Medical and Life-Safety Systems

Transcription

1 Medical and Life-Safety Systems Balancing Life-Safety and Critical System Reliability PRESENTED BY Michael Fluegeman, PE Principal, PlanNet

2 Learning Objectives Identify the unique operational aspects of managing medical and life safety facilities Understand what puts life safety systems at odds with reliability Analyze common causes of emergency shut downs Learn about real-world shut down scenarios in a variety of healthcare systems 2

3 Speaker Background PlanNet since 2007 Ø A Technology Consulting & Construction Company Ø Assessments Ø Strategy/Design/Basis of Design/Specs Ø Construction/Project Management Ø Commissioning Ø Operations/Documentation/Training Ø Litigation support Prior: Syska Hennessy, Power Management, PRK Emerson/Liebert, Siemens/ITE, Westinghouse 3

4 Life-Safety Priorities 4

5 Life-Safety Priorities Priorities Patient Life-Safety Worker Life-Safety Continual Functionality of Technology Supporting Patient-Care Equipment 5

6 Life-Safety Risks Risks Shock, electrocution, arc-flash Smoke, fire, fire detection & fire suppression shutdown of critical equipment Failure of patient-care technology Loss of communications during treatment v Tele-surgery, robotic surgery breakdown v Loss of remote phone / internet support 6

7 Shock, Electrocution & Arc-flash Risks 7

8 Shock, Electrocution & Arc-flash Risks Shock & Electrocution Risks Wiring issues Bonding & grounding issues Equipment malfunction Arc-flash Risks Largely affects electricians & electrical equipment service providers Live hot work no longer permitted. Without proper design & redundancy, maintenance & repairs requires critical systems shutdown 8

9 Wiring Issues Ground currents & high neutral-ground voltages Wiring code violations Ground loops (multiple neutral-ground bonds) Neutral & ground conductors reversed Difficult to troubleshoot The older the building, the more likely these problems persist Insulated, isolated ground systems contribute to problems if not carefully maintained throughout 9

10 Bonding & Grounding Issues Bonding Code minimum is not good enough for reliability Good practices include not relying on conduit grounding, making home-runs to master ground bars, two-hole lugs, not stacking lugs Grounding The goal is to achieve equi- poten9al grounding Exo9c chemical earth ground systems normally not required Do not violate code with separated ground systems 10

11 Grounding Fix Ideally, root out the problems to reduce N-G potential & ground currents Isolation transformers are effective electrical band-aids Grounding effectively starts over at the transformer output With proper wiring & bonding downstream of transformer, N-G potential and ground currents should be near zero, regardless of the mess upstream Ø Shock & electrocution risks reduced 11

12 Shutdown of Critical Equipment from Smoke, Fire, Fire Detection & Fire Suppression 12

13 Smoke & Fire Critical Shutdowns Most shutdowns are not because of an actual emergency! Ø Overly sensitive equipment Ø Hair-trigger actuation Ø Operator error Ø Technician error Ø Equipment failure Ø Not designed with uptime as a priority o EPO triggered by fire alarm 13

14 Smoke & Fire Critical Shutdowns Fire & Security design & technician professionals have a shut-down-when-in-doubt approach Ø Systems cross-wired to shut down Critical facility design & technician professionals have a shut-down-as-last-resort approach Ø Eliminate shut down cross wiring unless coderequired 14

15 Smoke & Fire Critical Shutdowns Fire & Security design & technician professionals design held-closed circuits Ø Open-circuit will become apparent (alert, alarm) Ø Open-circuit will normally be forgiving Critical facility design & technician professionals design held-open circuits Ø Open-circuit is forgiving, but may not become apparent Ø Short-circuit can be catastrophic 15

16 Failure of Patient- Care Technology 16

17 Failure of Patient-Care Technology ICU life-support machines require reliable, continuous power v Mechanical ventilators v Heart-lung bypass machines v Baby incubators Local UPS units are often included with life-support machines; UPS unit failures can get ignored Ø UPS batteries require proactive maintenance 17

18 Loss of Communications during Treatment 18

19 Loss of Communications During Treatment Loss of communications during treatment v Tele-surgery, robotic surgery breakdown v Loss of remote phone / internet support v Loss of access to patient records 19

20 Data Centers & other Critical Facilities 20

21 Data Centers Increasingly remote from healthcare facilities Enterprise Often poorly located within multi-purpose facility Ø Water intrusion risks, central-plant dependencies Colocation Single-purpose, multi-tenant, focused on data centers Cloud services Hybrid data services 21

