STARC Systems

The introduction of ASHE ICRA 2.0™ has significantly improved guidelines for managing healthcare construction risks, but implementing these updated standards effectively can still present challenges, especially in complex scenarios like active healthcare spaces, emergency repairs, behavioral health environments, and space-constrained areas.

Join our experts as they break down recent survey findings on ICRA 2.0™ adoption, highlight common implementation challenges, and share solutions. Gain actionable insights to help your team navigate complex infection control scenarios, improve compliance, and ensure patient safety during renovations and maintenance projects.

Learning Objectives

Review current trends in the adoption of ASHE ICRA 2.0™, including who is leading infection control implementation and where healthcare teams see the greatest impact.
Identify common challenges healthcare facilities encounter when implementing ICRA 2.0™.
Learn practical strategies for effectively applying ICRA 2.0™ guidelines in complex, real-world scenarios.
Understand best practices for maintaining compliance and proactively managing infection control risks, even during unexpected situations and urgent repairs.
Discover actionable insights from industry experts that will help your team implement and adapt ICRA 2.0™ standards to your specific facility needs.

Full Webinar Transcript

For those who prefer text, we've included the complete webinar transcript below. Use it to quickly find topics covered in the presentation and reference important details shared by our speakers.

Good afternoon, everyone, and welcome to today's ASHI lunch and learn. I'm John Farrell, senior content manager at STARC, and I'll be your moderator for this event. Our session, keeping up with ASHI ICRA 2.0 adoption, key trends and best practices for challenging situations, explores how health care facilities are adapting to the latest infection control standards.

We've brought together an incredible panel of experts to share insights, challenges, and practical strategies for implementing ICRA 2.0 in complex scenarios.

Before we dive in, I'd like to intro like to invite each of our panelists to briefly introduce themselves.

Hi. I'll get it started. I'm doctor Janet Haas, and I'm an infection preventionist, for a long time. I'm a former president of APIC, the Association for Professionals in Infection Control and Epidemiology, and I'm an associate editor of the AJIC journal.

A fun fact is that I'm a second career nurse and epidemiologist, and I actually started my career in the construction trade. So I'm thrilled to be here.

Hello. My name is Leon Young, network infection prevention manager of facilities and construction for Allegheny Health and Network in Pittsburgh.

I've been practicing infection prevention since two thousand eight with a specialty in, construction and, all things ICRA since about two thousand twelve. So I have a lot of experience with that under my belt. I've done several presentations, with APIC and others.

And my background actually is in microbiology. I was a microbiologist, in the microbiology lab for, well, probably about ten or ten or twelve years before transferring to infection prevention.

My name is, Dan Padrigo. I'm the SPFU for the health care practice at First On-site, restoration.

I have been in the industry for just about twenty years, seen all kinds of scenarios, been involved with all kinds of emergency response situations.

Prior to doing that, I was, in the military for ten years as a firefighter, and I did fire inspections and, various other, duties.

Good afternoon. My name is Marshall Friday. I'm the VP of field sales and performance development for STARC. I've been in sales and sales leadership roles for the past twenty five years and have been at STARC since twenty twenty three. Excited to be here, John.

Thanks, Marshall.

Before we get into the survey findings, here's a quick visual reminder of the top ASHI ICRA 2.0 clarifications.

Since most of you are already familiar with these updates, we'll use this as a reference point and dive straight into what the data tells us about adoption trends.

Janet and Leon, the survey offers an interesting look at how teams are approaching ICRA 2.0. Let's start with the chart on the left. Leon, any thoughts on how often teams are reviewing and updating the risk assessments?

Yes. Thank you, John.

So the survey showed that fifty five percent review and update their risk assessment response before each major project.

I I was thrilled to see that the the choices annually, monthly, and quarterly were a much lower percent.

However, I I was hoping to see that percentage higher than fifty five percent. In my professional opinion, it's it's very important that ICRA teams are reviewing the risk assessment response, before all major projects.

And, Janet, I'd love to get your perspective on the chart to the right about ICRA leadership and the collaboration between IP and facilities teams.

Yeah. Thanks.

I think this is not surprising.

After all, it's called an infection control risk assessment that, seventy percent of the respondents almost have said that infection preventionists are are leading the charge. But I do think that it's interesting that a fifth of the respondents said that this was a shared responsibility.

