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A Practical Guide for Healthcare Engineering Systems in Day Procedure Centres

With the Code of Practice for Day Procedure Centres (2023 Edition) (“the Code”) published by the Department of Health in January 2023, the requirements of specific healthcare engineering systems (i.e. electrical installation, specialized ventilation system and medical gas supplies) of day procedure centres form part of the regulatory standard accordingly. As a transitional arrangement, such requirements will take effect from 1 January 2028.

It is imperative for the prospective applicants or existing day procedure centres to collaborate with the engineering service providers so as to ensure that all relevant requirements pertaining to the healthcare engineering systems are adhered to.

To this end, we have compiled a practice guide as well as pamphlet for the trade practitioners and stakeholders, such as licensees of day procedure centre, registered professional engineers, consulting engineers, healthcare engineering installation contractors and property management personnel. These publications, though not exhaustive, outline the key points to note regarding the design, installation, operation and maintenance of healthcare engineering systems of day procedure centres, including the DOs and DON'Ts for compliance with the regulatory requirements, etc.

The following guide is for general reference and information purposes only, and should be read in conjunction with the Code of Practice for Day Procedure Centres (2023 Edition), other applicable ordinances, regulations and codes in the Hong Kong SAR.

Electrical Installations

• Engage competent service providers, e.g. registered professional engineer, with relevant qualification and experience, to carry out design, installation and certification of electrical supply systems for critical care areas.
• Follow the requirements of up-to-date international healthcare engineering standards, e.g. Health Technical Memorandum (HTM) 06-01 (2017 edition) - Electrical services supply and distribution, or equivalent, as set out in the Code.
• Identify all the installations and equipment that require back-up power supplies, e.g. critical medical equipment, operating lamp, and all general lighting in operating room and recovery area.
• Determine the back-up time required from operational point of view for sizing back-up power supplies.
• Prepare schematic diagram and layout plan of the electrical installations before carrying out on-site installation and statutory submission.
• Ensure all the electrical installation related documents properly kept and available on site, e.g. as-fitted electrical drawings, power demand calculation.
• Keep logbook to properly document all the maintenance activities, e.g. regular preventive maintenance, repair work.

✓	Design and install suitable back-up power supplies for critical care area, e.g. uninterruptible power supplies (UPS) system.
✓	Provide proper labelling for the socket outlets with back-up power supplies in critical care area.
✓	Provide uninterruptible power supplies (UPS) system or built-in batteries for operating lamp in critical care area, e.g. operation room.
✓	Provide back-up power supplies or secondary battery of light fitting for general lighting installations in critical care area.
✓	Design and install isolated power supply (IPS) system for life critical medical device, e.g. anaesthetic machine with ventilator for life support when general anaesthesia or major regional anaesthesia is performed.

✘	Provide critical care area with emergency generator only as a back-up power supply without due consideration of the need for continuous operation of critical medical devices therein. (Note: power supply from emergency generator can only be automatically available within 15 seconds upon failure of normal power supply.)
✘	Provide back-up power supplies only for part of general lightings in critical care area.
✘	Provide normal power supplies only for recovery area which is defined as a critical care area.
✘	Apply the requirements of outdated international healthcare engineering standards.
✘	Prepare a schematic diagram not tallying with the corresponding layout plans.

Specialized Ventilation Systems

• Engage competent service providers, e.g. registered professional engineer, with relevant qualification and experience, to carry out design, installation and certification of specialized ventilation systems.
• Follow the requirements of up-to-date international healthcare engineering standards, e.g. ANSI/ASHRAE/ASHE Standard 170-2021 – Ventilation of Health Care Facilities, or Health Technical Memorandum (HTM) 03-01 (2021 edition) – Specialized ventilation for healthcare premises, or equivalent, as set out in the Code.
• Ensure sufficient fresh air supply to achieve the minimum outdoor air change rate for operating room.
• Ensure sufficient room space and headroom in an operating room for installation of specialized ventilation systems including all the required components such as low sidewall return or exhaust grilles, supply diffuser array with unidirectional and downwards flow pattern.
• Prepare schematic diagram and layout plan of the specialized ventilation systems before carrying out on-site installation and statutory submission.
• Ensure all the specialized ventilation system related documents properly kept and available on site, e.g. as-fitted ventilation system drawings, air change rates calculation.
• Keep logbook to properly document all the maintenance activities, e.g. regular preventive maintenance, repair work.

✓	Provide at least two low sidewall return or exhaust grilles spaced at opposite corners in an operating room.
✓	Select suitable supply diffuser array with unidirectional and downwards flow pattern in an operation room.
✓	Provide individual temperature control for an operating room.
✓	Monitor pressure gradient at an operating room with the use of appropriate monitoring device, e.g. real-time differential pressure meter.

✘	Provide only middle to high level return or exhaust air grilles in an operating room.
✘	Select supply diffuser array with multi-directional flow pattern in an operation room.
✘	Install major air-conditioning units inside an operating room, causing risk of water seepage, bacterial growth and difficulties in future equipment maintenance.
✘	Design a single specialized ventilation system serving multiple operating rooms without individual room temperature control.
✘	Prepare a schematic diagram not tallying with the corresponding layout plan.
✘	Apply the requirements of outdated international healthcare engineering standards.

Medical Gas Pipeline Systems

• Engage competent service providers, e.g. registered professional engineer, with relevant qualification and experience, to carry out design, installation and certification of medical gas pipeline systems.
• Follow the requirements of up-to-date international healthcare engineering standards, e.g. Health Technical Memorandum (HTM) 02-01 (2006 edition) – Medical gas pipeline systems, or equivalent, as set out in the Code.
• Ensure sufficient space to locate multiple sources of piped medical gas supplies, namely primary, secondary and reserve / tertiary, and their associated gas manifold(s).
• Prepare schematic diagram and layout plan of the medical gas pipeline systems before carrying out on-site installation and statutory submission.
• Ensure all the medical gas pipeline system (MGPS) related documents are properly kept and available on site, e.g. as-fitted MGPS drawings, diversified gas demand calculation.
• Keep logbook to properly document all the maintenance activities, e.g. regular gas pressure test, repair work.

✓	Ensure all medical gas pipeline system (MGPS) comprising of multiple sources of supply, namely primary, secondary and reserve / tertiary, where automatic gas manifold is used (the photo displays a kind of arrangement for primary source of medical gas supplies through gas cylinders).
✓	Provide back-up power supplies to medical gas pipeline system plants and equipment.
✓	Provide gas test point for medical gas pipeline system.
✓	Install warning and alarm device to monitor the safe and efficient operation of the medical gas pipeline systems.
✓	Provide valve set (e.g. area valve service unit (AVSU)) for the medical gas pipeline system for maintenance / repair purposes.
✓	Install the discharge of anaesthetic gas scavenging disposal system (AGSS) at a suitable location to minimize the recirculation of discharged air back into the building.
✓	Appoint an authorized person in writing by the Facility for supervising the maintenance, repair and alteration work of the medical gas pipeline systems.
✓	Govern all works on the existing medical gas pipeline systems by a safety management system, e.g. a permit-to-work form.

✘	Provide only single or inadequate sources of medical gas supplies for the medical gas pipeline systems.
✘	Assume roughly medical gas cylinder's quantity and capacity without adequate justification according to internationally acceptable standard, operational policy and contingency plan of the facility.
✘	Implement a permit-to-work system with only the involvement of a contract-out service agent.
✘	Apply the requirements of outdated international healthcare engineering standards.
✘	Prepare a schematic diagram not tallying with the corresponding layout plans.

The electronic pamphlet with practical information is also available for download (Traditional Chinese version available only).