HOSPITAL ENGINEERS
electricity without interruption. Red outlets stop 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 on the specifications of medical equipment and instruments, but also on 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 of 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 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 shortage of electricity due to restrictions on electricity, requested by the government.
IFHE DIGEST 2022
Figure 1. Visualisation of power consumption on web. 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. We also had approaches to energy
saving. Our fundamental policy was that patient safety is a top priority. Personnel specialised in utilities, such as HE, analysed the collected data and simulated the energy consumption. According to this simulation, we could set the level of energy consumption. We maintained
Description
room temperature at the minimum required level and used the minimum amount of medical equipment. The influence of the electricity shortage spread throughout the hospital. In terms of hospital utilities, we had to reduce lighting by 50 per cent. Regardless of the fact that 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 stop blood tests. We had to stop central sterilisation due to a shortage of power and water. Besides the above-mentioned
approaches, the whole hospital made an effort to save energy. We visualised the energy consumption on the web. All staff
Table 2. Estimated major influences of blackout on hospital functions. Category
Utilities
50 per cent reduction of lighting Stopping air conditioning except for OT and Outpatient Dept Stopping EMR system
Radiology Suite Stopping large diagnostic equipment (e.g. CT, MR, angiography) Checks needed after recovery
Central Laboratory Stopping blood sample testing Central Sterilisation Stopping function because of lack of power and water
Operating Theatre Air conditioning for only limited period Stopping anaesthetic computer Stopping image server
Hospital Functions Suspended outpatient services Inactivated hospital server Stopping EMR in wards
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