And I think that probably, somebody has to be nominally in charge, but over the years, this has become much more of a collaborative venture, between facilities managers, construction, coordinators, project managers, and infection prevention to make sure that things are are going well. But I I think that probably it's reflective of reality that, infection prevention, takes the administrative lead on this in a lot of cases.

Sure.

Now survey sponsored, excuse me, survey respondents offered strong scores for ICRA 2.0's improved clarifications across seven key areas, but they also highlighted a few areas and about the built environment that makes these areas more challenging to put in place? Yes.

As we all know, that built environment is very challenging.

Doctor Haas and I, we're gonna, do our best to discuss a lot of these things.

The build environment and where construction containments need to be can be challenging as we all know. Items like air pressure, HEPA air exhaust, and cascading airflow can be difficult due to that build environment.

The fact that these infection prevention precautions are written into ICRA 2.0 is a great advancement by ASHI and much needed. And I hope to explain some of these things later in the presentation.

Great, Janet. Why don't you kick us off then?

Okay. So I'm gonna start with some of the key areas that cause problems for people, and that those are listed here, emergency work, nonacute care areas, and areas that close down, nonacute care areas that can't close down, and then areas that just can't close at all, like emergency departments. So next, please.

So let's just start off with emergency work, and nobody is expecting that there is an ICRA, when there's a fire or a smoke or a flood or a leak.

So it's important to think about the communication that goes out. And, while it's difficult to to and not expected to have something like a meeting, you should include your infection prevention and control team in the communications that happen to administration, and many places are using auto dialers and emergency alert systems. And if you you can plan in advance to just include your infection prevention team or lead, however you wanna do it at your facility, to be in that communication loop because, you know, it's not just the the event, it's the recovery from the event. So I think of these things in terms of the emergency preparedness plan. And so consider adding communication to fire drills or to consider having a drill about some kind of, you know, infrastructure situation like a flood or a leak that would impact patient care and the built environment.

Next, please.

So after the acute phase of of whatever the emergency is, you need to have prompt follow-up. Wet rugs and sheetrock can mean a mold risk, and the the wetness can be from your fire suppression is in addition to any kind of leak or a flood. So really have to be thinking about that and about contaminated supplies that may have happened as a result of your fire suppression system or a leak or a flood and, and getting those things out of circulation if that's what needs to happen. We worry about aspergillus, right there in the middle, which can can have a mortality rate of up to forty percent if people have it, an invasive case of aspergillus.

So as soon as that emergency part of the event is over, the recovery has to include infection prevention and rerouting patients if necessary and figuring out what what really needs to happen and follow-up to the emergency event. Next.

So moving into something that may be a little bit easier is nonacute areas, and areas that close down even in the acute care setting. So this is maybe your cath labs, maybe, other interventional areas and imaging areas. So you can prepare in the daytime and take advantage of downtime to do the work that needs to be done.

But the upside is that you have a time that nobody's in the area, and the downside is that the support systems that are there to help with moving of supplies and covering of things, and cleaning and oversight are usually not there during those downtimes as well. So you have to make sure that there's supervision that things are gonna go according to plan and a coordination for the setup and for the cleanup after the work is done.

Next, please.

So then you have areas that don't close, and some of these are in acute care, you can have behavioral health and also other areas of behavioral health. You have long term care, which is, people are living there. So you really have to take into consideration those those, kinds of issues and social issues of somebody who's who's at home, not in a hospital for a few days, and prisons and jails also have these ongoing things. So you may have to plan your work in stages and really start to think out of the box to have alternative areas for the activities that need to go on, group activities. When you have memory care, you also have to try the best that you can to not disrupt people's schedules because that can be very important to keep it keeping them as, healthy and optimized as they can be even when you take care of the facilities improvements that also need to be done.

Next, please.

So the areas that can't close, emergency rooms, labor and delivery rooms, and ORs, traumas trauma ORs and trauma bays in your emergency department and critical access hospitals, you have to think about, similar to our our nonacute care places, moving operations and changing things around, and the staging of of the work tends to be very important in these kinds of situations. So maybe you have two cath labs and you keep one open at all times for emergencies, so you can't plan to upgrade both of them at once. You have to make sure that one is still available and that you have a clear path to get patients to and from that place while you're doing the upgrades to the other one, and similarly for these other areas.

