The best practice that I think will be most essential in ensuring that an
organization's capital plan is successful is #4 - Ensure that utility
shutdowns and switchovers are properly planned and clearly
communicated. I chose this one because utility interruptions greatly
impact patient care. Ventilators, monitors, surgical equipment,
dialysis and chemo equipment, etc. all rely upon electricity to
function, and an interruption to that utility specifically can cause a
great deal of chaos if not properly planned and the times of
shutdown, duration, etc. are not clearly communicated.
Touchstone (2011) wrote, "The service that is being interrupted must
be identified and the affected areas or people must be notified so that
interim measures can be taken." He further went on to explain that
any disrupted utilities must also be locked out/tagged out to prevent
accidental reintroduction of the utilities while work is being
performed. This process is performed by physically placing a lock or
using an existing lock on an enclosed box, such as an electrical panel,
to prevent access while work is in progress. If it's tagged out, then
sometimes a zip tie or a color-coded metal tag is affixed as a way of
"communicating" that that utility is shut off for a reason. An example
of a utility that might be tagged out is a gas or water main.
As for the interim measures that must be taken, the contractor or
subcontractor must perform a physical test of the facility's backup
generator system, assess the facility's needs for water during daily
operations and the times that it is most needed, and if gas service is
interrupted, they should determine if there are electrical alternatives
or what runs on gas and when it's needed the most. Any
communications utility shutdowns should be planned and
coordinated based on a facility's emergency plans.
At my facility, maintenance gives at least 24-hour notice to residents
and staff before interrupting a utility service. They clearly explain
what the shutdown will include, the time it starts, the duration, and
the reason for the interruption. There are announcements made via
public address system one hour prior to shutdown, at shutdown, and
at restoration. I know this is "just a retirement community," but we
offer 3 levels of care, so we technically fall under the status of an
occupied healthcare facility. We have residents in all 3 levels that are
dependent on oxygen or other medical support devices, so we have
to regularly test generators, and do it again before performing work.
Being security with the maintenance director as a supervisor, it's a
unique job description sometimes because we assist with informing
residents, performing tests on the generators, and locking/tagging
out. I can't think of anything that could be worse than not having a
proper plan or clear communication, except having an accidental
restoration of utilities during work.
Touchstone, R. (2011). 5 Healthcare Construction Best Practices for
Occupied Healthcare Facilities. Becker's Hospital Review.
https://www.beckershospitalreview.com/hospital-management-
administration/5-healthcare-construction-best-practices-for-
occupied-healthcare-facilities.html
