Continuous remote sensor surveillance of hot and cold water usage within a new hospital building: relevance for design, patient safety and sustainability.

BACKGROUND: Low use of hospital water services is poorly understood and represents a major gap in risk recognition for occupant safety, creates excessive estate management costs and undermines environmental sustainability.

AIM: This single-blinded study aimed to examine hot and cold water use across two inpatient wards and multiple outpatient units within a newly designed hospital with 100% single-patient rooms with ensuites.

METHODS: Continuous remote sensor monitoring was conducted on 258 assets, including taps, showers and plumbed equipment, using changes in pipework water temperature to identify individual usage events and durations.

FINDINGS: Analysis identified 118 of 258 assets (46%) without regular daily use, and highlighted the fallibility of manual flushing regimens and reliance on cleaning processes to ensure adequate water service operation.

CONCLUSION: Understanding of risks from water and wastewater services has expanded over the past 15 years and spread of antimicrobial resistance (AMR) from wastewater systems has led to removal of services within healthcare facilities in order to control otherwise intractable outbreaks. Consequently, multiple and competing risks must be competently assessed, with the first consideration being whether a water asset should be installed at all. This study provides real-life evidence to support Project Water and wastewater safety groups, infection prevention and control teams, clinical staff, estates and facilities, capital projects, designers and architects in assessing the true need and placement of water assets to ensure regular, safe use, reduce patient risk, lower costs and improve sustainability.