This summer’s earthquakes in Ridgecrest, California, were a powerful reminder of the State’s vulnerability to seismic events, and served yet another red flag for the earthquake risks to hospitals’ aging infrastructure throughout the United States — including the Pacific Northwest.

As scientists urge the public to prepare for future events — and seismologists warn the Ridgequest quakes are a wake-up call to be ready for the next big one — California hospitals and healthcare systems continue to bring their campuses into compliance with the state’s regulatory requirements. But what about the Pacific Northwest, where regulatory compliance is in its infancy compared to its southern coastal neighbor — but seismic risks are just as alarming?

“Earthquakes come with very little, if any, warning. And the science tells us the Pacific Northwest is definitely vulnerable to seismic activity,” says Chris Hickman, Petra’s Assistant Vice President, Planning & Design. “It’s critical that hospitals and health systems in Oregon and Washington focus now on seismic preparedness, to make sure their patients and their operability will be protected in an earthquake, and so they can respond while there is still flexibility in how and when changes are implemented. Because compliance regulations are coming — in the Pacific Northwest, it’s really a question of ‘when,’ not ‘if.’

“Well-engineered, well-configured buildings designed to withstand seismic activity will perform better when — again, not ‘if ‘— a big quake comes to the Pacific Northwest,” he continues. “Protecting access to healthcare is not only critical for disaster response during an earthquake event, but afterward as well, when communities will depend on local hospitals to provide the ongoing medical care they will need throughout their recovery.”

A “big one” is likely in the future for the Pacific Northwest, which is home to the Cascadia megathrust fault, spanning 600 miles from Northern California to Vancouver Island, Canada — including the cities of Seattle, Washington, and Portland, Oregon. Scientists say it has the potential to trigger large earthquakes, as big as 9.0.

In a signficant earthquake, will your hospital stay standing? And will it stay open?

 

Why Seismic Preparedness Is Essential for the Pacific Northwest

California’s Ridgequest quakes are the latest alarm bell to the Pacific Northwest that it’s time to get ready. Beyond the #1 priority of protecting your ability to provide healthcare services, no one wants to respond to finger-pointing after an event — from stakeholders, community leaders, patients, and staff who demand to know why your hospital wasn’t better prepared.

Loss of building assets and/or lack of essential medical care can have a devastating impact on the resiliency of communities following an earthquake, both short-term and long-term. Clearly hospital buildings need to fare well in an earthquake to protect those inside — all patients, visitors, and staff, from the ER to the ICU. In addition, hospitals need to be at-the-ready to provide community emergency care immediately following an earthquake. Finally, hospitals are a critical resource after an earthquake, when medical staff and facilities will feature prominently in the community’s ability to successfully recover.

Over the past couple of decades, California hospitals and health systems have invested millions — if not billions — of dollars upgrading and replacing vulnerable buildings, to ensure campuses meet strict regulatory standards. Yet Washington and Oregon don’t have state mandates for seismic compliance, beyond triggers for significant changes to buildings, or  for new construction.

While the Pacific Northwest market probably can’t immediately take on the burden of a massive investment in readying buildings for future seismic events, administrators are aware of risks and are beginning to take steps toward seismic preparedness on their own, despite the absence of compliance requirements. At Petra, we’re currently working with a collection of hospitals in Washington and Oregon who seek to leverage our deep experience with seismic compliance in California in order to strategically approach adding implementation to their own master plans.

Whether required or proactive, funding seismic preparedness can be a challenge, considering the complexity of buildings and campuses — not to mention healthcare’s current economic landscape. But investment in seismic preparedness has vital, significant benefits that are, honestly, both altruistic and opportunistic, including:

  • Improves patient safety
  • Improves staff safety
  • Ensures reliable community access to critical emergency and other healthcare services during disaster response
  • Protects against building and revenue loss during and after the recovery period
  • Shortens hospital recovery time and costs
  • Protects against staff job and income loss
  • Prevents or minimizes replacement of heavily damaged buildings and facilities
  • Prevents or minimizes hospital down-time, short-term and long-term

The bottom line: Up-front, proactive investment in seismic preparedness has a direct correlation to hospitals’ and health systems’ ability to bounce back more effectively following an earthquake.

