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Resilient Design-Hospital Facilities Equipped To Withstand Disasters

It takes significant prior planning for a health facility to remain self-sufficient during a disaster.

The 2016 hurricane season ended on November 30. Hurricane Matthew was the worst storm to affect the United States in 2016, and caused damage all along the East Coast from Florida through North Carolina. Hospitals all along the East Coast initiated disaster preparedness protocols including the evacuation of several hospitals in central and north Florida.

Hurricane Matthew caused significant damage despite the fact that the storm stayed offshore until making landfall in South Carolina. The damage caused by wind and storm surge was significant along the coast and flood damage due to rain was significant. According to some estimates, parts of North Carolina were receiving up to 7 inches of rain per hour.

Luckily, hospitals and other health facilities plan for these events in advance and have designated teams to respond to these emergencies. The goal of these hospitals and health facilities is to maintain operations despite the loss of backup services. It takes significant prior planning for a health facility to remain self-sufficient during a disaster. Hospitals and health facilities need to be concerned with the design of the facilities, as well as having sufficient backup systems and supplies to operate the facilities during the disaster.

"Resilient design" is a relatively new term that describes designing facilities to withstand disasters and remain operational. The new VA hospital in New Orleans is one example of a hospital facility utilizing resilient design.

SEE ALSO: Emergency Preparedness in Hospital Settings

The old VA hospital in New Orleans, built in 1951, was one of several hospitals severely damaged by Hurricane Katrina in 2005. A major problem for both the old VA hospital and the Medical Center of Louisiana at New Orleans, also known as "Charity Hospital," was caused by the backup generators being located in the basements. The basements flooded after the levies broke during the storm, leaving the hospitals without power.

The designers of the new VA hospital employed resilient design principles for the new hospital, and in the case of the new VA hospital, all the critical functions of the hospital at least 20 feet above ground. The emergency department is also located on the second floor and is accessed by a ramp that also may be used as a boat launch during a flood. The walls are designed to withstand a category 3 storm, as well as severe impacts, both accidental and deliberate. (Unfortunately, healthcare facilities need to anticipate deliberate acts.)

1 year ago, University Medical Center opened in New Orleans, replacing the old Charity Hospital that was built in 1939. University Medical Center also employed resilient design principles by locating its critical functions well above ground level, installing backup generators that are able to power the facility for up to 7 days and numerous other modifications.

Resilient design considers the specific types of disasters that a particular facility might experience, and plans for those specific disasters. As such, resilient design includes different solutions based upon the unique vulnerabilities for any given situation.

In 2011, a category 5 tornado severely damaged St. John's Mercy Regional Medical Center in Joplin, Missouri. Mercy Health System built a new hospital, Mercy Joplin, which employs resilient design techniques. Mercy Joplin is designed to withstand severe tornadoes. The hospital is designed with secure interior corridors, and mechanical systems located partially below ground to protect from tornadoes. What works in Joplin might be the opposite of what works in New Orleans.

In 2012, Hurricane Sandy struck the Northeast causing widespread damage in several states. The storm caused an estimated $3.1 billion in damages to healthcare facilities alone. Five hospitals in New York were required to close temporarily due to storm related problems, and an estimated 4,000 patients were evacuated as a result of the storm. Resilient design techniques have been used by facilities in the area to minimize the impact of the next hurricane that will eventually reach the Northeast.

Resilient design is a relatively new term used to describe how critical facilities, such as hospitals, should plan for continued operations during disasters. Luckily, most hospitals and health facilities have been preparing for these disasters since long before the term resilient design came into use.

Michael L. Smith, JD, RRT is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Florida. This article is for general information only and is not a substitute for formal legal advice.

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