4 key areas of MEP resilience reduce healthcare facility risk during a natural disaster

Third in a series of excerpts from the free executive guide, “The Evolving Importance of Healthcare Resiliency: Preparing Your Hospital for a Crisis.” 

By Mike Zorich 

When a natural disaster strikes a community, your hospital can serve as a beacon of safety – but only if the facility’s vital systems have not been compromised. Without adequate power, ventilation and water, your hospital quickly loses its ability to provide service and safety to patients and staff.  

To ensure your facility can remain operational during such an event, the mechanical, electrical, and plumbing (MEP) infrastructure needs to be sufficiently protected and hardened. The first step toward increasing this resiliency is to determine what level of continuity your systems will need to maintain in the event of a disaster. Next, consider the types of threats your systems may encounter and what vulnerabilities they would face against those threats.  

While your best course of action is to have an MEP engineer thoroughly assess your facility’s risks and gaps, the following provides a high-level preview of the four main risk areas of concern.  

1. Location of building system equipment 

It’s not uncommon for facilities to have electrical equipment and emergency power infrastructure located in the lower level. While it might initially seem to be a good idea to have these systems in non-premium space, locating them in the lowest level of a building increases the risk of flood damage. This is especially dangerous if your hospital is in a floodplain or your building is at or below sea level.  

During the planning stages, one of the simplest steps you can take to reduce the risk of flooding affecting your MEP systems is to locate critical equipment on higher levels. For example, the generators at Memorial Medical Center in uptown New Orleans were able to withstand the initial impact of Hurricane Katrina in 2005, but the flooding in the following days reached the emergency power transfer switches, expediting the evacuation of the facility.  

2. Hardness of systems  

Hardness refers to the process of reinforcing individual systems within your hospital to make them more resilient against disaster. For example, during the planning stages of the Advocate Aurora Summit Hospital in Wisconsin, it was decided to locate the central utility plant 500 feet away from the hospital, connected with a utility tunnel. One of the main drivers for segregating the central utility plant from the main hospital was to hedge against a disaster impacting both locations simultaneously. The remote plant also allowed for the space to house underground fuel storage to allow the generators to run for 96 hours. 

3. Redundancy  

Baseline redundancy for critical infrastructure items such as boilers, medical gas, and power are required by code for healthcare facilities, but additional redundancy should be a key consideration when evaluating the resiliency of your MEP systems. For instance, assume your building load is 1,000 tons of cooling and you have two 500-ton chillers. If one chiller breaks down or is compromised, your facility will only have 50 percent of the required cooling capacity available. To safeguard against this potential problem, you could plan for one of the following:  

• Purchase a back-up 500-ton chiller to have on hand in case of emergencies 
• Have three 500-ton chillers to have an N+1 capacity, or, in other words, 100 percent back–up available should a single chiller fail 
• Upsize both of your chillers to be 750 tons, so you’ll still have 75 percent of what you need if one fails  

• Install outside piping to bring in an emergency back-up chiller when needed 

Though this example is specific to water chillers, the importance of having redundancies and back-up plans can be applied to all necessary systems and processes in your hospital. For instance, consider your plumbing system. What would you do if you could no longer flush toilets? This leads to the next consideration: potable water. 

4. Potable water  

Other than pallets of bottled water, it’s rare for hospitals to store water. This can lead to significant problems if something interrupts the water supply. How will you flush toilets or wash and sterilize equipment? How much drinking water will you need over a certain time period?  

To answer these questions, first determine how much water usage you truly have at your facility. A week’s worth of water might not be as much as you think. Once you understand your usage, you can make an informed decision of how much water you’ll need in an emergency. While on-site water storage is the best solution to this potential problem, you can also contract with a pumper truck to be available in emergencies.  

You also can enact procedures to save and reuse water. Plan to shut off water to designated, non-essential areas of the hospital; use recycled water to flush toilets; or install a roof drain for condensation recovery.  

By proactively addressing these four potential vulnerabilities in your MEP systems, you can avoid the challenges and tragedies that can occur when disaster strikes. 

Excerpted from the free executive guide, “The Evolving Importance of Healthcare Resiliency: Preparing Your Hospital for a Crisis.”  

Next: Enhance hospital security through CPTED principles

Also in this series: 

• Resilience in healthcare: How to prepare your facility and reduce risk in the event of a disaster 
• Three questions to help define the structural integrity of your hospital