Kris Noiseux: What if we can… Design a Hospital to Function Through an Earthquake?
Previous Healthcare Lead, WSP in New Zealand
Earthquakes occur far more often than any of us might imagine. At least once every 24 hours, there will be an earthquake somewhere in the world. Most seismic events are of such low magnitude they go virtually unnoticed, but some make headlines for the chaos and destruction they cause.
Designing hospitals to serve communities in seismic zones, means thinking through the effects of earthquakes on buildings and services. Major earthquakes may cause structural collapse but even more likely are crippling disruption to power, water and sanitation. Minor quakes can weaken resilience over time, making the hospital more susceptible to damage and functionality loss when a moderate earthquake strikes.
What if we can routinely and affordably design hospitals that will function effectively during an earthquake and its aftermath? What will be different about these hospitals compared with those we’ve built in seismic zones in the past? Do we have the capabilities right now?
What can stop a hospital functioning?
Most obviously, buildings can collapse in an earthquake, but the most prevalent effects tend to be a sudden influx of patients that coincides with power outage and loss of water supply. Sanitation systems may stop working, causing infection risks to rocket. Surgeons may need to treat patients with life-threatening injuries, often related to crushing.
To tend to the injured, medical teams need space to work, heat to prevent their patients’ core body temperature from falling, and electrical power for equipment that could include air compressors for orthopaedic saws. Medical gases for wards, surgery or triage must have sufficient redundancy in both supply and reticulation to remain operational. If water supply is lost, most hospitals can use gels and foams for sterilisation, but some water is still essential, particularly for fire-fighting. Basic sanitation is absolutely critical.
What if we can cope with all this – and more?s
We can design structures and building services to cope with these issues. We can design UPS systems to bridge the gap between power loss and back-up generator start-up, and establish water reserves. We can achieve sufficient sanitary water attenuation and storage until the sewer mains resume operation or pump trucks can be brought in.
Designs for new hospitals in seismic zones already involve an assessment of the risks to build up the necessary level of resilience. Emergency response planning tends to include identifying space that can be adapted from everyday use to handle a large volume of emergency admissions with complex injuries that could require immediate surgery.
But can we do more than simply dealing with the outcomes of earthquake by trying to prevent the damage that causes these problems in the first place?
Innovation in seismic design
Timber laminate products and rocking wall designs, active dampening, buckling panels, and new seismic joint geometries are amongst the design developments that can mitigate earthquake damage. Computational design techniques enable an enhanced level of geometrical complexity and models to test and verify structural designs quickly and accurately.
We are assessing the performance of flexible buildings that can dissipate energy from an earthquake without impacting weather tightness and infection control barriers, and using lessons learned to develop practical applications whenever and wherever possible.
Our track record for developing projects in seismic zones is strong – our patented seismic system, implemented in Torre Mayor, the tallest building in Mexico, is widely acknowledged as the precursor to the performance-based design method now used worldwide for this type of project.
But we never stand still. We are always striving to learn more. In particular, we are considering how to deal with repeated stresses from minor quakes that can result in the failure of components and systems well before their intended end of life.
Getting the balance right
As we innovate, we are aware of the immediate need for hospitals to serve communities in seismic zones, and we can help city and regional governments to make decisions about the level of resilience their hospitals require.
In the town of Greymouth on New Zealand’s South Island, we are working with architects CCM and Jacobs, to develop a new hospital appropriate to its earthquake risk. This has been done by designing part of the building to the highest risk – classified under New Zealand’s building codes at Importance Level 4 (IL4) – and the remainder to Importance Level 3 (IL3), which has seismic loads 130% of a standard building. The IL4 part of the building will provide sufficient capacity for triage and transfer to the nearest city for treatment in the case of a ‘1-in-500 years’ earthquake.
Getting the balance right between implementing what is currently possible, while remaining open to innovation on what we can do in the future, is a good way to protect communities in seismic zones. We can do that right now.
We still need outpatient rooms in our hospitals at the moment, but they must be designed and built to adapt to alternative uses in the near and medium-term future, probably on more than one occasion.
What if we can make medicine mobile? What if we could send medical equipment, medication, and critical supplies such as blood, directly to the scene of an emergency, instead of transporting the patient?
How can we achieve this? I believe the starting point must be human-centred design based on what works well in our hospitals and what could work better.
What if we can use smart technologies in designing children’s hospitals in the future? How will they compare with our children’s hospitals today?
What if we can design and build operating facilities for the future? How will they compare to the spaces surgeons often work in at present? How can we maximise the benefit of continuous leaps forward in medical sophistication?
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