Consulting-Specifying Engineer - June 2008 - (Page 32)

HOSPITAL PROTECTION for catastrophic events In disaster planning for healthcare facilities, engineers need to follow the Boy Scout motto. BY MICHAEL SHEERIN, PE, LEED AP; JAMES FERRIS, PE; JAMES D. WORTH, PE, LEED AP; STEPHAN KEMP, PE, CXA; and GERALD VERSLUYS, PE, LEED AP, TLC Engineering for Architecture, Orlando, Fla. s healthcare engineers, it’s one thing to know the Boy Scout motto—and another to design for it. It’s almost impossible, not to mention cost-prohibitive, to plan for every unforeseen occurrence. But natural and manmade catastrophes occur all too often, and when they do, they drive home the importance of designing hospitals to withstand potential disasters. Chapter 1.1 of the 2006 American Institute of Architects “AIA Guidelines for Design and Construction of Health Care Facilities,” Section 5, “Provisions for Disasters,” gives fair warning to hospital owners and designers to consider the implications of disasters, and the ability to remain operational after such events. But the prescriptive requirements to accomplish this task are left to the design teams themselves, based on a facility’s specific operational plan. The Joint Commission (TJC), formerly the Joint Commission on Accreditation of Healthcare Organizations, under its Environment of Care requirements, requires that a facility have an emergency operation plan that iden- B E P R E PA R E D : // A tifies how it would handle 96 hours without support from the local community. Total evacuation is allowable under this plan. However, in its 2003 document, “Healthcare at the Crossroads: Strategies for Creating and Sustaining Community-Wide Emergency Preparedness Systems,” TJC recommends that a facility “ensure a 48–72 hour standalone capability.” TJC also recognizes that for a hospital to serve its purpose, it must be able to withstand challenges with rigor, and if it should fail, to fail in a controlled fashion, which they refer to as “graceful degradation.” The goal is to “maintain its ability to provide care” and “avoid having the health system become a victim of the assault.” Following the disastrous hurricane seasons of 2004 and 2005, in which numerous major hospitals in Florida and all along the Gulf Coast were totally incapacitated, the American Hospital Assn. advised all hospitals to assess their electrical capacity. Many hospitals sustained hurricane wind, water, and debris damage, which spawned several types of upgrade projects—none of which were required by code, but which the hospitals saw as a “bare minimum” to enable them to survive similar disasters in the future by remaining as fully functioning as practical. These projects included: • Replacing generators with larger generators to serve loads that have been considered non-essential by the code books. These loads include laundry facilities, air conditioning, bathroom exhaust fans, and all of the cooking equipment. • Implementing water-resistant central utility building designs. A significant issue during a storm is water penetration, where water blows through window glazing, walls deflect several inches from the force, and water flows into the building through every crack and unsealed conduit. Hospitals have had to go back and waterproof central energy plants that became virtual bathtubs due to water intrusion. • Enacting greater code detail with respect to wind debris impact. Most states have specific wind loading requirements, but few go further into details of wind debris impact. Florida has building code requirements for both, plus specific guidelines for hurricane preparedness for new hospitals and additions. Many facilities 32 Consulting-Specifying Engineer • JUNE 2008

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Consulting-Specifying Engineer - June 2008 Contents Viewpoint Letters News M/E Roundtable No Gambling Allowed on Smoke Control in Las Vegas Be Prepared: Hospital Protections for Catastrophic Events Ready for Retail Commissioning Documents: Necessary Evil Codes & Standards Codes & Standards Case Study Equipment Lifecycles New Products Advertiser Index Green Space

Consulting-Specifying Engineer - June 2008

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