standards.

Hygienic Lead Lined X-Ray Doors

Due to the advantages that our seamless, hygienic GRP doors can offer, our lead lined solutions have become increasingly popular in hygienic applications requiring radiation shielding. Unlike more traditional solutions where the lead lining material is surface mounted and then covered, leaving voids or seams where dirt can accumulate. Dortek lead lined doors are manufactured in such a way that the lead sheet is completely encapsulated in the waterproof GRP shell. This ensures that our lead lined GRP doors still offer all the hygienic benefits which are critical for clean environments.

x-ray doors Dortek

Hygienic GRP Lead Lined Door Solutions

Hygienic GRP doors are made of a plastic reinforced by fine fibers made of glass, commonly referred to as glass reinforced polyester. The doors have a smooth, non porous and fluid/chemical resistant surface which makes them very easy to keep clean. They have no lips, joins or edges (even around vision panels) and the door finish and door core are timber-free and inorganic. This makes them extremely versatile and ideally suited to harsh or hygiene-critical environments found in healthcare and cleanroom facilities.

Dortek can offer lead thicknesses of up to 25mm for specialist high energy therapy applications and door sizes up to w 2850mm x h 2450mm. Our lead lined door solutions are extremely versatile and can be manufactured to offer a wide variety of performance characteristics to suit their application. This includes requirements for lead lining and lead lined privacy vision panels, fire ratings, hermetic sealing, smoke, acoustics and hands-free automations.

All our x-ray doors are manufactured to have an equal appearance to doors without lead protection. Our x-ray doors are available as hinged or sliding, with or without flush mounted windows.

For more than 50 years Dortek have been supplying hygienic GRP lead lined doors to the global Healthcare and Pharmaceutical sectors. Our solutions are specified by some of the world’s largest and most recognisable facilities due to their hygienic qualities, customisable features, hard-wearing properties and long-lasting nature.

Key benefits

✓ Fully sealed, ultra clean construction

✓ User defined lead protection

✓  BS lead thickness from code 3-8

✓  Non fire rated or fire rated

✓  Hinged, sliding or hermetic sliding

✓  Available with lead lined vision panels & factory-fitted hardware

✓  Integral Colour

✓  Standard or bespoke sizes

✓  Manual or automatic

Global Vaccine Manufacturing Facilities

Dortek hygienic GRP doors are specified for leading global vaccine manufacturing sites around the world. This has for over 20 years now included GSK Vaccines who are one of the world’s largest vaccine manufacturers.

Dortek’s hygienic GRP doors play an essential role in maintaining hygiene, as well as providing certified fire ratings and ensuring safe and efficient access across vaccine manufacturing facilities.

Dortek hygienic doors are manufactured from high technology engineering GRP using a unique closed mould process. This creates a strong, uniform product with no seams or joins on the door surface and no voids, holes or crevices within for bacteria to harbour. Dortek hygienic GRP doors are free of timber and other organic materials that promote bacterial growth. They are also completely impervious to moisture and common cleaning chemicals and disinfectants. This makes them ideally suited to vaccine manufacturing areas requiring maximum hygiene and cleanability.

A further key feature are the critical air pressure cascades required in vaccine facilities. Dortek doors are able to maintain air pressure differentials and therefore contribute to the smooth and clean running of the facility.

GSK Vaccines Wavre, Belgium
GSK Vaccines Wavre, Belgium
GRP Hygienic Fire Doors in Vaccine Facility
GRP Hygienic Fire Doors in Vaccine Facility

About GSK Vaccines

GSK Vaccines deliver over two million vaccine doses per day to people living in over 160 countries. GSK vaccines has a portfolio of over 30 vaccines, helping to protect people from 21 diseases. One third of the vaccines in development help to target diseases particularly prevalent in the developing world, including all three WHO infectious diseases priorities: HIV, Malaria ad TB.

Dortek have been supplying specialist hygienic GRP doors to GSK vaccines for more than 20 years. This has included the following manufacturing sites, GSK Wavre, GSK Rixensart Belgium, St. Amand Les Eaux, France, Godollo, Hungary and Singapore.

 

Hospital Infection Control: The Importance of selecting the right hospital doors

Here’s some advice about key design considerations when specifying doors in hospitals and other hygiene critical facilities.

Since microorganisms can be transmitted by contact, choosing the right doors can make a huge difference to infection control. Hospital doors can be a major source of contamination as they are the piece of equipment which is touched the most by patients and staff. Hospital doors are also vital for controlling clean air and traffic flow. This is why it’s crucial that the correct door is chosen as it can significantly affect the risk of infection.

Making the right door choice

When specifying hospital doors, considering the following points will not only help infection control, but it will also ensure building regulations are met and the doors operate efficiently, with a long, trouble-free lifespan.

  • Hygiene performance
  • Inorganic door construction
  • X-ray and laser protection
  • Hermetic sealing for clean air control
  • Fire and smoke regulations
  • Automations and accessibility
  • Strength, durability and maintenance requirements
  • Sound insulation
  • Life cycle costs.

Hygienic hospital doors

Choose Hygienic Door Materials

One of the most important aspects of a successful infection control policy, is choosing the correct materials for both the construction of the room and the components within it.

