Friday, July 18, 2014

Summer Heat and Storms, an Unreliable Electric Grid, and Resilience

GBMC has once again shown its ability to rise above adversity and meet its mission over the last few weeks. The summer has brought high temperatures, thunderstorms and our local electric grid has not been able to supply GBMC with a reliable flow of electricity. We had three significant events where our campus had power interruptions.  During the most recent event with the added dilemma of an electrical storm, lightning struck one of our main feeders causing a power interruption.   Approximately one hour later, the second feeder on to our campus was incapacitated.  Power was then restored 45 minutes later. St. Joseph’s was also affected by this event.

The good news is, over the past few years GBMC has installed three new emergency generators so that we do not go without power. The bad news is these generators do not backup everything.  Our priorities for emergency power include: life support devices, emergency lighting, fire protection systems, patient communications devices, critical computer systems and clinical equipment. Our chilling system, which among other things cools the air in our buildings, is not connected to emergency power. So, when the power goes down, the chillers shut off. The fans continue to run as they must for ventilation and pressurization, but they are then pulling high humidity air from the outside into the building, thereby increasing the internal humidity.

Our operating rooms and our surgical instruments must stay within a narrow band of humidity to keep them sterile. During the summer, with high external humidity, the chillers keep the internal air within acceptable temperature and humidity levels. But when the chillers go down, the humidity can quickly get too high, and the rooms need to be re-cleaned and the surgical instruments need to be re-sterilized. There is a renewed emphasis on humidity and temperature control by CMS/Joint Commission to prevent healthcare acquired infections.  We can clean the operating rooms fairly quickly but it takes many hours to re-sterilize all surgical instruments.  For this reason, GBMC has had to delay or cancel many operations during these events.

I want to thank all of our staff who have risen to the occasion over the past few weeks to help us get things back in order. Our operating room nurses, technicians, central sterile staff, anesthesiologists, administrators and environmental service workers have done an outstanding job under very difficult conditions. I want to also thank our surgeons for understanding the problem and for having done everything to get their patients what they need.

Our management team has realized that we did not have the emergency designs in place to communicate well with our patients, our surgeons, and the rest of the GBMC team. I apologize to all for this. Over the past few weeks we have learned from each event and we have developed better systems of communication, but we need to do even better - and we will.

As for preventing future events, we are working with vendors to see if we can install emergency air conditioners that we can connect to the generators to better protect our sterile supplies.  We are also exploring back-up systems and emergency power connections for our Sterilizers. The long range fix is to connect the chillers to the emergency power. This is a very expensive proposition and will take a significant amount of time, but we are presently studying this with our engineers.

GBMC is an excellent healthcare system and we will grow stronger as we learn from these events and make the required changes. Thanks to everyone who is helping us.


  1. I am amazed that no one, until now, realized that this was a potential problem and no fail-safe measure was in place. Who was in charge? A repeated failure like this does not elevate our status in the community; instead, we look "not ready for prime time."

  2. I am ultimately responsible . As I explained in the blog, when we made the decision not to spend the million dollars plus to connect the chillers to emergency power we thought it was the right decision. At that time the power grid was more reliable and the humidity standards were lower.

  3. As a GBMC operating room nurse, I want to thank you for this post. It's the most honest and straightforward communication that many of us have received about these events. It's been difficult but we have pulled through, and as a longtime GBMC employee (and past patient) I want GBMC to continue to be a great place to receive care.

    1. Thanks very much for your hard work and your understanding, Anonymous.

  4. I have worked in many healthcare facilities and this occurs in every operating room, the community just does not hear about it. It is unfortunate that our climate in the Baltimore and surrounding areas is changing because of global warming. All one can do is step-up and deal with the infraction when it occurs and move forward and it sounds like that is what GBMC did. Kudos to the team. This is why many organizations have moved away from storing sterile supplies in operating rooms and having a designated sterile supply storage area, it is easier to control one area then many. GBMC is not alone.


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