About the Project
The Pulmonary Function Test (PFT) laboratory operates to measure patients’ lung function for diagnosis of lung disease and to assess response to therapy. In the wake of the COVID-19 pandemic, staff and clinicians were challenged to provide a safe facility to assess parents’ lung function over time, as the PFT lab lacked an updated ventilation system which would enable clearance of potential aerosolized virus from an essentially unventilated room. This meant that instead of seeing one patient per hour, as was the standard in pre-COVID times, the lab was only able to perform 1 full PFT every four hours, leading to a 6 month wait list, increased stress of staff who were now working 7 days per week, and a reduction in services such as cardiopulmonary exercise testing. Guidelines from the Canadian Thoracic Society and Centre for Disease Control require 12 air exchanges per hour in order to efficiently remove airborne microorganisms, to permit hourly testing appointments. As a temporizing solution, simple spirometry testing was also undertaken in the negative pressure rooms in the TB clinic. However, the lab needed a more permanent, sustainable solution.
Dr. Heather Clark, Medical Director of the PFT lab, led an engagement project using funds from the South Island Medical Staff Association to address this issue with her colleagues in Respiratory Therapy as well as Island Health administration. Engaging across Facilities Management, Ambulatory Care, Respiratory Therapy Services, and with the expert project management help of Charlotte Bowey, the group was able to build consensus around the problem, and devise a workable solution. Drawing on funds from the capital expenditures budget, the group purchased several commercial air purification systems from Ambius (VK103) which employ a HEPA filter, carbon filter, and UV-C reaction chamber, to filter air and provide the equivalent of 12-16 air exchanges per hour to remove aerosolized infective particles.
In Dr. Clark’s words, “this represented a simple and extremely cost-effective means of improving air quality, avoided major construction and disruption of the labs, and provides portability in case the labs move in the future.” The PFT lab is now able to pursue a full patient schedule, rather than waiting for up to 3 hours between appointments, representing a 300% improvement in patient flow.
Dr. Clark described her satisfaction with the project outcomes: “I’m not only coming into this as the Medical Director of the PFT lab, I’m also thinking as a clinician. For my patients, these PFT tests are essential. I need to adjust their treatments based on their progress, as indicated by these tests. Yet I’m taking these very vulnerable people and asking them to come into my institution. So there is a real sense of burden and duty of care to those people.”
We congratulate Dr. Clark; Kristal Speed, Director of Ambulatory Care and Medicine Quality; Hans Crljenkovic, Clinical Coordinator Respiratory Therapy Services; Jodi Zimmer, Supervisory Respiratory Ambulatory Programs; Richard Barrette, Manager of Technical Services Facilities Maintenance Office; and Charlotte Bowey, Project Manager for this tremendous achievement!