The Health Building Note 00-09: ‘Infection control in the built environment’ offers valuable guidance for architects and specifiers. ‘Doors should be cleanable, that is, smooth, non-porous and fluid resistant’. This is particularly crucial in areas where infection control is paramount.

Hospital doors should be carefully selected to ensure they are constructed using an inorganic hygienic material such as GRP (Glass Reinforced Polyester). Doors should also be easy to clean and resistant to moisture and disinfection procedures. A smooth construction should be defined as seamless with no texture, voids, reveals or laminated components which can harbor bacteria.

Hygienic GRP doors infection control

Specifying hygienic GRP doors for infection control

Hygienic GRP hospital doors are manufactured from a high technology moulded composite which has been independently tested. Laboratory tests conducted by IMSL (Industrial Microbiological Services) prove that hygienic GRP doors help prevent bacterial and fungal growth. Dortek Hygienic GRP doors have been independently tested by IMSL for resisting infections such as MRSA, Aspergillus Niger, Staphylococcus Aureus & E Coli.

Critical to the doors hygienic performance is its one-piece moulded GRP construction with no seams, joints or voids where bacteria, dust or dirt can build up undetected. The inorganic construction and water repellency of Dortek doors provides no sustenance for harmful microorganisms. Hygienic GRP hospital doors have no lips, joins or edges (even around vision panels). They have an easy to clean surface which is unaffected by moisture or common cleaning chemicals and disinfectants. Colour is also built into the gel coat of the door to provide continuous long-lasting protection, which is not reduced by impact damage.

Hermetic sealing for clean air control

Hermetically sealing doors should always be considered for reducing cross contamination through air flow in high risk areas such as operating rooms and patient isolation areas.

Hygienic GRP hospital doors can be supplied with hermetic sealing options for controlling air. Hermetic hygienic doors have a unique patented track system so it seals perfectly against the floor and frame. The efficiency of the seal has been officially tested and results show it to be over 99% effective thus helping to reduce the spread of airborne infections, cross contamination and air handling costs.

Hygienic hospital doors

Third party tested fire ratings and lead protection

In certain areas of a hospital, evacuation in the event of a fire is almost impossible. Intensive care units and operating theatres are obvious examples. Fire doors are often the first line of defence in a fire and their correct specification can be the difference between life and death for building occupants.

Hygienic GRP doors have a vermiculite-core and can provide up to 4 hours fire protection. Vermiculite is a mined mineral rock, which is classed as non-combustible. Hygienic GRP fire doors have been third party tested and have a patented concealed intumescent strip built into the door. This maintains a smooth seamless profile ensuring that there are no seams or ledges where dirt and germs can gather.  It is also ideal for high traffic areas as it never comes lose or needs to be replaced. Hygienic GRP doors can also be supplied with x-ray ratings and sound insulation for the added protection of patients and staff.

Touchless automations to reduce cross contamination

Hygienic GRP Doors can be automated to provide hands-free entry and further reduce the risk of infection. The doors use an intelligent automation which is key for user safety. The automations react to the smallest obstruction and photo sensors stop the door from closing onto passing traffic. Doors can also be provided with access control systems, locking and interface with BMS (Building Management Systems) for extra security.

Durability and life cycle costs

With sustainability at the forefront of the healthcare sector, doors which require frequent servicing or redecoration should always be avoided. Hygienic GRP doors are up to 42% lighter than wood or laminate doors. This removes any need for expensive maintenance work or replacement due to excessive wear on hinges and closers. GRP is an exceptionally strong and heavy-duty material which gives it the lowest whole life cycle costs in comparison to other alternatives.

Hospital doors infection control

Complete project management from specialists with over 50 years’ experience

Dortek has over 50 years’ experience working in the healthcare sector and has completed over 2000 projects for the NHS, international healthcare authorities and the private sector.

Dortek’s in-house project managers work with architects to provide fully integrated, hygienic door systems which help to improve both infection control rates and operational costs. Dortek hygienic GRP doors are extremely versatile and can meet a wide variety of performance characteristics to suit all healthcare applications. This includes requirements for hygiene, fire ratings, smoke, air sealing control, touch-free automations, x-ray and laser protection, acoustics, water resistance, infection control and durability.

For these reasons Dortek hygienic GRP doors are specified by hospitals, architects, healthcare planners and infection control departments across the world.

Just some of the hospital’s already benefiting from using Dortek’s hygienic GRP hospital doors.

  • The London Clinic, Harley Street, UK
  • Great Ormond Street Hospital, UK
  • School of Hygiene and Tropical Medicine, UK
  • Royal London Hospital, UK
  • Guys and St Thomas Hospital, UK
  • New York-Presbyterian Hospital, US
  • Yale University Hospital, US
  • National Children’s Hospital, US
  • Baptist Health South Florida, US
  • St. Luke’s Hospital, US
  • Sengkang General Hospital, Singapore
  • Ng Teng Fong Hospital, Singapore
  • Singapore General Hospital, Singapore
  • KK Women and Children’s Hospital, Singapore
  • National Heart Centre (NHC), Singapore
  • National University Hospital, Singapore
  • National Centre for Infectious Diseases, Singapore
  • Alice Spring Hospital, Australia
  • Vincent’s Private Hospital, Australia
  • Royal Adelaide Hospital, Australia
  • Mercy Hospital, New Zealand
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