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‘Backups to our backups’

Here’s how hospitals stay open when everyone else closes


Disastrous weather can shut down cities, but the system’s hospitals keep humming, providing patients an oasis of safety in the storm. That’s thanks to some serious planning, coordinated teamwork – and massive, floor-to-ceiling generators.

“Patients or families of patients ... need to know that we have systems that are ready for any sort of situation,” said Chip Phifer, Novant Health plant engineering services director for the greater Winston-Salem market. “Even if we do have a failure, we have redundant systems that will continue to provide services.”

A power outage zips an alert to the hospital’s transfer switches. Those transfer switches – large metal cubes that glow with green and red lights – act as the “brains” of the facility’s electrical supply. They tell the emergency generators to kick in, restoring hospital power seven seconds after an outage, said Todd Reed, manager of plant engineering services at Novant Health Forsyth Medical Center.

Of course, even seven seconds of darkness might be too long for some patients. That’s why critical lights and machines have battery backups to keep power flowing during that tiny gap.

Novant Health Forsyth Medical Center’s generators are located in a secure space behind thick concrete block walls. Unlike the generators homeowners may stash in their garage for outages, these are massive, 12-cylinder mechanical beasts, guzzling diesel from a 25,000-gallon tank underground. When even just one is started up, it’s so loud you can feel the vibrations in your chest. And unlike the fuel in your spare gas can, the generators’ fuel stays stable and fresh, thanks to annual filtration.

All Novant Health hospitals keep their generators in above-ground locations safe from flooding. Novant Health Brunswick Medical Center, located on the North Carolina coast, has an above-ground fuel tank and generators secure above sea level.

And there’s still analog security in this digital world. While the entire emergency-power process is computer-controlled, even if the computer somehow failed, a human being could turn everything on with a manual switch.

If you happen to be lying in a hospital bed when a switch to emergency power takes place, it will be business as usual. “From a patient perspective,” said Phifer, “everything would be normal.”

‘Backups to our backups’

Talk to hospital engineering experts long enough and you realize that in their world, having one contingency plan is never good enough.

“We have backups to our backups,” Phifer said. Take earlier in the winter, for example. Extremely cold weather reduced supplies of natural gas on which the hospital normally runs, so Forsyth Medical Center switched over to oil. All hospitals are required to be able to run on two different fuel sources. Enormous boilers heat the hospitals, and they burn natural gas – if you peek through a tiny viewing window in each, you can see the blue-white flames inside. Even if the natural gas supply was interrupted, the boilers can run on diesel instead.

Medical centers are required to store enough to run continuously for four days without refuel and most Novant Health facilities set aside even more. And the hospital would keep vital operations running by shifting power to places that need it most. “In a catastrophic event,” said Reed, “if we can’t get fuel, we would cut back on all noncritical pieces of equipment.”

None of this comes cheap. The next time your monthly power bill leaves you reeling, consider that it costs Forsyth Medical Center $350,000 a month to power the hospital.

‘Everybody pulls together’

Of course, it takes more than machinery to keep patients protected. If the weather makes it risky for team members to travel, hospital leaders turn empty rooms into dormitories, setting up cots so staffers can spend the night. During Hurricane Matthew in 2016, Brunswick Medical Center declared a lockdown, a rare event in which all team members were required to remain at the hospital to help patients in need.

To get ready such events, plant engineer teams are like lookouts on a ship, constantly scanning the horizon for danger.

“We do risk assessments on a regular basis, looking at potential crises that might impact our facilities and plan for that,” Phifer said. “Hurricanes, tornadoes, ice storms – it could even be an earthquake.”

Ice storms, earthquakes ... or rodents. At another hospital system where Phifer once worked, the power was suddenly cut. It turns out “a squirrel got into a transformer on one of the poles and the transformer exploded,” he said. (No word on the fate of the squirrel.)

No matter the cause of the crisis, said Phifer, “everybody pulls together. It’s a great team effort.”

Published: 2/9/2018