Keeping the Lights On

Innovative Strategies for Healthcare Utility Systems

By Kristi A. Vilminot

Hospitals operate in a high-stakes environment where uninterrupted care is not just expected—it’s essential. Yet, the challenges of maintaining 24/7 operations during construction, meeting ambitious sustainability goals, and navigating staff and budget constraints can strain even the most resilient systems. Healthcare facilities are turning to phased construction methods, scalable infrastructure design, and holistic planning approaches to meet these challenges. These strategies ensure critical systems remain functional during upgrades, align with future sustainability mandates, and optimize resources to deliver efficient, patient-centered care in the face of evolving demands.

Maintaining 24/7 operations during construction

Seamlessly maintaining care during infrastructure upgrades is a significant feat. Hospitals must prioritize uninterrupted functionality, where even brief disruptions can have life-threatening consequences. Here, phased construction emerges as a key strategy, ensuring upgrades are executed in manageable steps without compromising care. Facilities can minimize disruptions by coordinating activities with hospital staff and scheduling work during off-peak hours or in less critical areas. This meticulous planning protects patient safety and allows construction to proceed without undermining essential systems. As these careful steps keep day-to-day operations steady, hospitals also set the stage for long-term resilience—a necessity as they tackle sustainability goals.

Long-term power and sustainability goals

In addition to maintaining daily operations, hospitals face mounting regulatory pressure to embrace renewable energy, carbon capture, and battery backup systems by 2030–2035. Meeting these ambitious goals requires a forward-thinking mindset, where systems are designed for current needs and future scalability. Hospitals address this challenge through integrated planning of power, mechanical, and structural systems. For instance, power systems, such as solar panels and energy storage batteries, now accommodate future expansions. This approach reduces the likelihood of costly retrofits and ensures compliance with evolving regulations. Ultimately, investing in these systems helps hospitals lower long-term costs and champion sustainable practices within the healthcare industry. However, this focus on sustainable infrastructure must be balanced with many hospitals’ financial and staffing constraints.

Addressing staff and budget constraints

Upgrading utility systems can seem daunting for hospitals with tight budgets and staff shortages. Financial and resource challenges often delay necessary improvements, but innovative strategies enable healthcare organizations to bridge the gap. Automation and efficient design solutions are transforming operations. Automated maintenance systems allow staff to focus on more complex tasks, while streamlined designs reduce energy waste, stretching limited budgets. Additionally, spreading upgrade costs over several fiscal years will enable hospitals to address critical needs incrementally, maintaining system reliability without overwhelming financial resources. By balancing these constraints with operational demands, healthcare facilities can prioritize essential upgrades and ensure systems are prepared for all contingencies. This is necessary when considering the unique requirements of different hospital environments.

Understanding hospital types and critical environments

A hospital’s specific utility demands vary depending on its type and the criticality of its environment. Designing systems tailored to these unique requirements ensures reliability and patient safety across all levels of care.

• Level 1 trauma centers require the highest redundancy to support critical emergency operations.
• General hospitals need reliable systems to ensure essential services with minimal disruption.
• Specialized facilities like outpatient centers depend on uninterrupted power for sensitive tasks such as surgeries or specimen preservation.

Tailoring designs to meet these diverse needs helps healthcare facilities deliver consistent care regardless of external challenges. Yet reliability depends on more than system design—it also hinges on redundancy strategies.

Calculating N+1 redundancy needs

Redundancy is a cornerstone of healthcare utility systems, ensuring operations remain unaffected by failures. The widely adopted N+1 configuration exemplifies this principle, providing an additional backup component to maintain system functionality. For example, a hospital needing 50 megawatts of power might install a third unit to safeguard against disruptions during maintenance or malfunctions. While redundancy enhances reliability, it also comes with challenges, including higher costs and spatial demands. Hospitals must balance these factors to ensure critical systems operate seamlessly without overextending resources. By implementing tailored redundancy strategies, hospitals protect against unexpected failures and reinforce the resilience needed for future growth.

Future-proofing healthcare utility systems

A forward-thinking approach becomes essential as hospitals navigate the dual pressures of operational demands and regulatory compliance. Phased construction ensures uninterrupted operations during upgrades while scalable, sustainable infrastructure positions facilities to meet long-term goals. Coupled with tailored designs for specific hospital needs and strategic redundancy planning, these measures empower healthcare facilities to remain adaptable in a rapidly changing landscape. Ultimately, these strategies’ success lies in keeping the lights on literally and figuratively. By embracing innovative, holistic planning, hospitals can ensure they provide exceptional, uninterrupted care no matter what challenges lie ahead.

Kristi A. Vilminot, P.E., is Director of Engineering – Power Generation & Energy with Commonwealth Associates, Inc., and can be reached at Kristi.Vilminot@cai-engr.com.