As natural disasters get worse, we are going to need more resilient hospitals

Given the potential consequences, it’s imperative for healthcare leaders to invest in hospitals and care facilities designed for maximum resiliency. In an age of worsening storms, selecting materials that can withstand 150 mph and higher winds, having plans for sustained power loss, and other resiliency measures should be on the table at the outset of every new building project. Failing to design for resiliency can lead to serious challenges and even tragedy. Consider the following:

Hurricane Florence has led to the closure of numerous care facilities across the Carolinas and forced government and healthcare agencies to establish mobile, telehealth, and temporary care options. The city of Wilmington was even completely cut off from outside access for days due to flooding.
12 residents of a Florida nursing home died during Hurricane Irma in fall 2017 when the building’s central air conditioner failed and led to extreme overheating.
When Hurricane Harvey brought more than 60 inches of rain and strong wind to the Houston area last fall, 20 of the roughly 120 hospitals in the area had to close or evacuate. Per the Texas Hospital Association, the estimated disaster-related costs for reporting hospitals totaled $460 million spanning capital, operating, emergency work, uncompensated care, and other costs.

These examples and data begin to reveal the serious threats Mother Nature can pose for healthcare facilities. Fortunately, there are actions health systems can take to ensure stronger resiliency today, next year, and long in to the future.

Assess existing buildings’ strengths and weaknesses

Given thousands of healthcare facilities across the country were built years before we understood climate change and resiliency as we do now, numerous existing facilities are ill prepared to face serious weather events. Still, numerous building renovation or modification efforts can bring hospitals up to code or strengthen their resiliency. Here’s a look at key tools health systems can leverage to understand their real estate’s current strengths and weaknesses:

Passive survivability models use computer simulations to reveal how existing buildings will perform during loss of power or water utilities. These simulations also reveal the interior environment conditions staff and patients will face.
Existing building resiliency assessments consider the resiliency of every material, component, and system that comprise a building. They inform extensive reports that indicate building failures, weaknesses, and strengths and then outline a prioritized list of mitigation strategies with associated costs and timelines for investment. While these assessments should be executed years before storms arrive, they can also help inform recovery efforts for buildings recently impacted by weather events.
Emergency power tests verify critical backup, and emergency power systems will be reliable if storms damage a facility and/or force it to run without access to larger power grids.
Equip new buildings with customized resiliency plans?: While resilient design plans for hospitals are usually rooted in common focuses around power redundancy, material selection, adaptability, building insulation, and more, each hospital requires its own unique solution that responds to its exact environmental conditions.

For example, a project we worked on, Nantucket Cottage Hospital on Nantucket Island, faces remarkably different threats than a hospital located on the country’s west coast mainland. Set to open later this year and located on an island, the Nantucket Hospital may need to face hurricane-level winds in the future, but it also needs to be prepared to endure if weather cuts off access to the mainland.

The hospital’s unique location leads to extreme focus on power reliability, access to water, and flexible space. Beyond maintaining care for patients, Nantucket Cottage Hospital may also act as shelter for residents of the island who can’t fly, boat, or jet back to the mainland. Given that every hospital faces its own weather challenges–hurricanes, drought, fire, earthquakes, tornadoes, etc.–it’s important they don’t just rely on common practices and develop customized resilient design plans.

Consider future climate conditions

New healthcare facilities cost hundreds of millions of dollars and should be designed to drive value for 50-100 years. This means buildings can’t just be responsive to current environmental conditions, but also must consider future climates. The prime development land of today may actually be on track to become a floodplain over the next half century.

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