By Scott Cormier, Contributing Writer

Extreme heat causes more deaths in the United States than hurricanes, tornados and floods combined. Because heat waves are rarely perceived as life-threatening, people are less likely to take the appropriate precautions. Unfortunately, that is the reason there are more than 67,000 emergency department visits due to heat in average every year. 

This summer has already seen record-breaking extreme heat across the Southern U.S. with little relief in sight. Healthcare facilities need to be prepared for an influx of heat-illness-related patients, as they are with hurricanes and floods. But healthcare facility managers face unique workplace challenges when caring for patients and workers during extreme heat. 

Cool the environment 

When temperatures rise, people lower their thermostats. This prolonged strain on power grids can lead to blackouts and brownouts that cause a domino effect of heat issues: More individuals with heat illnesses seek relief from the heat, meaning more patients end up in hospitals for treatment. 

But what if the hospital has lost power? While all hospitals must have backup generators, they typically do not put HVAC on emergency power. Managers need to have a plan for backup HVAC energy. 

Operational guidance needs to address the way managers ensure a facility stays cool, whether through a national contract with organizations to bring in generators across the hospital system or by establishing a microgrid. With recent federal investments in microgrid installations, sustainable backup power might be more accessible to facilities preparing for more extreme heat events. 

Patient care also extends beyond keeping people cool and hydrated. Refrigeration is necessary for storing many drugs and vaccines, so refrigeration should always be on generator power during outages. Yet many drugs that are shelf-stable at room temperature need to be monitored if the ambient temperature begins climbing above 77 degrees to prevent them from degrading or spoiling. 

Managers should pay special attention not only to the drugs’ storage but to their transportation between rooms, wards and buildings to prevent too many extreme temperature fluctuations. Managers can extend this focus to all supplies to ensure sensitive instruments and equipment are not left in humid or hot rooms or in direct sunlight. 

Keep outdoor workers safe 

Not every heat-related emergency is accompanied by rolling blackouts, and crises can occur right on a hospital’s grounds if facilities are not prepared. It is vital for groundskeepers, landscapers and other outdoor workers to know when feeling “a little warm” becomes dangerous to one’s health. 

To provide a safe work environment, managers must know the signs of heat illness and how to factor in different risks that might accelerate the condition. Heat-related illness can occur in temperatures as low as 70 degrees, according to the National Integrated Heat Health Information System. Some of the risks beyond high temperatures, humidity and direct sunlight include: 

• limited air movement 
• moderate to heavy exertion 
• heavy personal protective equipment 
• dehydration 
• medications, including selective serotonin reuptake inhibitors. 
• other sources of heat, such as furnaces, ovens and exhausts. 

One way to prevent overexertion in extreme heat is by implementing a work/rest schedule. This example from a collaboration among multiple federal agencies provides guidelines that organizations can follow to help decrease the risk of heat illness among their employees. 

Supervisors are responsible for preventing heat-related illness in the workplace and must be committed to monitoring daily temperatures and remaining aware of workers' exertion. Employees are also responsible for recognizing the signs that they or their coworkers might need to cool down and be ready to assist or seek help if needed. 

Extreme heat days are becoming more common in much of the United States. Healthcare facilities managers need to understand their regions’ risk levels for extreme heat, ways to manage it and strategies to implement to provide quality care for patients and safe working conditions for employees. 

Scott Cormier is the vice president of emergency management, environment of care and safety at Medxcel, an integrated facilities management organization with a focus on healthcare.