While the world continues to react to the COVID-19 pandemic, healthcare providers are working with their local communities to expand treatment capacity. Power management company Eaton answered the call when Long Island’s Southside Hospital extended its triage capabilities with an emergency hospital tent and tasked a local partner with providing the critical equipment needed to keep the facility functional.
On the heels of this announcement, Justin Carron, Eaton’s global healthcare segment manager, sat down with 24×7 Magazine to discuss the lessons learned from this assignment and what healthcare facilities should know about critical equipment moving forward.
24×7 Magazine: Have there been any commonalities in the infrastructure needs of temporary facilities built to treat patients amid the COVID-19 pandemic?
Justin Carron: It’s important to differentiate between the two main types of temporary facilities most commonly deployed during the pandemic: converted convention centers and new, temporary field hospitals—the latter of which also includes on-premise COVID-19 testing.
While specific power needs vary between these two types of facilities, one of the commonalities that has been clear is the need for continuous uptime. The idea of an outage bringing down critical equipment is simply not acceptable. We delivered critical power distribution equipment for both convention centers and field hospitals, and a majority of this equipment was dedicated to building resiliency into the infrastructure.
Another commonality is the speed of construction, leading to the need for rapid equipment delivery. Everyone involved is working against accelerated timelines to convert and construct facilities quickly. Complex electrical equipment that would typically take several weeks to source, customize, and deliver onsite now must be delivered in a matter of days—even as little as 24 hours—to meet construction timelines.
24×7: What kind of power equipment does it take to operate these temporary facilities?
Carron: The scope for convention centers varies depending on the size of the facility and how much treatment capacity the provider needs to create. These facilities have existing power distribution, so converting them means adding onto or redistributing existing systems. From a resiliency and power management perspective, this means bringing emergency power to the facility, along with power distribution equipment (e.g., wiring outlets) and power quality devices (e.g., uninterruptible power systems) used to power each individual patient pod and ensure uptime.
Field hospitals typically need to bring in more distribution equipment. Some of these field hospitals may be tapping into an existing power system, but many cannot due to being constructed on “green field” sites. On average, the configuration can include multiple 75kVA transformers to bring the power from 408V to 208V/120V. These feed 1,200- to 2,500-amp switchboards to 12 to 15 downstream panelboards, along with multiple safety switches.
24×7: What things have healthcare providers overlooked when designing these facilities?
Carron: We have found that engineering firms tasked with designing and building temporary facilities have done a tremendous job in challenging circumstances. Many of the sites were built for the worst-case COVID-19 scenario and, fortunately, many have not yet been put to use. Convention center conversions were well designed and included many of the components Eaton typically recommends, such as emergency power, safe power distribution, and UPS (backup) power. Field hospitals were generally more customized compared to the convention centers, but similarly included many of the critical aspects we like to see, such as the aforementioned switchboards, transformers, panelboards, and switching devices.
In the event of future builds, we would encourage earlier engagement—from the up-front assessment and design phase to deployment—with all parties involved in the process, including the contractors, healthcare providers and equipment manufacturers. In many cases, providers were not brought in until the facility was ready for use and manufacturers were only consulted when the equipment needed to be ordered. Earlier engagement during this critical phase would enable designers to make more informed choices about facility infrastructure needs, enabling them to “right-size” equipment to the exact requirements of the facility.
24×7: What have you learned from working with healthcare providers seeking to expand their capacity to treat COVID-19 patients?
Carron: The biggest takeaway is that building a temporary facility is not a one-size-fits-all approach. Convention centers typically have a standard design for their layout and conversion, but future field hospitals would benefit greatly from a more standardized approach. Standardization in the design build process may help speed up the deployment of facilities and create repeatable processes, particularly in the area of electrical system design.
Another good lesson is to consider how to make better use of a hospital’s available space, as well as HVAC and electrical systems, to deliver greater power and load flexibility. Hospitals will need to expand and contract quickly based on patient demand, and critical infrastructure will need to be deployed with the ability to meet shifting requirements. Collaboration between providers, engineers, and manufacturers is key to determining how to better accommodate future needs.
24×7: How should healthcare providers prepare for another possible COVID-19 outbreak in the fall?
Carron: New design and operational standards could potentially arise because of the needs identified in the pandemic response. While on the lookout for these new standards, providers should frequently communicate with their vendors to assess their ability to handle additional electrical requirements for whatever comes next—whether it’s HVAC, IT, or simply supporting a greater number of devices.
Scalability will also be a major factor, and providers should start assessing how they can more effectively scale their electrical infrastructure to meet the requirements of a possible second wave. Some facilities may want to consider more advanced control systems, energy storage, alternative energy sources, and even microgrids in the overall system to provide greater flexibility, scalability, and manageability. With these technologies, providers can better integrate standalone components, such as energy storage devices, in their overall systems and make them more “plug-and-play” to enable greater resiliency.
Finally, providers should conduct a continuous review of their emergency management plans to prepare for another possible wave. This is good practice for any provider, even in non-pandemic times, but it becomes even more crucial now since they have experienced this pandemic and can take valuable lessons from it. This crisis has forced many to evolve their approach to face the mounting demands placed on them. Facilities that maintain a clear focus on addressing infrastructure challenges to allow for quickly expanded capacity will be better prepared to address potential future spikes in demand for treatment.