The elements of an overall risk mitigation effort

Many organizations only focus on authority having jurisdiction (AHJ)-required emergency power testing. However, the larger and more important concept includes not only testing but also other activities that find new or ongoing risks in time to mitigate and then remove unresolved vulnerabilities.

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Conducting assessments of electrical system risks

Emergency power reliability

Consider ensuring that a utility management program addresses the following considerations to assist an organization in maximizing electrical system impact and safety:

• Designing for reliability with input from the hospital’s hazard vulnerability analysis.
• Careful construction, augmented by full-system commissioning and installation acceptance testing.
• Determining system load profiles to predict accurate peak demand loading during emergencies.
• Weekly inspections of all emergency power supply system equipment and locations.
• Monthly testing with proactive examination of operational issues and surprises during testing.
• Investigation, resolution and trend analysis of training or systemic issues.
• Extended run load test every 36 months.
• Vulnerability analyses, risk assessments and vulnerability mitigation activities.
• Preparedness for all emergency power system failures, including contingency planning for all levels of subsystem failures.
• Contingency planning for other internal and external failures.
• Comprehensive utility management plans with accurate and up-to-date system documentation.
• Integration of utility management plans and emergency management programs.
• Comprehensive and accurate short circuit and protective coordination studies.
• Coordination with construction/renovation and infrastructure upgrade projects.
• Consideration of essential electrical system subsystem failure plans in renovation and infrastructure designs.
• Awareness and follow-through of the patient safety impact of emergency power systems.
• Maintenance and clinical staff education on emergency power system-related issues.
• Comprehensive emergency power system maintenance program that also includes the branch subsystems.

Emergency power testing

Most emergency power testing requirements are clearly documented in the 2010 edition of the National Fire Protection Association’s NFPA 110, Standard for Emergency and Standby Power Systems, and AHJ requirements. The primary goals are to maintain the emergency power system in a constant state of operational readiness and to comply with regulatory requirements without adversely affecting the operation of the hospital or the well-being of the patients. 

Additional goals are to verify the infrastructure’s ability to withstand power transfers that will occur when utility power is lost and to educate clinical caregivers accordingly so that patient care is not at risk during utility power outages or internally caused normal power outages. 

A comprehensive, proactive emergency power testing program should train maintenance and clinical personnel to deal with the loss of utility power and power system transfers; test the functionality of all equipment related to the generation and distribution of emergency power; test the mechanical and building system responses to power system transfers; test clinical equipment responses to power system transfers; and avoid conditions that compromise patient treatment and safety.

All electrical equipment test failures should be analyzed to discover whether they were caused by human error, problem system interactions, test procedure inadequacies, equipment malfunctions or other causes. Corrective action should be planned regardless of the cause of the failure, and the corrective action should be sure to address the cause. 

If an equipment failure results in the emergency power system failing a test, interim measures should be implemented until the necessary repairs and corrections are completed, followed by a retest that is passed. Each failure should be considered for its generic relevance as well. Similar circumstances could cause similar failures to occur again elsewhere in the health care system.