The final post in a series that explores the vital signs of a healthcare system’s infrastructure, this blog dives into the threats to which physical infrastructure is exposed every day. It discusses how facility managers can build their healthcare system’s immunity through solutions and practices that drive the optimization of both products and people to ensure reliability, compliance, and efficiency across the healthcare system all at the lowest total cost of ownership.
People come into contact with 60,000 germs every day1. But when the immune system is healthy, the body can efficiently fend them off and avoid illness.
Healthcare operations, too, face constant threats to continuity. These include factors such as aging physical infrastructure, rising energy costs, natural disasters, ever-changing regulatory requirements, and a shortage of skilled workers, to name a few. Individually, each of these threats has the potential to disrupt a healthcare system’s lifesaving work or jeopardize its profitability. Collectively, they create a complex, challenging environment that demands that facility managers proactively take steps to optimize operations and the physical infrastructure that supports them. Just as people need proper nutrition, enough rest, and regular checkups to keep their immunity up, healthcare systems need to be intentional about how they care for their physical infrastructure.
Thinking beyond the network.
The previous posts in this series have focused primarily on the digital infrastructure and steps data center managers and IT leaders can take to ensure availability of healthcare data and equipment. But none of these efforts much matter if the healthcare facilities’ physical and electrical infrastructure is flawed. Indeed, even the best UPS systems are only intended to provide backup power for a short period of time. The physical infrastructure includes:
- electrical distribution system from the utility to the end points
- building HVAC systems
- alternative power sources to maintain temperature, emergency lighting, fire detection systems, alarm systems, and sewage and waste disposal
- automatic transfer switches to transfer power to the backup generator
Each of these assets must be properly maintained and optimized in order for healthcare systems to reliably provide safe care to patients, even when utility power fails or natural disaster strikes. The physical infrastructure is primarily the domain of the facility manager, and these professionals must work with IT to ensure overall healthcare continuity.
With threats to continuity coming from every direction, building physical infrastructure immunity starts with three critical practices that need to be at the forefront of every facility manager’s radar:
- Properly maintaining assets. Maintenance is a major component of every hospital system’s budget as well as a key driver of continuity and compliance. As some of the most valuable assets in your facility, electrical and mechanical systems can have a major impact on your bottom line. Regular assessments and proper maintenance practices in accordance with NFPA70B Recommended Practice for Electrical Equipment Maintenance and NETA Frequency of Maintenance Tests guidelines ensures physical infrastructure is in good working order and doing its job to maintain the healthcare environment day in and day out, as well as when emergency strikes. Maintenance increases the working life of equipment and is much more cost effective than repairing or replacing assets that fail, reducing total cost of ownership. Additionally, proper maintenance ensures efficient operation and the optimal settings for equipment, helping to keep rising energy consumption under control, further reducing operating costs, and promoting the best possible ENERGY STAR® scores. In existing facilities, investing in a recommissioning process can give you comprehensive insights into the health, performance, and efficiency of infrastructure that supports your operations and identify assets that need to be serviced, optimized, or replaced to in order to operate as reliably and efficiently as possible.
- Complying with expanding and changing requirements related to system reliability and safety. Often times, maintenance isn’t just a best practice; it’s a requirement. For healthcare organizations, the regulatory environment is nothing if not complex. Multiple entities dictate everything from how and when electrical systems must be maintained to how to keep patient data secure in the event of an emergency. Failing to comply with these constantly evolving requirements and mandates doesn’t just increase your exposure to costly penalties and fines; it jeopardizes reimbursement, puts your equipment and business reputation at risk, and could harm workers and patients. The three areas of compliance that most impact healthcare continuity are:
- Emergency preparedness. Even during the most disruptive natural disasters, hospitals must stay online. Communities depend on their hospitals’ ability to serve as first responders and help care for those injured in such events. Accordingly, the Centers for Medicare & Medicaid Services (CMS) published a ruling that requires hospitals, critical access hospitals, and long-term care facilities to evaluate their emergency and standby power systems in compliance with NFPA 99, NFPA 110, NFPA 111. The codes cover fire, life safety, and emergency or standby power systems and give details on when and how these systems need to be inspected and tested and what maintenance practices must be completed to ensure compliance.
According to The Joint Commission’s latest list of most challenging standards, hospitals most often miss the mark when it comes to fire extinguishing systems and utility systems. So, increasing familiarity with these standards is key for all healthcare facility managers. They must also be compliant with a newer standard, NFPA 1221 - Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems. This standard covers all aspects of service delivery, from receiving calls to dispatching emergency units to the correct location in the appropriate time period. The standard provides complete criteria for the installation, performance, operation, and maintenance of public emergency services communications systems and facilities. - HIPAA backup power standards. If you work in healthcare, HIPAA is always top of mind. But it’s critical for facility managers to remember that HIPAA rules and regulations stay in effect even when the power goes out. HIPAA rules on contingency planning include a backup power standard—Section 45 CFR § 164.308(a)(7)(ii)(C)—dictates what healthcare organizations must do to protect data during a power outage, ensure that providers still have access to the patient data they need to deliver care, and keep data secure even when operating in emergency mode. The keys to compliance with this requirement are testing and maintenance to ensure backup electrical power will operate effectively under any circumstance.