I think, COVID taught us how to be flexible, and one of the areas that that can sometimes be flexed is the ambulatory surgery pre and post op areas can be used for other things like emergency room bays or, for those urgent care visits if you need to do that. And I think that the soft skill that I'm I'm hoping that, for my part, you take away from this is the communication and the collaboration and having everybody at the table because they're coming with different perspectives to see how you can manage the flow of your patient care safely and get the work done that you need to get done. And

you have to remember that the ICRA 2.0 is not a requirement document. It's a guideline, and it's meant to be adopted to your specific situation. The built environment is different in each case, and your program is different from one facility to the next. So, those needs are gonna be unique to your facility or your program, and you need to really tailor your construction project to meet the needs of the ICRA and to meet all these other needs by by having the that dialogue and, communication.

And with that, I'll turn it over to Leon.

Thank you, doctor Hass. Excellent information.

In these next slides, I'll be speaking about airflow and filtration, above ceiling work, and then finish with plumbing and black water.

Exhausting negative air to the outside from the construction site is always the first choice. As most of us know, Acre 2.0 states, exhaust directed outdoors that is twenty five feet or greater from entrances, air intakes, and windows does not require HEPA filtered air. That all makes sense, but we as an ICRA team need to be careful when considering taking this action. That activity has the potential for a future bad outcome as most infection preventionists I know do not want the HEPA filter to be taken out of the machine.

Because then there will be the question, was that HEPA filter put back into the machine?

Probably ninety percent of health care construction projects do not have windows to use, or the windows can't be opened, to exhaust that negative air. Just discharging negative air into an adjacent space is acceptable and must be verified as HEPA filtered per IHRA classes four and five.

Using a particle counter is an effective way to detect containment breaches, detect dust and particle migration, and most importantly, using that particle counter is an effective way to confirm HEPA filtration efficiency.

Measure number of particles being drawn into the air take into the intake of your HEPA machine and measure the number of particles coming out of the exhaust.

And from there, calculate the percent reduction in the efficiency of the HEPA machine with a simple formula using those two numbers and multiplying by a hundred.

Next on the doc here, I'd like to discuss the concept concept of cascading airflow.

Now ICRO 2.0 states the following for ICRO classes four and five. Negative airflow pattern must be maintained from the entry point to the entry room and into the construction area.

The airflow must cascade from outside to inside the construction area.

The entire construction area must remain negatively pressurized. Now this picture hopefully shows what cascading airflow looks like.

Now in my recent discussions with contractors and IPs, it seems that cascading airflow is somewhat difficult to understand and sometimes tricky to establish.

Cascading airflow along with HEPA filtration verification is critical to establish proper construction site airflow to ensure patient safety in your surrounding areas.

Now this here, this is an this is an example of establishing establishing excuse me, establishing cascading airflow.

Inside this anteroom, there's a HEPA machine exhausting air directly into the construction site.

This setup is what I just showed you in the previous stick figure picture with the arrows.

The yellow digital manometer is showing negative pressure inside the construction site compared to the corridor at a value of negative point zero three six.

The handheld manometer is showing negative pressure inside the anteroom compared to the quarter at a value of negative point zero one one four. Now since the construction site is pulling more negative air than the anteroom, we have proper cascading airflow with this setup.

Now this next setup is a little different.

Instead of exhausting the anteroom HEPA machine into the construction site, the contractor is exhausting the anteroom machine out into the corridor.

This has the potential of creating the opposite of cascading airflow and the potential of pulling the bad construction air into your anteroom.

The manometers on the screen are now showing the opposite of the previous setup. We now have more negative air being generated inside the anteroom than we do inside the actual construction space.

Because of this, the anteroom has the potential to pull air from the construction space into the anteroom.

Now this can be fixed by simply moving the machine, switching the machine to a lower speed, or switching the machine to the off position.

Next, talk a little bit about about above ceiling work.

Precautions needed for above ceiling work have historically been a gray area. Enerco 2.0 aimed to remove the uncertainty with regards to work versus no work above the ceiling.

Removal of ceiling tile for visual inspection only, only only falls under type a activity, whereas work conducted above the ceiling falls under type b activity.

And as you can see from this ICRA matrix, work conducted above the ceiling, which is your type b in any patient care area, takes you down and requires an ICRA class three or four.

