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In the Dark !

In the Dark !. The quiet of a cold November evening was broken by the sound of fire alarms. It was A Facility Managers biggest fear, a fire in the main electrical switch room of the hospital.

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In the Dark !

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  1. In the Dark! The quiet of a cold November evening was broken by the sound of fire alarms. It was A Facility Managers biggest fear, a fire in the main electrical switch room of the hospital. The end result, an 1800 plus degree fire completely disabling all of the automatic transfer switches for the generators and melting through the utility feeds for Normal, Critical and Emergency power thus rendering the facility without power services and in the dark. 1st 911 Call from Hospital Operator 19:08:57

  2. Breaking News

  3. IN THE DARK!

  4. Incident Demographics • November 21, 20 13 • 21601 76th Ave. W. • Thursday Evening 1909 Hours • Weather • 37 Degrees • Clear • Minimal Wind

  5. Swedish Edmonds

  6. Swedish Edmonds OverviewStructure Year Built: 1964/1974 Number of Floors Above Grade: 9 Number of Floors Below Grade: 4 Square Footage Per Floor: 13k sq. ft. avg. Total Square Footage: 220k sq. ft. Construction Type: concrete/reinforced masonry

  7. Swedish Edmonds Overview Number of Patients during incident:120 Number of Staff during incident:75 Total Number of people in the hospital during the incident: 200+

  8. Incident Communications 3rd 911 Call from Simplex Grinnell 19:20:04 4th 911 Call from Swedish Off-site Employee 19:26:08 5th 911 Call from Simplex Grinnell 19:28:53 6th 911 Call from Swedish Emergency 19:29:48

  9. Incident Communications Received: 19:08:58 Entered: 19:09:30 Dispatched: 19:09:31 En-route: 19:11:22 On-Scene: 19:11:29

  10. Command and Control FIRE DISTRICT ONE Battalion Chief Don White FIRE DISTRICT ONE Assistant Chief Mark Correira Mark Nunes-DIRECTOR OF FACILITIES/SAFETY OFFICER-Swedish Edmonds

  11. Fire Department and Hospital Command Structure HOSPITAL HICS FIRE/HOSPITAL

  12. Incident Priorities • Life Safety • Civilian-patients/staff/visitors • Air Quality • Evacuation • Shelter in Place • Transport Support • Relocation • Emergency Responders • Property Conservation • Rapid and Aggressive Fire Control • Smoke Management and Removal

  13. Incident Priorities • Business Operations: • Restore Power to Facility • Assess electronics/monitoring equipment capabilities • Assess IT Capabilities • Plan for Immediate Operational Stability • Plan for Future Operational Needs: • Current Patients • Next Day Surgeries and Appointments

  14. Total Fire Unit Response Engine Companies: 9 Truck Companies: 3 Medic Units-ALS: 3 Aid Units-BLS: 2 Command Units: 6 Specialty Units: 5 Total of 28

  15. Resource Response:Agencies Represented Fire Agencies: Other Agencies: Fire District #1 Lynnwood Fire Shoreline Fire Swedish Edmonds Edmonds PD SnoCom PUD Support 7 Falck Ambulance AMR Ambulance

  16. Incident Challenges • Below Grade Fire • Access Issues • Visibility Issues • Rapid Smoke Extension to Multiple Floors • Evacuation/Shelter in Place Dynamics • Ventilation considerations • Evacuated Patient Assembly and Control • Loss of power to entire facility • Inability to isolate power grid due to lines affected. • Re-generation dynamics

  17. Incident Challenges from Hospital Command perspective • Significant Interruption to Hospital Operations • Patients in Surgery • Patient in active labor • Patients in Emergency Room • Patients in Post-Recovery Status • Pre-evacuation of patients • Patient Tracking • On-Going Hospital Operations-What could we still do?

  18. Emergency Department • 12 Patients Tx • 10 BLS • 2 ALS • 8 PGMC • 3 Northwest • 1 Swedish Ballard

  19. Emergency Department

  20. Remaining Hospital • Sheltering in Place: • ICU/PCU/PCU2- Moved to the ED after it was cleared. • One ventilated patient • 9th Floor Patients- Normally locked unit-Patients self evacuated. Patents were moved to the cafeteria after smoke cleared. • Surgery- Sheltered patients in surgery and in recovery suites. Coordinated movement as needed.

  21. Private Ambulances Private Ambulances- Supervisor coordinated patient movement to other hospitals, and kept additional resource onsite in case they were needed.

  22. Investigation Origin and Cause

  23. Domestic hot water tank pump failure

  24. Origin and Cause

  25. Origin and Cause

  26. Origin and Cause

  27. Origin and Cause

  28. Origin and Cause

  29. Origin and Cause

  30. Origin and Cause

  31. Origin and Cause

  32. Origin and Cause

  33. Origin and Cause

  34. Origin and Cause

  35. Incident Summary Electrical fire with difficulty isolating circuit High volume of smoke due to storage of synthetic combustible materials Difficulty removing smoke Fire extinguished quickly No patients, staff, or responders injured Hospital returned to service sooner than projected. Surgery resumed on Monday the 25th of November.

  36. Lessons Heard Need to get Senior Leader and Medical Staff more involved in the “preparedness” process* Hospital Staff need to review emergency plans by Floor, to include magnetic/self adhesive signs indicating hazardous areas Designation of a single person to be part of Unified Command immediately. This needs to be someone that is on site and preferably in a leadership position DAS could come up for fire response to increase communication reliability within the facility Do not store any combustibles in electrical/mechanical rooms

  37. Lessons Learned Communication efficiency increased dramatically with the SNOCOM Communications Van on scene A Command Post buffer zone is critical Additional master keys available to fire personnel would provide faster access and more efficient operations Some method of providing (secured) natural ventilation on Floor 9 would aid in smoke removal Senior Leadership and Medical Staff attendance in advanced HICS training

  38. Lessons Learned Cannot have too many redundancies in your communications plan. Engage your local fire and police responders in many if not ALL of your drill and exercises. Have at least TWO deep in your incident command structure Be ready for the CURVE!

  39. Six Days Later

  40. Upgrades Mechanical room above switch room floor epoxy sealed

  41. Upgrades

  42. Gratifying Achievements-Most Proud of • Surgery resumed on Tuesday the 26thof Novemberafter 24 hour safety pause. • No patients, staff, or responders injured. • Teamwork of staff and partners from other Swedish /Providence campuses. • Hospital returned to utility service sooner than projected (12 days). • Hospital did not receive one patient complaint for the incident and disruption.

  43. Thank You Mark Nunes Director of Facilities/Safety Officer Swedish Edmonds 425-640-4993 Mark.nunes@swedish.org

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