22 Critical Rooms in Healthcare Facilities q Telecom rooms q Network equipment rooms q Distribution rooms/closets (MDF, BDF, IDF) q Radiology centers q Emergency Operation Centers (EOC) 22

23 Critical Rooms in Healthcare Facilities Telecom/network rooms, MDFs, BDFs, IDFs require or may have: ü Reliable network/telecom/internet/phone system ü Reliable 24/7 cooling ü Reliable power: UPS & generator backup ü Fire protection (upgrades from wet sprinklers) ü Central-plant dependencies (generator, chilled water, etc.) ü Regulatory requirements ü Emergency Power Off (EPO) shutdown systems 23

24 Critical Rooms in Healthcare Facilities Reliable network/telecom/internet/phone system ü Redundant rooms ü Redundant electronics ü Redundant carriers, diversely routed back to separate PoP sites ü Reliable network architecture 24

25 Critical Rooms in Healthcare Facilities Reliable 24/7 cooling ü Redundant cooling equipment ü May require backup to central plant (DX, etc.) ü Generator backup for cooling ü Redundant cooling equipment should be powered from redundant ATSs 25

26 Critical Rooms in Healthcare Facilities Reliable power: Generator backup for long-duration outages. Generator system typically supports: Emergency lighting Fire alarm, suppression, pumps, etc. Elevators Essential medical equipment & treatment areas Reliable power: UPS backup for short-duration outages Telecom/network rooms, radiology equipment UPS equipment ideally located outside of critical spaces Redundant power distribution 26

27 Generator & UPS Power Back-up Systems 27

28 Backup Generator Systems Life-safety generator system Supports life-safety systems; may also support a data center Life-safety loads higher priority than data center Normally configured as parallel N+1 redundant 10-second availability required by Code Regular load transfer testing required by AHJ ATSs normally closed-transition to reduce testing power bumps Optional standby generator system Cannot support life-safety systems Supports data centers and other critical operations Better to configure as distributed redundant (2N, 3N/2, etc.) Regular load transfer testing not required by AHJ ATSs normally open-transition to reduce failure risk & complexity 28

29 Backup Generator Systems If one generator system supports both life-safety & technology: Use separate ATSs & breakers Life- safety ATSs require regular Agency- mandated transfer tes9ng Ø Closed- transi9on ATSs are befer Op9onal- standby ATSs do not require Agency- mandated transfer tes9ng Ø Open- transi9on ATSs are befer 29

30 UPS Systems UPS systems provide 5-15 minutes of battery backup Healthcare network/mdf room healthcare power typically configured with A-side UPS/generator; B-side utility o B-side allows full maintenance bypass of UPS and ATS o B-side will get bumped during power failures Better to configure A-side UPS/generator/ATS-A; B-side UPS/ generator/ats-b (or at least generator ATS-B) o No single-point failure risk; no need to rely on straight utility o No B-side bumps or alerts Lead-acid batteries used for decades; remain inexpensive Lithium-ion batteries gaining acceptance o Smaller, less weight, much longer life, more reliable 30

31 Critical Rooms in Healthcare Facilities Fire protection for telecom/network rooms, MDFs Dry-pipe pre-action sprinklers Early warning, aspirating smoke detection (VESDA) Gas suppression decreasingly used due to cost 31

32 Critical Rooms in Healthcare Facilities Central-plant dependencies Central backup generator system with life-safety as priority Ø Almost never more than N+1 redundant Ø Small critical rooms can draw from separate, redundant ATSs Chilled water plant Ø Generally available 24/7 and reliable Ø Subject to partial or full shutdowns for maintenance & repairs Ø Small critical AHUs can draw from separate, redundant ATSs 32

33 EPO Systems 33

34 Critical Rooms in Healthcare Facilities Emergency Power Off (EPO) kill switch shutdown systems Shutdown mechanism at the computer room exit(s) Ø Typically a button at all doors Entire room shutdown not normally required Ø Only power & supply air to IT equipment needs to be shut down Ø Lighting, UPS & PDU equipment can remain energized Legacy from 1960s mainframe data centers Required by national safety codes & Local AHJs Only applies to certain types of computer rooms Ø Generally those with access floors used both for supply air and cabling that is not anchored (flex power cabling) 34