Providing active means to prevent airborne dust dispersion essentially means containment around the work area.

Environmental containment units, HEPA carts, pop up containments are acceptable, and also this type of containment must be equipped with HEPA filtered exhaust air. It's also important to remember the why behind this.

Obviously, if a black ceiling tower is discovered, then a containment with HEPA air will be will be needed. However, what if something like this goes unnoticed? Maybe it's hidden or maybe it's in an adjacent room.

Plumbing and black water will finish it up. Plumbing work is typically classified as a type a activity under ICRA 2.0, meaning it is clean in nature. For example, your minor plumbing work behind the sink or toilet, replacing a trap or replacing supply lines. The same clean and nature concept can be said for simple above ceiling plumbing work like maybe replacing a shutoff valve.

And then there are the more invasive plumbing jobs plumbing jobs where accessing the plumbing lines needs to be taken into account.

Minimal dust created takes us to a type b activity, and then a moderate amount of dust created will take you to a type c activity.

Wall cuts and demolition, as we know, always have the potential of mold exposure because we don't know what is behind drywall until it gets cut, especially when dealing with water sources.

It's important to remember to apply a proactive infection control strategy, especially when work is performed in sensitive health care environments.

And floods, as we know, they can be minor or catastrophic, and floods are always a major issue when caused by black water.

Moisture meters are very helpful tools when determining the extent of a flood and evaluating what wallboard was impacted and what wallboard may need to be removed.

Plumbing and black water are important issues from an infection prevention perspective and obviously must be dealt with swiftly and carefully.

As we all know, mold loves water.

I will now hand the mic back over to John.

Thanks, Leon. Dan, as senior vice president of health care practice at First On-site, what are some of the most common challenges your teams are seeing at Project Start?

Alright. We're gonna discuss couple common challenges, the why solutions and and really enforcing the standards. But if you'll go to the next slide, one of the, biggest things as we get into it is really understanding the the education and who's responding to to a loss and what they actually know about, said response.

What we find is that the expectation is when a when a restoration contractor responds, the entity wants the space to be dry dried out as fast as possible, which is normal thinking.

But as a restoration contractor in responding to these, we understand that we have to bridge the the gap between the s five hundred and an s five twenty. These are the this is the documentation and the standards that we use that help us understand how to dry spaces. This takes into consideration, installing fans and installing the proper dehumidification and having the proper balance.

As we've gone over already the to do this effectively inside of a hospital then, has the considerations of moving air, and we have to consider how that can be affect the, the environment and the occupant safety within the space. So this isn't easily achieved and it's difficult to to truly have everyone educated and understand and truly, be under the proper expectations that they're not gonna get their space back as fast as possible.

Key things are to to build the proper barrier, establish, negative air, prior to implementing any of the s five hundred, s five twenty practices and principles that the IICRC has created.

Go to the next slide.

And as we move on to the to the why of everything that we're doing, we have to consider that, HAIs are are one of the biggest problems inside hospitals. We're the air that we're moving has a potential to, pass these around. So HAIs are health care associated infections. And, this is when a patient acquires or gets, an infection inside of a health care facility.

HAIs cost facilities ten billion dollars per year. And according to the CDC, about one point seven million hospital acquired infections are occurred each year. And more importantly, about ninety nine thousand hospital patients die each year from an HAI. So when we we discussed this, that's the why, and that's why we have to, consider that's why Ashley has even gone further with the, ICRA 2.0 to help, others understand and help everyone understand and come together with a team approach to prevent the HAIs from occurring and to to protect the occupants within the space.

You can go to the next slide.

So as we respond to to, a loss and we're trying to, erect the proper barriers, here's situations you you, need to avoid.

Contractors and anybody trying to hurry up and do it because we're in this, an emergency situation and we're trying to act fast and trying to to get everything done properly. But we really have to consider what's behind those walls and what what are we moving throughout the facility. And, occurrence that happens when we do it and you do it too fast or a contractor does it too fast is what you see on the screen right now. It was poorly built containments, poorly built, chambers to where now there's a potential for cross contamination. That's why it's important to understand, the way the air is flowing, the way that the amount of negative air that the the space has. And then if you are venting back into the public space to to truly be using the laser particle counters as, we mentioned just a little bit ago to verify that your HEPA filters are achieving the proper reduction and are protecting the, occupant occupied space.

