HOSPITAL ENGINEERS
Hospital engineers’ key role in disaster mitigation
Tokyo Teishin Hospital director, Hiroshi Yasuhara, and lecturer in the Department of Healthcare Information Management at the University of Tokyo Hospital, Hidenao Atarashi, discuss they and their colleagues’ experience following the Great East Japan Earthquake in 2011, and some of the measures taken in the aftermath to ensure continuity of care. They also describe some of the key learnings, and how these have informed actions to further improve their hospitals’ resilience and preparedness for future natural disasters.
Natural disasters, including the coronavirus pandemic, have a massive influence on the healthcare services. Japan experienced a massive earthquake in 2011. More recently, in 2019, Typhoon Hagibis triggered floods and caused damage to many healthcare facilities. The last earthquake caused direct injury to patients and healthcare workers. In addition, it had various other influences besides the direct impact. One of the most serious collaterals is a blackout, because modern medical activities are supported by a number of electrical devices. Therefore, once there is a blackout, almost all sophisticated medical equipment cannot be used. Even if a machine is equipped with a battery, it does not last for a long time. We also experienced afterload impact such as the administrative restriction of electricity and water supply according to Article 27 of the Electricity Business Act (see Table 1). During the disaster, we realised that approaches to both blackouts and energy saving are key issues at hospitals in remote areas. Here, we present the important roles of hospital engineers (HE) we learned from our experience of the Great East Japan Earthquake of 2011.
Methods We categorised the major issues we had to resolve according to the timeline of the earthquake. These included direct damage to humans and property and
Restriction of Use of Electricity
Article 27 When it seems that if no adjustment is made to the supply or demand for electricity, a shortage of electricity supply will adversely affect the national economy, standard of living or public interest, the Minister of Economy, Trade and Industry may, to the extent necessary for resolving such a situation and pursuant to the provision of a Cabinet Order, restrict the use of electricity supplied by a General Electricity Utility, Specified Electricity Utility or Specified-Scale Electricity Utility by limiting the power usage or peak load or specifying the purpose of use or the date and time when power usage should be stopped, or restrict the receiving of electricity from a General Electricity Utility, Specified Electricity Utility or Specified- Scale Electricity Utility by limiting the capacity of receiving electricity.
Table 1. Article 27 of the Electricity Business Act of Japan.
Figure 1. Visualisation of power consumption on the web.
indirect sequelae. For this purpose, we focused on the key issues of blackout and energy saving (see Tables 2&3). In terms of infrastructure, the performance of in-house generators, the location of uninterruptible batteries, the hospital information system, and the water supply are important.
In Japan, medical devices that require electricity are supported by not only charged batteries, but also by hospital utilities. In fact, the machine-mounted batteries were not sufficient to continue to drive machines in the disaster we experienced. The power supply for medical equipment should be assessed in each department in the context of emergency circumstances. In addition to checking whether medical equipment had batteries, the kind of outlet to which the medical equipment in each department was connected was checked. In terms of outlets, we have three types.
These are differentiated by colour: white, red and green. White outlets are ordinary ones, which means they cannot supply electricity during a blackout. Red and green outlets are for emergencies. The difference between them is whether the outlet can constantly supply electricity without interruption. Red outlets stop
February 2022 Health Estate Journal 25
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