Taking a proactive, holistic approach to seismic preparedness will empower you to evaluate and plan the best resources and timelines to strengthen your hospital in this mission-critical area, saving you the frustration and expense of knee-jerk reactions or mandated implementations down the road — or, worst-case scenario, not being ready for a seismic event.

Questions to Ask Now About Seismic Preparedness

If you’re already thinking about seismic preparedness in the Pacific Northwest and want to learn more, here are some commonly asked questions to get you started:

What do I need to do to my buildings right now?

Join other hospitals and health systems in the Pacific Northwest that are taking proactive steps to assess the level of risk within their existing building portfolio. We recommend starting with a high-level screening to understand the potential vulnerabilities prior to determining potential mitigation. There are a number of tools available to help you navigate an assessment and evaluation process. Currently, regulations within building codes mandate seismic retrofit of existing buildings under certain instances. However, at the time of this writing, there are no blanket mandates forcing hospital owners to upgrade buildings to a specified performance level. Our experience, backed up by research, points to the benefits of proactive planning and preparedness as the best mitigation against adverse impact from a seismic event.

How much will seismic compliance cost?

At Petra, we have worked with many building owners who have taken a variety of different approaches to this issue. Seismic risk from buildings depends on many factors, including specific building configuration and construction details, local seismicity, and occupant ability for self-preservation. Our advice is to integrate strategic facility planning decisions with operational goals and financial sustainability considerations in order to holistically determine the cost/benefit of seismic upgrades. The good news is that much can be done to develop a strategy to reduce exposure to earthquake risk with limited resources.

When we’re remodeling, will we trigger a retrofit?

This question often arises when an organization is planning to undertake a cosmetic remodel of a bed unit, imaging suite, or another area within an existing hospital building. In some cases, the local Agency Having Jurisdiction (AHJ) — the governmental body that reviews plans and provides a permit to start construction — will have specific code language or an ordinance establishing criteria that differs from the model building codes. Our experience in the Pacific Northwest is that AHJs follow model codes, modified by state code bodies. The International Existing Building Code (IEBC) is a helpful document for understanding when the need to upgrade a building structure due to seismic vulnerability is triggered. We have developed a flow chart to navigate the code requirements when making changes to an existing building.

In most cases where the scope of remodel is superficial, there is no code mandate to retrofit. However, the other consideration to remember is the ethical perspective — what is the right thing to do? In our experience, most organizations, and especially not-for-profit healthcare organizations, want to do the right thing. We help organizations navigate this important question, balancing the moral goal with the economic and logistical reality.

Will we have to meet seismic regulations in the future?

It’s inevitable that codes and legislation will catch up with experts’ sentiment that a specific minimum level of protection against earthquakes is necessary for hospital buildings. Our experience with such legislation in California has taught us a few things that are transferable to the Pacific Northwest. A few key points:

  1. Seismic safety of hospital buildings involves more than a structural engineering evaluation. We approach this issue from an integrated standpoint, considering operational transformation, staff and patient comfort, and clinical excellence as well as the nuts-and-bolts perspective, schedule, sequence, cost, and disruption.
  2. The first step to accomplishing meaningful seismic preparedness is to have a thorough plan. All too often we see master planning that focuses only on constructing new buildings to replace older, seismically compromised, buildings. In today’s economically challenged acute care landscape, few organizations can afford building their way out of this problem.
  3. The question of seismic safety in hospital buildings is as much a question of healthcare delivery as it is about structural engineering.

Getting Started with Petra

At Petra, we understand competing priorities and shrinking revenues in today’s healthcare environment leave limited bandwidth for healthcare leaders to focus resources on seismic preparedness. We assess seismic vulnerability and evaluate recommendations using a holistic approach to problem-solving and developing creative, integrated solutions. Our recommendations include consideration for limited capital, organizational disruption, capital capacity, and future healthcare delivery methods and options, and we do it all with limited strain on the C-suite’s already-full calendar.

If you’re ready to get serious about the serious issue of seismic preparedness, contact us today.

At Petra, we’re all about creating better — for our clients and the patients we ultimately all serve. Our team of experts ensures your next facility project meets tomorrow’s healthcare needs by delivering holistic, innovative solutions with the benefits of long-term sustainability and flexibility for the future. Contact us today to learn more about seismic compliance and how you can better prepare for the next quake in California, or beyond.

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