Next slide.

So there's, various different types of containers that we can, can use. Soft barriers are one of them. Soft barriers work well. They protect the space, but they need to be done properly.

You need to be able to, erect them and seal them off properly and create the negative chamber. Now these are, barriers that should be kept for should only be used for a small amount of time. If the project is gonna, endure longer than just a couple of, a day or two, then you should consider using, rigid barrier. Next slide, please.

Rigid barriers as we have up right here, on this slide, are preferred. Something that can, protect the the occupied space, prevent any cross contamination, make also give a a nice finish so that, occupants within the space don't necessarily, aren't concerned with what's going on because the more they see, the more they hear, the more questions that arise. So, the nice things about having more rigid barriers is that you can have some some sound attenuation.

And based on what you put up, you could have, additional, forms of fire, fire protection based on which types you actually use.

Next slide.

Well, thanks, Dan. Marshall, why don't you, maybe walk us through how STARC takes a unique approach to enabling ECRI 2.0 compliance during occupied renovations?

Absolutely, John.

One of the last lines that Dan just said was the more they see and hear, the more questions they have. I I'm thinking back to the beginning of this, and Leon mentioned that the survey results showed fifty five percent of infection prevention teams doing a risk assessment update every time before every project. But on that survey, I noticed twenty percent of folks saying there's not a regular schedule. So here at STARC, we're we're committed to solving for the containment challenges around ICRA to make that part of the risk assessment a simple box to check off.

Next slide, John.

Here at STARC, we accomplish that through four different solution pillars. The first and most important to us in a health care setting is experience.

The experience of the staff coming through the hospital as well as patients that are in the hospital is paramount to the overall experience when it comes to acre containment.

Profits are an important pillar for us as well for the facilities teams working on-site, as well as the contractors that come in and out day after day. Reusability is a big profit driver when it comes to hard containment barriers.

Gone are the days of single use drywall being the only option.

Protection is our third solution pillar, and all of our panels are ICRA class four and five certified, negative air capable and sound attenuating.

And finally, one of the more important things is the planet. Everyone has green initiatives these days, and some of our longest term customers have redeployed the same panels close to a hundred times in a hospital setting.

Next slide.

On top of the pillars that, I just talked about in the previous slide, our product also meets ASTM e eighty four for fire and smoke. All of our products have sound attenuating principles to them, with STC ratings from nineteen all the way up to forty one. So to Dan's point, the less they see and hear, the less questions they have. In the examples here, you can see the walls aren't just for blocking construction, but also serve, in some of these cases, as semipermanent walls for message boards, like you see in the top right, as well as directional signage throughout the hospital to keep patients and, staff moving through the hospital with the new containment that's up.

Next slide, John. Some of the biggest hospitals in the country are already leveraging modular reusable containment from STARC, including Kaiser Permanente, Cleveland Clinic, HCA, and several VA locations, across the country.

There are several things that contractors and facilities teams really like about the products that we offer. Number one is fast installation.

Dan, everyone really has talked about the the need for a quick response in several of these situations, and our product can be installed up to one hundred feet in an hour. So it saves a lot of time when it comes to blocking off anything in a hospital that needs to be kept away from patients to to reduce those HAIs.

They are safe.

Infection preventionists love the ICRA class four and class five ratings on the panels. They are durable.

Contractors who are great at maintaining the product are not having to rebuy this product over and over again, so durable and reusable there.

Our walls deployed five times are already cheaper than drywall being used five times, single use drywall.

And it's completely sustainable. There's zero waste to our product, and it is over ninety percent recyclable by weight.

Now there are four different products that can be used. RealWall is STARC's flagship product and is most commonly used in occupied health care renovations.

LiteBarrier actually came from customer demand for a lighter, easier to use, easier to deploy, but still maintain the same high level of STARC quality.

FireblockWall was a creation, that arose from areas that needed a one hour rating. And then StackBarrier, I have seen used in common spaces in a hospital, such as a a lobby where renovations in the lobby exceed twenty feet.

So great product there. Let's dive into RealWall real quick, John.

First thing about RealWall is that it has the appearance and stability of a RealWall.

It reduces noise up to fifty percent, and most of the applications for RealWall have been adjacent to active OR or ER areas, and I've seen it a lot in children's hospitals.

