Medical Gas System Failure Plan

Kaiser Foundation Hospital Manteca/Modesto

Stockton Medical Offices

MEDICAL GAS SYSTEM FAILURE PLAN

LOSS OF MEDICAL GAS

GENERAL INFORMATION:

In the event of any failure or disruption of a piped medical gas system, Engineering will direct repair/replacement activitiesto resume normaloperations with sustained reliability in a timely manner.

PREVENTATIVE MAINTENANCE:

• Testing and maintenance is conducted by the approved vendor on an annual basis to ensure the piped medical gas systems and alarms are functional.

FAILURE PROTOCOL:

• In response to a leak, rupture, or other failure of a piped medical gas system, Engineering will inspect functionality of the system, controls, distribution system, valves, and (as needed) the end user equipment.
• Engineering will expedite needed repairs in house or via the approved outside vendor.
• Engineering will complete the Unusual Occurrence Report and inform the Chief Engineer and/or Assistant Chief Engineer.
• Engineering will notify affected departments and the Support Services Assistant Administrator of the issue, approximate down time, and whether or not a back-up system is in place.
• Engineering will notify key personnel of any failure or disruption of the facility’s piped medical gas system by initiating a Code Green: Utility Failure through an overhead page and the mass notification system.
• Engineering will provide regular updates to key personnel as to the cause of interruption and expected time the facility’s piped medical gas system will be restored.
• If the facility’s piped medical gas system cannot be restored in a reasonable time frame, the Incident Command Center will be activated, as deemed appropriate by the Support Services Assistant Administrator, facility Administration, and (for the hospitals) the House Supervisor. The mission of the Incident Command Center is to safely manage the operations of the facility during a piped medical gas system failure and minimize time to restore service.

Recovery:

Considerations of the most efficient and timely recovery to normal operations will begin early in the emergency response, guided by the nature of the incident and existing Business Recovery Plans. As the incident evolves, the Business Continuity Branch in the Incident Command System structure will be activated to provide appropriate attention to recovery activities. Affected departments will activate department specific Business Continuity Plans.

Incident Response Plan: Medical Gas Failure