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Managing Healthcare Utility System Risks

| Dave Stymiest

During a global pandemic it may be difficult to consider beyond the next change, however facility infrastructure risks still need attention.

A July 2020 Healthcare Facility Management (HFM) Magazine article entitled “A review of common hospital utility risks – Proactive assessment of hospital utilities can help to minimize risks and ensure safe and efficient operations” and its companion sidebar article entitled “Methods for facility risk assessment – Performing facility risk assessments for systems beyond utility infrastructure” address broad categories of healthcare facility utility infrastructure risks.

In the water management arena as an example, some well-known industry resources used to establish existing healthcare facility water management programs have been recently updated, and there is also a new industry standard (ASSE/IAPMO/ANSI 12080) that outlines qualifications, including knowledge and competency, for water safety team members.

The “A review of common utility risks…” article and the “Methods of facility risk assessment…” article also address mitigating risks associated with other major health care facility utility systems and processes.

Additional types of risk mitigation activities not covered within those articles can include:

  • Review utility system drawings, one-line diagrams, flow diagrams, riser diagrams, and layouts when changes occur, and then proactively update them with the new changes.
  • Ensure both equipment and pathway shutoff devices and other control devices are correctly and effectively labeled; and then use that labeling in the utility failure training and related exercises. Make sure all utility failure procedure documentation is consistent with the field-installed labeling.
  • Practice utility failure procedures as well as other emergency procedures. Proactively look for new equipment failure risks. Utility equipment failure procedures are very important, and work most effectively when they are accurate, well thought out, parallel well with control device nomenclature in the field, and also make sense to the workers who will be required to follow them during emergency conditions.  Training on the procedures should be practiced frequently to be effective. Documentation should also be accurate to reflect the potential loss of institutional memory over time.
  • Review all risk-based protocols, such as the water management program as an example, and factor into those documents the lessons learned from real events (the COVID-19 pandemic for example.) Then learn the changes.
  • Consider creating infection prevention drawings (showing air pressure relationships) if you do not already have accurate ones; and use them when making decisions. Tie those drawings into your inventories of critical care areas and non-critical care areas that have mandatory HVAC requirements.
  • Also consider how you might address the following as common root causes of hospital utility infrastructure equipment failures:
    • Component failure that reasonably could not have been anticipated or prevented by inspection, testing or maintenance
    • Mishandling or misuse
    • Inadequate or incorrect instructions, procedures or processes
    • Wear and tear that was not corrected by maintenance
    • Sabotage, vandalism, malware, or hacking
    • Failure of incoming utility service with inadequate onsite backup
    • Unavailability of another necessary component

Questions related to this article may be directed to the author, David Stymiest, PE, CHFM, CHSP, FASHE, at