HOSPITAL ENGINEERS
Category Utilities
Radiology Suite
Central Laboratory Central Sterilization Operating Theatre
Hospital Functions Description
50 per cent reduction of lighting Stopping air conditioning except for OT and Outpatient Dept. Stopping EMR system
Stopping large diagnostic equipment (e.g. CT, MR, angiography) Checks needed after recovery
Stopping blood sample testing Stopping function because of lack of power and water
Air-conditioning for only limited period Stopping anaesthetic computer Stopping image server
Suspended outpatient services Inactivated hospital server Stopping EMR in wards
Table 2. Estimated major influences of blackout on hospital functions.
supplying electricity for a second at the start and end of a blackout, but recover immediately, whereas green outlets are uninterrupted. The power of in-house generators should be assessed after the location and the type of outlet are confirmed. Our hospital has a total of 1,210 beds, and the power company is contracted to supply 44,100 kilowatts (kW) of electricity. The hospital is divided into areas depending on the source of electricity. There are two in-house generators. One has an output of 3,200 kW by an air-cooled engine, while the other has an output of 2,000 kW. A major difference between the two generators is the operating time. One can work for approximately 69 hours, while the other can work only for seven hours. There is another aspect of prevention of
collateral damage from a natural disaster. We need to consider preventive measures against future disasters. The BCP (business continuity plan) is one strategy. This approach requires knowledge not only of the specifications of medical equipment and instruments, but also of building standards and building codes.
Results In terms of direct damage, the medical staff checked whether patients had been injured, and took care of patients in the wards and outpatient department immediately after the first shock of the earthquake. Fortunately, there were no seriously injured patients. At the same time, the medical staff and office workers went around the building. As most buildings in Japan – including our hospital – have an earthquake- resistant or absorbing structure, we experienced limited patient injury and destructive damage to the building. Physical damage included minor cracks in walls, drug bottles falling over or off shelves, and bookshelves falling over. Utilities such as water supply, electricity
26 Health Estate Journal February 2022
and medical gases were almost intact. There was some indirect damage. In the
outpatient department, it was requested that patient care should be stopped as soon as possible. In the operating room, surgeons were asked to stop operations in process after determining the appropriate timing. Planned operations were cancelled. Then, outpatient consultations were rescheduled because of limitations of the transport system. Operations were also rescheduled, mainly because of aftershocks. Three days later, as the Fukushima Daiichi nuclear plant was severely damaged by the tsunami caused by the earthquake, we suffered from its collateral damage, such as from a shortage of electricity due to restrictions on electricity, requested by the government. There are several approaches to
blackouts undertaken by the whole hospital. First, we need to determine a fundamental plan for the whole hospital. Next, each department needs to determine its action plan for blackouts. Furthermore, we need to develop a working group and carry out a simulation. Finally, we need an action plan to avoid blackouts.
Infrastructure of hospital
n Performance of in-house generators n Performance of interruptible batteries n Usability of medical gases during blackout n Air-conditioning and water supply n Hospital information system
Medical equipment
n Types of outlets to which medical equipment is connected n Equipped with battery? (performance of battery, if any) n Information-sharing in power shortage n Between medical team and administrative personnel
Table 3. Key issues for blackout and energy saving. We also had approaches to energy
saving. Our fundamental policy was that patient safety is a top priority. Personnel specialised in utilities, such as our healthcare engineers, analysed the collected data and simulated the energy consumption. Based upon this simulation, we could set the level of energy consumption. We maintained room temperature at the minimum required level and used the minimum amount of medical equipment. The impact of the electricity shortage
spread throughout the hospital. In terms of hospital utilities, we had to reduce lighting use by 50 per cent. Even though we did not experience a blackout in our hospital, we had to stop the air conditioning and the hospital information system. In the central laboratory, we had to cease operation of blood tests. We also had to cease central sterilisation activity due to a shortage of power and water. In addition to the aforementioned
approaches, the whole hospital made an effort to save energy. We visualised the energy consumption on the web. All staff in the hospital could view the data on power consumption. Above all, information- sharing on power shortage is crticial. Again, the healthcare engineers created the basic data for this approach (see Fig 1). In the last earthquake, we formed a
working group on energy saving. At the first meeting, a report on the number and types of outlets and medical equipment was requested from each department. This approach also served to make all healthcare staff aware of where the emergency outlets were located in the hospital. At the second meeting, the collaboration of medical staff was confirmed.
Based on the answers to the
questionnaire, we stratified the measures depending on the level of requirement (see Table 4). At the staff meeting we shared information on energy saving among the medical staff. The responses to the questionnaire were presented, and a fundamental policy on
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