For Safety’s Sake: Creating more resilient healthcare environments

Lessons learned from COVID-19

In 2020, we learned a lot about how infrastructure needs to be transformed to support our communities. We saw that hospitals with flexible ICU capacity along with scalable air handling and electrical systems were able to better manage a larger inrush of patients. These design considerations are especially important to treat COVID-19, as this level of flexibility enables the treatment of patients with respiratory problems requiring ventilators while helping reduce the likelihood of virus transmission to other areas within the facility.

At the beginning of the coronavirus pandemic, many experts predicted that demand for ICU beds would be a critical barrier for patient treatment. It was anticipated that the U.S. would need 1.9 million ICU beds, or 20 times the current supply, to treat COVID-19 patients.  

The challenge for hospitals is that it’s difficult to scale up ICU capacity to that level, as the vast majority of this infrastructure would be unused most of the time and associated costs could be prohibitive. For this reason, I believe it is critical that essential ventilation and electrical system scalability and flexibility are considered so rooms can be repurposed or easily transformed to manage intake spikes. 

Designing healthcare systems beyond the code

Healthcare facilities must be both proactive and flexible. Retrofitting infrastructure upgrades come at a much larger financial burden during an emergency situation than if they had been designed into building plans in the first place.

Within the past year, the ability to quickly add temporary ICUs and negative pressure air environments became a major obstacle for healthcare facility managers. Although we helped support many successful retrofit projects, it is far more challenging to upgrade all the electrical, oxygen delivery and room ventilation systems needed at the spur of the moment while ensuring that existing patients could continue receiving proper treatment.

However, there were a few U.S. hospitals already engineered for extreme situations. The value of their proactive investment in adaptable infrastructure became apparent during the COVID-19 pandemic.

Perhaps the best example is Rush University Medical Center in Chicago. The hospital was redesigned shortly after 9/11 with the ability to quickly transition many of its rooms into ICU units. The hospital could also expand its bed capacity by 133 percent with negative-pressure air systems already in place to prevent cross-contamination. One lobby within the hospital was even proactively designed with access to power and other utilities built directly into its columns in order to quickly turn the large, open space into a treatment area if needed. 

Similarly, at Westchester Medical Center in New York, every ICU was engineered with negative-pressure air systems before COVID-19 and could be quickly reconfigured to manage the local outbreak.

Further, the Cleveland Clinic in Ohio had emergency response plans in place that allowed the rapid conversion of its health education building into a surge hospital, with 327 beds for patients who didn’t need ventilators and accommodations for up to 1,000 hospital beds if needed.

To address air containment, many hospitals have been able to adapt by implementing different air handling system modifications. Some were able to transform existing beds or patient treatment wings to private rooms thanks to existing negative air pressure infrastructure. Meanwhile, others transitioned existing rooms with individual ductless units.

Older hospitals, or those with budgets that won’t support major conversions or equipment investments, can still prepare adequately. The American Society for Health Care Engineering (ASHE) states that standard patient rooms can be retrofitted as negative pressure isolation rooms. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) standard allows the use of recirculated air, provided the air first passes through a HEPA filter, which can be accomplished with a recirculating HEPA filter unit. This retrofit solution is a powerful and effective approach, especially for smaller or rural hospitals that do not have or typically need many ICU units during ordinary times. 

Digitalization is powering the future of healthcare

It is more difficult to transition the role of normal healthcare spaces into ICU and critical treatment centers without direct visibility into available electrical capacity. Digitalization and intelligent power management solutions collect and transform data into clear insights that provide the information needed to make better decisions faster and easier. These innovations are fundamentally changing the way our world produces and consumes electrical energy – the same shift is occurring in healthcare facilities.

By adopting intelligent power management technologies, healthcare facilities can better prepare for the demands of tomorrow, today. For example, we’ve received feedback that electrical power monitoring systems with remote capabilities have significantly helped healthcare facilities teams remain safe while keeping a 24/7 eye on their critical infrastructure from a socially distanced location.

Additionally, intelligent circuit breakers can provide the ability to accurately measure energy consumption, delivering critical data about your power distribution system and energy use in your facility. These devices timestamp captured events, and store data and waveforms associated with each event for fault analysis and forensic timeline reconstruction. These solutions can also be monitored and managed from a remote location.   

Modernizing essential electrical system components can also offer drastic improvements in overall electric system flexibility. For example, modern panelboards, switchboards and automatic transfer switches (ATSs) can help simplify facility management by instantly matching available capacity to actual load, adding or shedding loads based on generation capacity, and centralizing all relevant alarms and status at a single interface point.

Creating the healthcare facilities of tomorrow, today

COVID-19 has accelerated innovative thinking across the healthcare industry. For example, amid the personal protective equipment (PPE) shortage that became apparent in the early weeks of the global pandemic, we applied our additive manufacturing expertise to design and made hundreds of thousands of face shields and thousands of touchless tools for healthcare workers.

Now, we’re developing intelligent PPE to deliver on new capabilities that enhance safety. By embedding sensors into face shields, for example, hospitals can capture biometric and environmental data. Just like in other parts of their business, healthcare management teams can track patterns in data and gain insights that can help make workplaces safer.

This innovation yields data that can be used to indicate or predict employee well-being, workplace air quality and environmental conditions, PPE compliance, potential hazards, and more. Even figuring out when it’s time to rehydrate and get a glass of water.

Just as we’ve seen fast-tracked vaccine testing and PPE manufacturing, I believe it is time to fast track the modernization projects that support more scalable and flexible healthcare systems.

Most infrastructure upgrades cannot wait for official code changes. This pandemic has proved the effectiveness of going “beyond the code” to create more flexible, resilient patient care. As an industry, we can do more than just prepare for the worst-case scenario. We can expedite projects that enable healthcare environments to react more quickly, safely and effectively to the challenges of the future. 

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