Tuesday, 30 June 2015

Is Your Healthcare Facility Prepared for Power Outages?: Planning for Resilient Healthcare!

Healthcare facilities have one of the lowest tolerances for power disruptions. Minor disruptions or fluctuations in power, for instance, can disturb the delicate voltage requirements for effective magnetic resonance in MRIs, CT scanners, and similar equipment. Longer disruptions can require advanced logistical responses, even without considering immediate inconveniences and safety issues.

During the 2013 ice storm, for instance, the National Post reported that, "the flow of electricity into [Toronto's Sunnybrook Health Science Centre] stopped at about 4 a.m. Sunday and was not restored until late afternoon Monday." This outage of almost two days required the transfer of a number of patients, including several babies from the neonatal intensive care unit.1

More recently, a March power outage at the Mississauga Hospital Trillium Health Partners' site resulted in the postponing of "100 surgeries and 119 endoscopies" and ambulances being rerouted for four days, according to Metroland Media.2 This demonstrates how, in addition to short-term disruptions, contingencies must be made for outages that last hours, or even longer.

What Happens If Your Healthcare Facility Doesn’t Focus on Energy Resiliency?

A hospital power outage can jeopardize patient safety and negatively impact operations through a number of ways, including but not limited to:

  • The loss of heating, ventilation, and air conditioning systems that rely on electricity
  • The loss of respiratory devices and critical equipment used for patients in intensive care or cardiac units
  • The loss of lighting during surgical procedures and total blackout of sections of the hospital without emergency lighting
  • Inability to sterilize equipment
  • Inability to read X-rays or operate diagnostic equipment
  • Inability to read X-rays or operate diagnostic equipment
  • Inability to access electronic patient records and hospital files
  • Being locked out of doors and medicine cabinets that use keyless entry
  • Spoilage of medicine that requires refrigeration
  • Loss of patient signalling systems and monitoring equipment
  • Inability or extreme difficulty in transporting patients and carts between floors without elevator access

It is important for hospitals to have contingency plans for blackouts in place well before power disruptions actually occur. The purpose of a contingency plan is to have a trusted “plan of attack” for responding to the unplanned and potentially expensive power shutdowns. Forming an effective plan involves understanding your facility's place on the grid, your own power needs, and the minimum power levels needed for effective operation, and having the proper backup generator.

Foster a Relationship with Your Utility Provider

Hurricane Sandy was not the only time Sunnybrook suffered power trouble. In 2013, the Toronto Star noted Toronto Hydro chief Anthony Haines as saying that, "Our friends at Sunnybrook (Hospital) have had 23 outages this year," resulting from the aging infrastructure of the power grid. These outages "were made of 13 outright interruptions, plus another 10 incidents when the quality of power 'sagged.'”3

In order to have a proper power outage contingency plan, you must start with knowing more about your utility provider. Keep your provider's contact information readily available to have easy access to report power shortages or outages. Learning your healthcare facility's place on the power grid, and other critical infrastructures you share the sector with, can provide an understanding of how reliable the electrical services can be. It is important to also talk to your utility provider about making sure your healthcare facility is considered a priority when you contact them about power shortages or outages.

Power companies perform regular exercises to practice responding to loss of power scenarios. Consider asking to participate with them, in order to better drill your own hospital staff.

Understand Your Power Requirements

Find out how much power your hospital uses on a regular basis. It is important to check usage during different times of the day and night and on different days of the week to get an accurate picture. Afterwards, identify essential functions and the minimum power required to keep them running effectively. This will form a baseline for the needs of your backup power generator.

You should also go through hospital equipment and systems and determine priority for power distribution in case of a shortage or blackout. Establish what can be left powerless, what can be given only partial power, and what must be at 100% power, as soon as possible. This can be better quantified by identifying the minimum and maximum possible losses and disruptions that an outage to a particular system or device can cause.

Have a Response Model

Have a plan in place to prioritize emergency power allocation, and train the responsible staff members so that they are familiar with the process. People are the pillars that enhance the reliability of any plan. Building a reliable power outage response model requires healthcare facilities to have the right people with the necessary skills, knowledge, and training.

