QEUH building increased risk of infections
A review into Glasgow's Queen Elizabeth University Hospital says aspects of the design, build, commissioning and maintenance of the site increased the risk of infections.
The report on the £842 million compled found adult and child cancer patients "have been exposed to risk that could have been lower'' but said failures had not led to "avoidable deaths''.
The review was ordered by Health Secretary Jeane Freeman following the deaths of three patients between December 2018 and February 2019.
An adult and a child died after they contracted cryptococcus, an infection linked to pigeon droppings, while another adult died after contracting fungal infection Mucor at the hospital.
The independent review found no sound evidence that avoidable deaths have resulted from failures in the design, build, commissioning or maintenance of the QEUH and Royal Hospital for Children (RHC) which is part of the campus.
But it said patients, staff and visitors who are vulnerable due to immuno-suppression or who are in proximity to patients with certain highly infectious communicable diseases have been exposed to risk that could have been lower if the correct design, build and commissioning had taken place''.
The review, led by Dr Andrew Fraser and Dr Brian Montgomery, found the hospital was not built, finished and handed over in a manner that took full account of the specific needs of vulnerable patients.
Dr Fraser said: "While the hospital provides a safe healthcare environment for patients, staff and visitors, as the review progressed our findings caused us to focus on those clinical places caring for children and adults with cancers including leukaemia.
"These specific groups have been exposed to risk that could have been lower if the correct design, build and commissioning had taken place.
"The series of problems and influences that we have identified through the phases of the QEUH project has disrupted treatment for defined groups of patients, meant additional workload for Infection Prevention and Control teams, many clinical groups and hospital management, and diverted resources and attention from the running of this large and complex facility.''
The authors said they took the view that in the design, construction and commissioning of QEUH, the client and construction contractors set out to comply with "standards consistent with a more conventional hospital'' and should have taken greater account of the needs of all potential patients including those in the high risk groups such as severely immuno-compromised patients.
An independent review by Health Protection Scotland (HPS) into the water supply confirmed contamination of the system in 2018.
Ten-year-old Milly Main died in 2017 at the RHC from an infection, which her mother said she believes was "100%'' due to contaminated water.
The review team was asked to investigate if the management and execution of the project had adversely impacted on the risk of healthcare associated infection at the hospital.
The 226-page report, which makes 63 recommendations, made a number of findings, including that the design of the hospital did not effectively reconcile conflicting aims of energy efficiency and meeting guidance standards for air quality.
It also said the project would have benefited from greater external expertise and greater uptake of internally available expertise to support decision making on the water and air ventilation systems at key points in the design, build and commissioning phases.
But in the case of the two people with Cryptococcus infection, there was no sound evidence to make a link between their infection, subsequent deaths, and the presence or proximity of pigeons or their excrement while in the case of the other person Mucor had been ruled out as cause of death.
The review authors said the QEUH and RHC combined now have in place the modern safety features and systems they would expect of a hospital of this type and stated that the general population of patients, staff and visitors can have confidence that the QEUH and RHC offers a setting for high quality healthcare.''
NHS Greater Glasgow and Clyde has been asked for comment.
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