FacilityCare Magazine

May/June 2012

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Page 16 of 39

we construct continue to change and evolve as building codes respond to lessons learned over time, it is often historical aspects of the longevity associated with a healthcare facility that can lead to weak links in a complex chain of components that protect the inhabi- tants of the healthcare facility from the exte- rior environment. Maintenance budgets con- tinue to tighten, furthering the difficulty in maintaining the facility's exterior thermal and moisture envelopes. It is not uncommon for a healthcare facili- ty to represent a 75-year community invest- ment in development and growth. However, all this can come undone in a matter of hours under the pressure of hurricane-force winds. The exterior envelope and thermal and mois- ture protective systems of our country's healthcare facilities may represent the weak- est link in hurricane survivability. As wit- nessed in previous storms, wind damage has the capacity to shut down even the most pre- pared healthcare facility. Vulnerability Assessment and Shelter-in-Place Planning Strategies It is recommended that all healthcare facilities perform comprehensive exterior envelope vulnerability assessment and shel- ter-in-place planning. These assessments would consist of a review of key compo- nents necessary to ensure a successful shel- ter-in-place survivability plan and a hard- ened exterior envelope capable of perform- ing as required to protect the health safety and welfare of hospital occupants both dur- ing and after a storm. Envelope assessment and shelter-in-place planning go hand in hand, as once the envelope is breached, patient movement will be necessary to ensure safety and protection from the ele- ments, especially given the fact that a healthcare facility's entire patient popula- tion is dependent on the building envelope. A comprehensive exterior envelope-based assessment would include: • Pre-storm infrastructure surveys and assessments. • Establish policy and procedures for maintenance and testing of exterior envelope components. • Research NOAA Coastal Services Center website or similar websites to evaluate hurricane strike potential for facility's geographic region. • Assess roof, coping and parapets and other systems relative to codes and stan- dards to ensure uplift criteria are met. • Assess building envelope, window and curtain wall assemblies. • Perform a windborne hazard assessment and a roof ballast and equipment tie- down assessment. • Coordinate assessment strategies with insurance carrier. • Identify the magnitude of loss scenarios and damage scenarios based on assess- ment findings. • Identify recovery scope relative to loss scenarios. • Identify recover timelines relative to loss scenarios and response plans. • Form recovery team consisting of archi- " " Hurricane Preparedness The exterior envelope and thermal and mois- ture protective systems of our country's healthcare facilities may represent the weakest link in hurri- cane survivability. tects, engineers, contractors and other critical support to aid in post-storm recovery and develop resource database. • Pre-storm shelter-in-place planning strategies. • Identify benchmarks/criteria to evalu- ate strategies for patient mobilization and evacuation. • Create shelter-in-place scenarios to assist in a risk assessment and manage- ment plans. • Create horizontal/vertical evacuation and mobilization plans, perform drills and compare to benchmarks. • Review physical plant and develop areas of refuge for both patients and staff. • Discuss shelter-in-place scenarios with key department heads from dietary, security, IT and communications, nurs- ing, surgery, radiology, emergency and others as necessary. • Discuss ILSM and infection control policy issues related to possible partial hospital occupancy due to storm dam- age potential. Hurricane Survival Pointers In the event a healthcare facility finds itself in the midst of a hurricane prior to performing in-depth planning, there are a number of pre- and post-storm strategies that can be employed to assist in recovery. • Increase personnel pre-storm. Mobilize quickly because time is limited. • Assess and order supplies pre- storm…again, mobilize quickly. Envelope destroyed by Category 3 hurricane force winds. MAY/JUNE 2012 • Secure equipment and nonessential facil- ities pre-storm. Every minute counts, so facilitycare.com FACILITYCARE | 17 pharmacy,

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