The goal of a hospital it to make patients well, but hospital-acquired infections can result in just the opposite. That‚Äôs why infection control has become a top priority in medical facilities ‚ÄĒ and, increasingly, in veterinary settings as well.
At the James M. Moran Jr. Critical Care Center, on the New Bolton Center campus of the University of Pennsylvania School of Veterinary Medicine, biosecurity permeates every nook and cranny. To ensure the best treatment for critically ill large animals admitted to Penn Vet‚Äôs George D. Widener Hospital, everything from the building‚Äôs architecture to its flooring materials is designed to reduce the chance that patients acquire or pass on infectious diseases.
Before the Moran Center opened in 2010, Penn Vet‚Äôs isolation facility for large animals was in need of an upgrade.
Funding for the 18,540-square-foot Moran Center came from the Commonwealth of Pennsylvania as well as private donors, including Thoroughbred horse breeder and owner Betty Moran of Paoli, Pa. The center was named in honor of her son, who had a passion for Thoroughbreds.
Though a concern for preventing infection is common to both human and animal doctors, certain challenges are unique to animal hospitals.
‚ÄúWe have different issues for sure,‚ÄĚ said Helen Aceto, director of biosecurity and an assistant professor of veterinary epidemiology at Penn Vet. ‚ÄúOur patients at New Bolton Center live, eat and sleep in a stall, which might include eating hay from the floor. So salmonella outbreaks, for example, are more of a problem for us than they are in human hospitals.‚ÄĚ
Taking these facts into consideration, architects and vets collaborated on the design. Aimed at containing infections of all kinds, the Moran Center is comprised of two wings. One, with 14 stalls, including two designed to accommodate both a mare and her foal, is devoted to the treatment of colic. Colic is a general term to describe abdominal pain in horses; it can have many causes and is the leading cause of premature equine death.
The second wing, known as the isolation wing, has six regular stalls and four mare-and-foal stalls for patients who have, are suspected to have or are at high risk of contracting an infectious disease.
In both wings, all stalls are effectively self-contained, with their own ventilation systems, storage areas and dedicated equipment. Positive air pressure in the hallways ensures that air flows from the hall into the stalls and not the other way around. Every stall has a video camera, capable of rotating and zooming, to allow staff to check on their patients remotely. Clinicians can also adjust fluid and oxygen levels without ever entering a stall.
There are also specific biosecurity protocols for entering each wing and for entering a stall. In the isolation wing, for example, each stall has its own anteroom where patient equipment and medications are stored. Staff must don protective coveralls, shoe covers, gloves, and in some cases hair covers and masks in the clean central hallway before entering the anteroom. Once there, they put on overboots before entering a stall. After they have finished working with a patient, all protective apparel is removed and discarded in the anteroom before they return to the clean hallway.
‚ÄúThe new building is light years ahead of the old one,‚ÄĚ said Janet Johnston, a staff veterinarian at New Bolton Center who handles emergency and critical care. ‚ÄúIt‚Äôs comforting to know that we are confining any disease that might be infectious to the isolation stall, keeping all of our patients safe and not spreading a problem throughout the hospital.‚ÄĚ
The Moran Center also has ample spaces for staff to work, change and shower, as well as storage for hay, feed and medications.
‚ÄúEverything we need in case of emergency is at our fingertips,‚ÄĚ Johnston said. ‚ÄúIt‚Äôs great to have everything right here when you‚Äôre in crisis mode. In general, it makes it much more efficient and easy to take care of the most critically ill patients.‚ÄĚ
Clinicians at New Bolton Center have already seen the difference that a high-tech facility can make. Recently, a 2,200-pound draft horse mare had a C-section with complications. This ‚Äúextra-large‚ÄĚ patient benefited from having an ‚Äúextra-large‚ÄĚ stall. The ability to easily administer supplemental blood and medications, provide intranasal oxygen and support her in a hoist when necessary made a difference in her recovery. And the remote video link allowed staff to keep tabs on her to ensure she didn‚Äôt fall.
The Moran Center has also housed the equine victims of barn fires, which have special needs. The building‚Äôs easy access to oxygen, along with its sanitary environment and climate-controlled stalls, helped them heal.
‚ÄúThis building has made a huge difference in our ability to provide great care for all our patients,‚ÄĚ Johnston said.