If there are other hospitals or health facilities nearby, coordinate with them on developing mutual aid agreements for how to handle incoming patients, or transfer existing ones, in the event one or more of your facilities experiences a power failure.

Test your Response Model

Know your backup. Familiarizing yourself with your backup generator is a key element in securing a power outage contingency plan. The natural first step is to find out how much of your hospital's power needs the generator can meet and for how long. You should also consider how quickly the generator can begin power distribution, whether it will automatically turn on following the loss of main power, and if it will shut itself off following restoration of primary utilities. Like any high-powered piece of machinery, the generator should have adequate ventilation and cooling during extended operation.

Make sure to plan for blackouts lasting longer than your generator's fuel supply. Set up agreements with your generator supplier and/or another vendor beforehand to have fuel deliveries made during extended blackout situations. Mind the placement of the generator to ensure a fuel truck can have ready access to it.

Keep It Ready

Time Magazine describes how, during the events of Hurricane Sandy in 2012, "New York University's Langone Medical Center was forced to evacuate [215] patients due to power outages during the peak of the storm." As the hospital's spokesperson observed, "We lost power when ConEd cut [it], and our auxiliary generator malfunctioned."4

Your hospital's backup generator should be regularly tested, maintained and, if necessary, upgraded to ensure it is capable of reliable activation and sustained operation. Practice different types of scenarios and under various weather conditions to ensure that no errors will occur when switching between systems and loads. Testing backup generators as per the CSA 282-09 and CSA Z32, the Canadian Standards Association guidelines, would also help meet safety requirements and identify points of failure. Make sure you have plans to provide adequate cooling to the generator as well in order to prevent overheating.

Partnerships and Resources

Partnerships need to be built well in advance. Contracting with a generator and temperature control provider is integral for long-term energy resiliency. For a deeper understanding of the supplier’s capabilities, consider the size of their fleet and network, as these are indicators of their ability to provide necessary power and temperature control rental equipment on short notice. It’s also critical to assess whether your supplier keeps necessary parts, fuel, supplies and manpower on hand to support their rental fleet. For instance, equipment such as an uninterrupted power supply, distribution switchgear, resistive and reactive load banks, fuel tanks, and redundant generator sets should be available for customizing the devised power solution. Response time and safety record must also be examined as the provider must be able to provide service promptly but also without risk.

Effective communication with a provider is also integral. The rental company should be made aware of the conditions of your site prior to arrival. This includes information on site access, extraneous conditions, and, if weather is the cause of the outage, any hazards they should be aware of. Keeping your facility's partner informed is an important but easily overlooked step.

About GAL Power

GAL Power has 25 years of experience with power solutions. We believe all healthcare facilities should have a power outage contingency plan tailored to their needs and should keep it at the ready. We also advise that anyone managing one of these facilities look into a more in-depth healthcare-specific risk report and get a detailed power outage risk report of your facility. For more information, contact the experts at GAL Power today.

Sources:

Blackwell, T., “When Toronto’s Sunnybrook hospital lost power, six of the tiniest, most fragile patients were sent packing,” National Post, December 23, 2013; http://news.nationalpost.com/toronto/when-torontos-sunnybrook-hospital-lost-power-six-of-the-tiniest-most-fragile-patients-were-sent-packing.

Rosella, L., “Four days after power outage, Mississauga Hospital now fully operational,” March 5, 2015; http://www.mississauga.com/news-story/5462017-four-days-after-power-outage-mississauga-hospital-now-fully-operational/.

Spears, J., “Sunnybrook Hospital hit by 23 power outages this year,” The Toronto Star, November 21, 2013; http://www.thestar.com/business/2013/11/21/sunnybrook_hospital_hit_by_23_power_outages_this_year.html.

Sifferlin, A., “Lessons from Storm Sandy: When Hospital Generators Fail,” Time, October 30, 2012; http://healthland.time.com/2012/10/30/lessons-from-storm-sandy-when-hospital-generators-fail/.

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