Healthcare Design - March 2019 - 17

CASE STUDY

S E I S M I C S U R V I VA L
MAT-SU REGIONAL Medical Center is a 215,000-

square-foot replacement hospital in Palmer,
Alaska, completed in 2006 to serve the Matanuska-Susitna Valley, the fastest-growing region in
the state. It includes emergency, surgery, endoscopy, and radiology services as well as 100 inpatient beds and a 10-bed obstetrics department.
The project design team from E4H Environments
for Health Architecture was challenged with responding to numerous conditions unique to the
site, most importantly its location between two
distinct fault lines where seismic events are recorded on a daily basis.
To that end, the three-story project was finished to meet Seismic Design Category D requirements, the category used to classify buildings in geographic areas that are expected to
experience "severe and destructive" ground
shaking but not located near a major fault line
(Mat-Su's fault lines weren't considered major).
Those requirements were put to the test on the
morning of Nov. 30, 2018, when the region was
hit with a 7.0-magnitude earthquake.
Due to these standards being in place, the

MAT-SU REGIONAL MEDICAL CENTER

facility experienced only minimal cosmetic
damage. For example, a small amount
of floor tiles inside the facility cracked.
The interior non-structural systems and
assemblies were anchored in such a way
that during an earthquake they would
absorb or counteract the movement that
the earthquake transfers to them.
The building envelope was finished to
withstand 120 mph winds and driven snow.
The paint, for example, was selected for its
shell-like components to protect the façade,
allowing it to survive the quake with just
hairline cracks.
Additional design strategies included the
use of huge mat-type foundations, 40-footby-40-foot squares made of 3,000 psi
concrete ranging from 48 to 60 inches thick,
which acted as super-sized spread footings.

EMERGENCY 1
PLAN

S T R AT E G Y

CHRIS AREND

Each one anchored up to four continuously
vertical concrete shear walls, depending on
orientation, to create a monolithic structure
capable of transferring and dispersing
significant forces to the ground.
Other resilient components include
systems for well water, pumps, and storage
for fire water and potable water, as the
hospital's remote location meant that
utilities could potentially be unavailable for
unknown periods of time. The standalone
facility is capable of generating power, as well,
that's independent of municipal systems.
Thanks to these solutions, the hospital was
able to see 117 people in its emergency room
on the day of the earthquake and remained
fully operational.-Adam Hillman, associate,
E4H Environments for Health Architecture
(Dallas-Fort Worth, Texas)

AS THE ENTRY point for a hospital's response to
many types of crisis scenarios, emergency departments must develop disaster preparedness plans
that include events such as biological, chemical, or
nuclear exposures; outbreaks and epidemics; and
mass casualties.
Organizations should assess the likelihood of
various disaster scenarios in order to balance
preparedness with risk management and budgetary considerations. Then, design and construction
partners must deliver projects that support ED operations during both ordinary and extraordinary
circumstances.
While the specifics will vary from facility to facility,
here are some general steps to consider in this
process.

Identify options to quickly expand a facility's
capacity during a disaster. For example,
some EDs may be able to treat more than one
patient per room when volume increases rapidly.
Organizations may also identify alternative spaces
for receiving patients and triage, such as parking
structures or surface parking. Suitability of alternative
sites depends on a range of factors including the
type of incident, accessibility, security, and even the
weather. Consideration should also be given to utility
access (oxygen, water, electrical) and preparation
for rapid deployment of necessary equipment.
Assess the amount of space needed for mass
decontamination areas immediately adjacent
to the exterior of the ED. Space can be permanently dedicated, or exterior canopies can be used
for temporary, convertible mass decontamination,
with appropriate plumbing, curtains or screens, and
drainage. Equipment should be stored with portability and rapid deployment in mind-for example,
utilizing equipment storage trailers that can be transported for disaster response at a moment's notice.

Anticipate the domino effect of a mass event
on the entire hospital by identifying additional
space and equipment needs beyond the ED that
could be impacted by a dramatic influx of patients. For
instance, areas such as lab, pharmacy, imaging, and
surgery could also experience increased demand during a mass incident. Close coordination between the
ED and these other areas will lead to a more complete
disaster preparedness plan for the facility. Similar to
the ED, these other spaces will need to identify ways to
handle increased capacity within the department and
leverage alternative spaces, where appropriate.
Allocate spaces to support nonclinical crisis
management operations. For example, identify
a suitable area to accommodate an incident
command center team, including its individual IT and
telecommunications needs. Organizations may also
need to identify a location for crisis communications
events such as press conferences or communications with large groups of family members and loved
ones.-Greg Euston, vice president, healthcare project
executive, JE Dunn Construction (Austin, Texas)

MARCH 2019

Healthcare Design - March 2019

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