One site that you’d like to be up and running smoothly in case of an emergency is the emergency room itself. Hospitals play a key role during disasters and, as the extreme weather conjured up by climate change begins to take its toll on the built environment, health-care facilities need to be retrofitted and redesigned in ways that can stand up to mother nature’s fury. That way, the essential job of caring for patients can continue, even in the midst of a hurricane or flood.
Partners HealthCare, a nonprofit hospital and physicians network in New England, has made this the heart of its mission, as it works to deploy resilience measures across its more than 30 facilities, including existing hospitals and offices, as well as new facilities. Engineering.com reached out to Dr. Paul Biddinger of the Partners HealthCare network to learn what such a massive plan looks like.
Biddinger is the director of the Center for Disaster Medicine and vice chairman for emergency preparedness at Massachusetts General Hospital in Boston, as well as the medical director for emergency preparedness at Partners HealthCare. He explained that the project is being enacted in three phases. Phase I of the project included outlining every climate vulnerability the sites had, which was followed by a phase dedicated to understanding solutions to those vulnerabilities. The last phase, to be completed in September 2018, will see how these solutions can be best put into action.
Biddinger said that Partners HealthCare has learned a number of lessons from Hurricanes Sandy and Katrina to understand how its facilities can remain protected and operational in the event of an emergency related to heavy precipitation, flooding and storm surges.
These solutions include moving vital components like the facilities’ electrical systems and emergency generators above grade, where they will be protected from flooding. Not everything can be moved higher up in a facility, however. Fuel tanks and fuel pumps cannot be moved above grade, so Partners is making them fully watertight. The switch gear is also being made watertight so that it can remain resilient in the face of flooding.
The Netherlands has been a pioneer in creating deployable storm surge barriers, with the construction of the massive Maeslantkering gates completed in 1997, long before many countries developed concern over climate change-related flooding. Partners have taken this as a cue, exploring flood barriers that can be deployed to prevent flood waters from penetrating the ground floors of buildings.
Biddinger explained that Partners also plans to make some of its sites “extra resilient” so that high-risk patients can find refuge in Partners hospitals during extreme storm events.
This process could involve placing submarine doors in select below-ground floor areas to wall off safe areas for storing supplies and food in the basements of some hospitals. In the case of extreme storm events, some Partners sites could become isolated, even if they’re not damaged by flooding. Such preparations would make it possible for these facilities to continue operations during the period of recovery following a disaster.
“Even if it’s cost prohibitive to make an entire campus as fully resilient against all the threats we face, as we would like, with new construction we’re trying to consider how we might be able to better support evacuation from the more vulnerable parts of the campus into new construction,” Biddinger said. “[We’re also considering] how the buildings can better accommodate more storage of disaster supplies, food and water, and durable medical equipment, so if even if part of the campus is affected by a future storm related to climate change, at least our patient care operations can continue for the community.”
In many ways, the paragon of Partners’ resiliency and sustainability work is the Spaulding Rehabilitation Center, which was completed in 2013. The center is Boston’s first waterfront building to be designed with climate change in mind. Spaulding was built much higher above grade than required by code, with the first floor located 30 inches above the 500-year flood elevation. Large granite berms further block flooding from Boston Harbor and the local river.
The site uses triple-paned glass and super insulation for a tight building envelope, light-colored concrete to create an albedo effect, and natural ventilation. The mechanical systems—heating, cooling and air ventilation—are stored in the penthouse, rather than at the ground floor, with a concrete chase used to carry electricity through the hospital. This protects these systems in the case of ground floor flooding.
A secondary combined chiller and HVAC system is in place in case the main system stops operating. The site has two emergency diesel generators that can operate for at least four days or more, if fuel is used conservatively. To achieve this, Spaulding features key-controlled, manually operated windows that staff can open to let in outside air in lieu of air conditioning. The numerous windows throughout the building also ensure natural daylight can replace electric lighting to further conserve back-up energy.
To learn more about the relationship between climate change and the built environment, read our recent article on the topic. To learn more about Partners HealthCare, visit the company website.