- Electrical safety for workers. Patient safety is always a key concern in healthcare, but worker safety is just as important. OSHA sets the requirements in this area and NFPA 70E® Standard for Electrical Safety in the Workplace® provides the guidelines for how to comply with OSHA requirements. Overall, the purpose of the requirements and standards is to protect workers from exposure to major electrical hazards and reduce injuries and fatalities resulting from shock, electrocution, arc flash, and arc blast. Some of the key actions facility managers can take to ensure OSHA compliance include:
- Conducting regular electrical testing to detect problems with electrical system components like switchgear, circuit breakers, panelboards, relays, and protective devices that could disable your system.
- Conducting an arc flash study to identify threats to worker safety, calculate the degree of arc flash hazard, and develop a safety program that includes worker training, personal protective equipment, and warning labels on equipment.
- Updating the single line diagram to understand the electrical infrastructure and provide a roadmap that enables proper protection and system reliability.
- Conducting periodic short circuit and coordination studies to ensure devices are properly set and coordinated to quickly isolate a failure and improve protection for equipment, personnel, and your business as a whole.
- Providing documentation and reporting to show that electrical system components have been properly configured, maintained, tested, and inspected.
- Conducting regular electrical testing to detect problems with electrical system components like switchgear, circuit breakers, panelboards, relays, and protective devices that could disable your system.
- Emergency preparedness. Even during the most disruptive natural disasters, hospitals must stay online. Communities depend on their hospitals’ ability to serve as first responders and help care for those injured in such events. Accordingly, the Centers for Medicare & Medicaid Services (CMS) published a ruling that requires hospitals, critical access hospitals, and long-term care facilities to evaluate their emergency and standby power systems in compliance with NFPA 99, NFPA 110, NFPA 111. The codes cover fire, life safety, and emergency or standby power systems and give details on when and how these systems need to be inspected and tested and what maintenance practices must be completed to ensure compliance.
- Supplementing your staff’s expertise. Staying on top of efficiency, compliance, and maintenance goals is a challenge that can easily tax any healthcare system’s workforce, especially as healthcare networks become more distributed. Entrusting a qualified third-party testing and maintenance organization with some of the work that must be done on a regular basis can go a long way in helping your staff work as efficiently as possible and optimizing productivity. The right partner needs to be well-versed in healthcare compliance requirements, including HIPAA, and should have experience working in healthcare facilities. If you use a partner for any specializations, such as testing and maintaining your electrical system, make sure service technicians have the appropriate knowledge, training, and certifications to work on or around energized equipment, including NETA certification. Qualified professionals can help with:
- Establishing a regular preventive maintenance program that can help you check compliance boxes and keep up with the latest standards and best practices, while also reducing unplanned downtime and disruptive maintenance fire drills that take your staff away from their regular work.
- Carrying out the maintenance program in various remote locations, saving on time and travel for your staff to put eyes on equipment.
- Properly documenting all maintenance activities to demonstrate compliance with regulatory requirements and reduce some of the legwork your team needs to do to meet these requirements.
- Collecting and maintaining equipment data to ensure easy access to insights on trends and equipment performance that help your staff more efficiently make decisions and prioritize upgrades and repairs.
Ultimately, outsourcing service for your electrical and HVAC systems can promote efficiency goals and give you the confidence that your business is making every effort to ensure compliance and keep data, patients, employees, and the business safe. - Establishing a regular preventive maintenance program that can help you check compliance boxes and keep up with the latest standards and best practices, while also reducing unplanned downtime and disruptive maintenance fire drills that take your staff away from their regular work.
Manage and minimize your risks
From weathering the next storm to remaining in regulatory compliance, few industries face as much risk as healthcare. And the stakes couldn’t be higher. The keys to ensuring patient safety, protecting your organization’s reputation, and boosting financial stability starts with building your healthcare organization’s immunity through optimized critical infrastructure along with flexible services and support for your team.
To learn more about how to enable robust, reliable, and compliant operations that are optimized on every level for the lowest total cost of ownership, contact Vertiv or visit us at Vertiv.com/healthcare to discover how our solutions are helping more than 80% of U.S. healthcare systems achieve continuity for life.
1 – ABC News - https://abcnews.go.com/Health/ColdandFluNews/story?id=5727571&page=1