It does exceed class four and class five requirements.

And as you can see in this picture, whether it's a corner, a single door, a double door, a sliding door, anything that will still allow egress through the hall, the the wall can be set up to accomplish that.

LiteBarrier is about half the weight of RealWall and about forty percent less expensive.

It still exceeds class four and class five requirements, and any renovation work in an area that's not as concerned about sound attenuation could use a product like LiteBarrier. It comes in five different panel widths and includes all the same type of door and corner configurations to make any length of a run possible.

The last product that I'm gonna talk about is FireblockWall. It is actually e one nineteen certified as a full assembly and is the only one hour rated modular reusable system, used in health care right now. It does carry an STC rating of forty one and can actually be installed four times faster than traditional drywall.

Interesting to note, it has been approved and inspected by HCAI and OSHPD in California, for use in those kind of situations in a health care environment.

And, John, as we head into the q and a, wanted to just throw up some quick examples of these products in action. We saw some from Dan as well. No matter what type of project you're working on in a hospital, we've got a solution for you from FireblockWall to RealWall to LiteBarrier.

Great. Thank you, Marshall. That was great. I really appreciate it. If the panelist could please turn on your cameras, I'll go ahead and take a few questions from the audience.

For anybody attending, if you have a question on your mind you'd like to address to one of our speakers today, please add it into the question box, and I will take them as they come.

Let's see.

So here's one to the group.

When it comes to collaboration, and Janet, you were speaking about this earlier, collaboration across infection prevention, facilities, and construction teams, what are some of the best practices you've seen in action?

I think that, having everybody at the table is key.

And, one of the things that went was in favor for a while, and I'm not sure if it's still in favor, was to have everybody sign off on the plans for, for what's gonna happen both in terms of the what the finished space will be looking like, what the finished, you know, treatments are in the space, and how the construction barriers and the construction site integrity will be maintained during the actual project, because you don't wanna leave the users of the space out. You don't wanna overlook anybody from their perspective on how to how to make the project go smoothly and to have an area that's gonna be easily usable for for the future.

I can I wanna add to that real quick just to and if you guys have implemented ICHRA 2.0, that's one of the nice things that Ashley did with it is that they've they've tried to go to the, team approach, and they really want you to, get the entire group, together so you can avert any kind of changes after the, initial ACRA has been established? So, really nice part that they've gone into that and said to bring everybody into it from your infection preventionist to your facility managers to the, the nurses and anyone who's gonna be inside of that space just so that you can avert those those changes, prior to them happening.

Yeah. I mean, I've been doing this a long time, and we it used to be not completely, unique that as soon as the project was done, you would find the things that didn't work well for the team. And that's really unfortunate that you spend the time and money and and energy to do construction and then don't end up with a with a space that's gonna meet everybody's needs.

And although we're talking about the process during construction, you know, both during construction and the final products are really important to have everybody's agreement on.

Well, thank you both for weighing in on that.

Leon, a question for you about airflow.

If a project is in an exit corridor, I'm not permitted to exhaust air into, oh, well, it doesn't specify, into per life safety component. What is best practice in this situation?

So I think that question is asked is is stating that they cannot exhaust negative air into the exit stairwell.

That's what that sounds like. Okay. Yeah. In those in those instances, you just have to basically take a look around.

You can if if there's there should be another option for exhausting that negative air. There should be somewhere else on that containment, somewhere else on that on on that STARC wall where you can exhaust negative air so it's not going down the court, not going down the exit stairwell.

There are also options to I've seen a lot of contractors do this, and it it works very well.

They will take their negative air, and they will take it up into the ceiling of the construction space. And they will take it through one of those corridor walls or one of those ICRA walls that's that's above the removed ceiling grid, bring that bring that exhaust duct over on the other side of that wall, connect that exhaust duct to a brand new diffuser, remove a ceiling tile, put a new diffuser, then you have your negative air coming coming down from the ceiling, so you're not, exhausting, down a stairwell or you're not, you know, putting putting tubes down a stairwell. But there's it is it is sometimes, difficult to figure that out, but there there's always a way.

Question for Janet.

Do you have a free sorry. Do you have a formatted preconstruction ICRA? The joint commission surveys are asking for this with each ICRA.

So I think that there are some I think ASHI has one.