35 EPO Systems Everyone has an EPO story. An unplanned shutdown. The story almost never involves an actual emergency! 35

36 EPO Systems For critical system reliability, the best EPO system is one that not required and is never designed or installed Ø Zero EPO systems The next best EPO system, if required, is a system designed to prevent or limit erroneous activation Ø Two EPO systems for A/B power & redundant cooling A single EPO system presents high risk to reliability Ø One EPO system requires special care 36

37 EPO Systems EPO systems are not normally required in small telecom/ network rooms, MDFs, BDFs, IDFs, etc. An EPO is normally not required for the following: Room with no access floor With access floor, but not used for supply air Access floor for supply air but not for cabling Access floor for supply air & cabling but all cabling anchored Once an EPO is installed, or even part of a design package, it is difficult to remove 37

38 EPO Systems Dual EPO System q Code allows two buttons Much Lower Risk q Use separate A & B systems wiring, separate j-boxes q Requires proper signage 38

39 EPO Systems Single EPO requires hardening High Risk High Risk Lower Risk q Covered, recessed buttons are best q Consider alarming cover (siren, strobe, etc.) q Maintenance bypass systems allow low-risk testing, changes q Avoid held-closed designs q Avoid fire alarm & control interfaces to EPO shutdown q Maintain accurate wiring as-built diagram 39

40 EPO Shutdown Recovery q Maintain step-by-step recovery procedures q If buttons are held-locked, provide access to key q Do not disable an EPO system Do not remove shutdown wiring! Do not padlock EPO button covers! q To reconfigure or eliminate an EPO system, do it thoroughly and completely. Argument: If life-safety (patient-care) technology is supported by the UPS and cooling systems, then patientcare might be better served without an EPO system 40

41 Reliability Killers 41

42 Reliability Killers EPO systems Circuit breaker nuisance tripping Ø Make sure trip settings are adjusted out from minimum Ø Don t set ground fault current interrupters (GFCI) too sensitive Generator, switchgear or ATS not in auto mode Generator breaker left open Generator incorrect software installed UPS battery failure Ø Monitoring & self-testing can provide false sense of security UPS left in bypass Maintenance, construction w/o effective MoPs 42

43 Keys to Reliability 43

44 Keys to Reliability Design commensurate with reliability requirements Ø Eliminate or reduce single-point failure risks Effective remote monitoring & controls Accurate, maintained as-built construction drawings Site-specific operating procedures, maintained Continuous operator training Preventative maintenance Ø Be aware of non-oem service-provider limitations: UPS Performance testing, commissioning Evaluate live facility risk vs. benefit 44

45 Regulatory Requirements 45

46 Healthcare Facilities Regulatory requirements NFPA 70, 99 & 110 Generator load testing 30% testing Load transfer of operating mechanical, electrical, plumbing, vertical transportation and clinical systems from normal power to emergency generators and then back to normal power Emergency power supply system (EPS) maintenance The Joint Commission Accredits Healthcare Organizations 39 month survey OSHPD: California's Office of Statewide Health Planning and Development OSHPD also monitors the construction, renovation, and seismic safety of hospitals and skilled nursing facilities and provides loan insurance to assist the capital needs of California's not-for-profit healthcare facilities Special equipment ratings: shake table testing Regular EPO testing (bypass, simulation allowed) 46

47 Healthcare Facilities Regulatory requirements Surge Protection Devices (SPDs) NEC Article requires SPDs on all emergency power system switchboards and panel boards, added to NEC 2014 Special requirements for SPDs with patient care equipment. The National Electrical Code for Health Care Facilities (NEC Article 517) requires SPDs to protect medical equipment used in general or critical patient care areas. SPDs in these areas also must comply with the requirements of UL Medical Electrical Equipment, Part 1: General Requirements for Safety and IEC Medical Electrical Equipment - Part 1: General Requirements for Basic Safety and Essential Performance. NEC 2017, issued in September of 2016, added requirements for SPDs on disconnects supplying emergency systems in Article (E). This section addresses SPD requirements for elevators, escalators, moving walks, platform lifts, and stairway chair lifts. Where any of the disconnecting means has been designated as supplying an emergency system load, surge protection shall be provided. 47

48 Comments & Questions Contact: Michael Fluegeman, PE, Principal PlanNet 2951 Saturn St., Suite E, Brea, CA Office (rolls to mobile) 48