Inside Duke Medicine

Engineering: First responders for our facility

Zone mechanics, Jamie Coombs (left) and David Conklin, repair the Cafeteria grill. Photo by Tom Wooters

We often think of the term “first responder” in the sense of healing people.

But, there is a team of “first responders” who make the healing of others possible. This team maintains the hospital building, Health Services Center and Lincoln Community Health Center, 24 hours a day, seven days a week. Without the maintenance provided by Engineering, the hospital would not function.

Durham Regional’s Engineering team is the first called for anything in need of repair—this includes broken equipment and electrical systems. To make this happen, there are 32 skilled individuals who “do it all.”

Did you know there is a steam plant in the first floor of the hospital? In this room, steam is produced and sent through the hospital to heat the building and operate the equipment that sterilizes surgical instruments. A complex system of boilers, pipes, pumps and centrifugal chillers create and distribute steam and chilled water for air conditioning. And, the steam plant maintenance team works around the clock to monitor the plant and handle any maintenance issues in the hospital that occur after first shift.

Bobby Carden is a steam plant operator who works nights and weekends. When Bobby started his shift today at 4 pm his first responsibility was to run a chemical test of the water in the two boilers, which create the steam for Durham Regional. The 2,800 gallons of water in each boiler must be balanced to keep the interior of the boiler clean so it will function properly.

Bobby checks the boiler gauges and pumps. He monitors the water levels and the condensate tank, which is used to help recycle the steam. He checks the Heating, Ventilating and Air conditioning (HVAC) chillers, which are also housed in the steam plant. He maintains the nitrogen and nitrogen oxide tanks, used for running some Operating Room instruments, and oxygen tanks, through which oxygen is sent to inpatient rooms.

Because Bobby works nights and weekends, he also handles all requests for maintenance during these hours, which on first shift is a responsibility of the zone maintenance mechanics. In 45 minutes, Bobby received 15 pages on his beeper for maintenance requests—a number he says is average for both first shift and after-hours. All patient-related work orders must be completed first and with-in the work shift, even if help must be called in. There is an electrician, HVAC mechanic and zone maintenance mechanic on-call if back-up is needed.

You name it, the zone mechanics repair it. This includes items as simple as the remote control in a patient’s room to something as complex as the equipment sterilizers and trayline.

When a patient's bed is not working or the light won't turn on, Engineering is called. If someone's keys fall down the elevator shaft or they have a signage request, he or she calls Engineering.Whenever employees have issues with non-clinical equipment or their environment, they call Engineering to resolve them.

“What’s so wonderful about our team is that they are so versatile. While each person in Engineering has a specialty—for instance carpentry or plumbing—each can also be counted upon to repair almost anything,” says Larry Holder, assistant director. “This is a team who truly comes together and helps everyone.”

The Engineering team includes: carpenters, electricians, HVAC mechanics, grounds crew, steam plant mechanics, zone mechanics, a painter, plumbers, a signage drafter, support staff and administration.

Engineering has numerous responsibilities in addition to maintenance:

• All construction and renovation projects are managed or completed by Engineering. This year, Engineering has completed the following renovations: Critical Care Unit, Cath Lab, Radiology Oncology, MRI, Nuclear Medicine, The Duke Center for Metabolic and Weight Loss Surgery and the Psychiatry, Bariatrics, Medical and Postpartum units. The team is currently working on upgrades to the Emergency Department, Vascular Radiology, Labor & Delivery and Pharmacy.

• Engineering has an important role in customer service and patient satisfaction, because if something is broken in the room, it can mean an unpleasant patient experience. The team has implemented daily room checks Mondays through Fridays. This is a time during which the Engineering personnel visit all new admissions. They introduce themselves to the new patients and check to make sure there are no questions or issues with equipment, lighting or plumbing.

• Engineering employees serve on task forces to improve patient safety and care. For instance, David Conklin, who is a zone mechanic and serves on the falls prevention team, is training staff on best methods for using the Hill-Rom Versa Care patient beds in a way that is safe for patients and staff to help avoid patient falls.

• The team plans and implements shutdowns—such as electrical, plumbing, medical gas and fire safety.

“We never know what we will be asked to do on any given day,” says David Conklin. “We just have to be ready to go and ready to pitch in at all times.”

A recent example was a major electrical failure in the hospital this Spring. The electrical feeder for the MRI, CT Scan, Vascular Radiology, Operating Rooms 12-17 and parts of Lab and Information Systems shut down. Electricians immediately started to work on temporary wiring around the areas that lost power to keep the power on until new parts could be delivered.

“The Engineering staff were amazing. They quickly found a solution without having the needed parts. The outage occurred at 10 am. By 4 pm, all the temporary wiring was in place so we could operate the affected areas,” says Scott McCarver, senior director for Performance & Support Services.

Perhaps Bonnie Daniel, administrative assistant, best summarizes what it means to be part of the Engineering team. “We are here to solve problems. We respond to everything, and we’re all in this together,” she says.