There are some that are out there.

I think you may have to buy them, though.

Okay. Let's see. Marshall, a question for you.

For a friarated temporary wall, and in parenthesis, we have STARC, when the temp wall goes to underside of existing ceiling and a suspended one hour barrier is suspended from the slab above, how is the area of the existing ceiling addressed to maintain the continuity of the fire rating?

There are a couple different options there, John. We've seen it work, different ways in different hospitals. If you are going to go all the way up to a grid ceiling, a soffit does need to be built down from the deck. But STARC has recently launched a fire block cap that will go from the top of the one hour rated containment back to the one hour rated wall to create a fully enclosed one hour rated anteroomer on the area that you're trying to work in.

Okay. And, Dan, how are organizations approaching ICRA 2.0 planning for emergency repairs based on what you've seen in the field?

Really, they they've been trying to get training. There's a lot of, Ashley 2.0 educators out there, who are offering this, giving them the the understanding and some of the changes that we went over today to the the LPC reductions, to truly understanding the manometers and the additions that that, ASHI has put into the different levels as far as, the the spaces and the risk the risk groups associated with those. So really, understanding, Ashley has some really good training, training module out there as well so that you can dig deeper into it and understand what they, are specifying for it, but really training and and really understanding and working with individuals who understand it well.

Excellent. Thank you. And, Marshall, I have two here for you that I'm gonna bundle together. The first, I believe, was in response to when you were talking about FireblockWall and and the state of California.

Is the product available in all states?

And then the second one, I'll I'll get into in a second, but if you wanna jump in on that.

Yes. Fully available in all states, and, we have moved into Canada as well and have some international options. So all fifty states in the US, hundred percent.

Okay. And what barriers do you recommend for above the ceiling work, such as cable pulling for IT related projects?

One of the products that I did, share, John, that we didn't go into too much detail on was StackBarrier, which can be field cut to go around piping, cabling. I've seen some fantastic work from some mill workers and carpenters out in the field using StackBarrier above the grid to go around cabling, go around piping. It is designed to be field cut to cover above the grid as well.

K. I'm gonna throw this one out to the group. Do you have any advice about general maintenance projects in restricted Biomed engineers often need to open up sterilizer machines, and in parentheses, the IUSS in the sterile core, to do maintenance of repairs, but I have concerns about the potential for dust dispersal in the area.

I think in those situations, it's really important to consider and and look at the, ICRA document because those would be four and five projects, and they're gonna require anterooms.

And that that additional anteroom, that additional barrier is gonna give you that chamber to where you can do that and then still having that negative air, keeping in mind that you're battling with pressures inside of those situations because ORs and SPDs have very strong pressures going the opposite way of sometimes what you would like them to go. So really understanding those pressures, how they're going using the manometer for that, but having that that anteroom as specified in the ICRA 2.0 in level fours and fives, which you will see in the operating areas and the sterile processing areas.

So I'm gonna also take a minute to just remind people that there is the the, class two, the b level maintenance, option for some of these things. So I agree that if you're doing something big and pulling out a lot of, you know, equipment and liberating a lot of dust, then you have to you have to go the whole, range.

But for routine maintenance, you may not have the ability to do that if they're just doing their monthly checks. Now we we have the s t one zero eight water testing that brings people into the backsides of sterilizers sometimes, and and, you can't always build that whole thing for that. So I would, there was another question here that I'm gonna sort of combine this with. Like, you think it's a small thing they think it's a small thing. You think it's a big thing, and I think you have to really look at what is it, how frequently is it being done, how much dust is being liberated, what where are you getting into with this, what what are the particulars? And then come to an agreement of how you can approach it. Again, SPDs in many places close down, so you might have to do it on the overnight when people aren't there and you can clean up afterwards and and you're not impacting things in, as much as you would during the day.

Other question for the group. Do we need to protect the interstitial space above the ceiling space between construction area versus the occupied areas from smoke or fire?

In those situations, depending on what type of work you're doing, you should be protecting that as well. That's kinda I think the question earlier was asked about the fire block of where that goes to, but you do need to be, dependent on the type of work that you are doing, you there's a good chance that you have to take your construction barrier from the ceiling grid all the way to the deck above to protect that and protect any cross contamination. Because if you are opening, barriers that getting outside of that space, can still land and, create, create potential growth in areas that we don't want that to occur in.

K. Thank you.

I have one for Leon here.

Leon, when exterior exhausting options are very limited, what are the recommendations for maintaining ICRA levels, and what are the best resources for for communicating possible HEPA filtered interior exhaust options to customers and clients?

I'm sorry. John, can you repeat that?

Sure. So when exterior exhausting options are very limited, what are the recommendations for maintaining ICRA levels, and what are the best resources for communicating possible HEPA filtered interior exhaust options to customers and clients?

Okay. Customers and clients, I'm assuming, means maybe facilities personnel or contractors.

Yeah.

Yeah. Like I said in in my slides, it's you don't always always have the windows to go out. And, again, that's our first choice, but you don't always have those windows. So you do have to exhaust, your negative air into occupied spaces, other other corridors, things like that.

So it's just very important that the contractor understands, how to exhaust that negative air.

And, and then to touch again on the HEPA filtration, that's why this is this is exactly why ASHI put the HEPA filtration verification into the Equiterno platoon on our document because a lot of construction spaces cannot go out a window. They don't have windows, so the exhaust they have to the negative air has to go into an occupied space. So that's why that HEPA filtration verification is in there to make sure that you were actually dealing with HEPA filtration and that your machines are actually HEPA filtering. And that's why Ashley Ashley, asks and and and and expects it to be tested to make sure it is HEPA.

Thank you. And, Marshall, we've seen STARC systems pop up more frequently in hospitals and sensitive environments. What's really driving that adoption? Is it the infection control aspect, aesthetics, acoustic performance, or something else that's making STARC stand out in those high stakes stead settings?

Boy, what a great question, John. I I would say all of the above.

I'm gonna have to reach out to that participant afterwards and give a virtual high fives.

I would say it is a combination of those.

Obviously, STARC has been in the healthcare space. We were actually founded by a healthcare contractor who was for an easier way to erect temporary walls during occupied renovations.

The infection control aspect, I believe Doctor. Hass and Leon have really spoken a lot about the, really raising the game when it comes to ichor containment and STARC checks those boxes for a lot of folks.

The acoustic performance is, really fifty fifty. It depends on whether that sound attenuation is necessary or not, but STARC has products that meet both of those different requirements depending on that.

We have a bunch more questions here, but we are coming up on time. So I'm gonna make this the last question, and we'll we'll follow-up people we'll follow-up with people after the the presentation as best we can.

So this one's to the group. How do you see ICRA 2.0 evolving over the next couple years? Are there emerging challenges or opportunities teams should be preparing for?

I don't personally see anything at this time. I think ICR 2.0 is excellent. And, just to just to preach again that about the advancement of ICR 2.0, they really, just like Marshall just stated, they they really stepped up the game, in putting different precautions into ICRA 2.0 with with the airflow exhaust, have the filtration cascading airflow. Really, really, the the the the nuts and bolts of the ICRA when it comes to con construction containment. So I think they've done a very good job. As of right now, I don't see any challenges. I don't see see any things that need to be changed.

It's from my experience and from my, rounding and taking a look at things, it seems to be working, very well.

Anybody wanna add to that?

I'll add. I think I agree with with Leon. It's it's really good document. The only thing that I think could change in the future that that, in their document, one of the last lines of, I think, the five level fives is, to consider surrounding spaces. They may expand upon that just because it really truly helps you understand, what's going on outside of the contained space, that the dust could be, or particles could be elevated, in different areas and helps you understand why and if it's from that specific barrier.

The consider, gathering data from surrounding spaces may evolve into, some form of understanding why, dust is being elevated around a containment to prove that it's not from within.

K. Very good.

Well, on that note, I I wanna thank our panelists for sharing such valuable perspectives, and I'd like to thank everybody who joined us today. If you'd like a copy of our ebook that breaks down the survey results and offers actionable takeaways for managing sticky situations, you can go ahead and scan the QR code now. The slides for today's presentation and a reply link will be forwarded via email early next week.

Like I said, we we had a lot of questions we weren't able to get to. We will try to address those as best we can on the back end.

We hope today's session provided valuable insights and practical strategies to strengthen your infection pro control programs.

And, thanks again for joining us. We look forward to continuing the conversation and supporting your teams and future initiatives. Have a great day.