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7 years after Joplin tornado, Mercy builds hospitals with disaster in mind

Sarah Fentem | St. Louis Public Radio
Mercy Hospital's John Farnen demonstrates the laminated safety glass at Mercy Hospital Jefferson's new wing in Festus, Missouri.

A visitor to the new wing of the Mercy hospital in Festus can likely tell immediately where the old building ends and the new part begins. The atrium still smells of fresh paint, and instead of dark, winding hallways, windows let in natural light.

Builders designed it to be prettier and more user-friendly. But Mercy Hospital Jefferson is safer, too.

Making its new hospitals safer has become a top priority for St. Louis-based based Mercy health system after one of the most destructive tornadoes in recent memory hit St. John’s Hospital in Joplin in 2011.

Six people died in the hospital that day. Since then, Mercy has made it a mission to build safer hospitals, with stronger windows, walls and power sources.

Mercy has hospitals through Missouri, Kansas, Arkansas and Oklahoma, in the middle of Tornado Alley, where these violent storms are most frequent. For Mercy officials, creating modern-day fortresses is essential to keeping the communities they serve safe.

“We plan for if we lose power, if we lose water, we plan for a lot of emergencies, but we never plan to just lose everything,” John Farnen, Mercy’s vice president of facilities said of the Joplin tornado.

But in the Joplin storm, the Mercy hospital did lose everything. Since then, the health company has strengthened its construction methods and disaster plans to include storm-resistant materials and backup generators.

Windows — the very things that make the new Festus hospital wing seem so different than the old — are the feature that make hospitals the most vulnerable. In the 2011, the outer building in Joplin remained intact. In newspaper pictures, it rose out of the flattened rubble, one of the only buildings left standing. But the hospital’s windows shattered, destroying the interior.

“The whole hospital shook and vibrated as we heard glass shattering, light bulbs popping, walls collapsing, people screaming, the ceiling caving in above us, and water pipes breaking, showering water down on everything,” emergency room doctor Kevin Kitka wrote later in a blog post.

“We suffered this in complete darkness, unaware of anyone else’s status, worried, scared. We could feel a tight pressure in our heads as the tornado annihilated the hospital and the surrounding area. The whole process took about 45 seconds, but seemed like eternity.”

Eerie security footage of a St. John’s ER waiting room shows how everything was destroyed. For a few seconds, everything is normal: orderly rows of chairs and a stack of magazines on a table. The lights suddenly go out, and within seconds, the wind blows the chairs out of frame, the lights off the ceiling — until there’s nothing left but a cloud of dust.

Farnen watched the footage of the destroyed hospital on the news, and immediately left for Joplin.

“When we pulled up to the hospital, all the windows were blown out, there were parts of the roof that were blown off, [and] inside the hospital was exposed,” Farnen recalled. “The parking lot was full of cars that were just entwined together, you couldn’t even make out the models of the vehicles.”

Mercy went to work rebuilding the hospital, working with an Iowa company to design special tornado-proof glass that can withstand up to 250 mile-an-hour winds. That glass is now put in new intensive care units and other parts of hospitals that house patients who can’t easily be moved or evacuated.

Windows are the key when it comes to disaster proofing a hospital, says Nathan Gould, a structural engineer at ABS consulting in St. Louis. Missouri requires all patient rooms to have windows, but they make a structure vulnerable to high winds.

Credit Mercy Hospital
The scene outside the St. John's after the Joplin 2011 tornado. The building was one of the only structures in the tornado's path left standing.

“You can’t allow the wind and the rain to get into the structure and basically scour through the structure, because once that happens, you’re going to lose that entire space,” he said.

Most builders don’t design their buildings specifically to withstand extreme storms and floods, just to be easy to evacuate, Gould said. But because many hospital patients can’t leave, hospitals need to withstand the storm.

“What you’re asking is did the structure, and the elements that make up the structure, [did] they perform to a level that the patients can survive the storm,” Gould said. “You’re asking a lot more of a structure than you would in a typical building.”

The windows Mercy designed for Joplin are so strong, Farnen said they are essentially “bulletproof.”

“We tested some of the glass in Joplin with the fire department … they decided they couldn’t get through the glass and they would have to go through the building to get to the patient,” he said.

The new hospital wing in Festus doesn’t house critical patients, so instead it has the next level of windows: laminated safety glass that can withstand winds of more than 100 miles an hour. Those windows withstood the force of the 2011 at the Joplin hospital, said Farnen. It also has windowless areas where patients can move before a tornado hits.

"You're asking a lot more of a structure than you would in a typical building."

The other pressure point during a storm is a hospital’s electricity and fuel source. In Joplin, the electric equipment was vulnerable on the outside of the building. So the new hospital in Jefferson County has its power sources encased in their own attic – what Farnen refers to as “the Penthouse.”

“We put it inside to try to protect it better,” he said. “[In Joplin] we had air-handlers and such that blew off the roof and down onto generators and equipment buildings below.” That destroyed those buildings.

Mercy officials are also worried about stairwells. When elevators don’t work, it’s important to be able to get patients on beds down stairs quickly, safely and easily. In Joplin, the tornado knocked down lights and drywall in staircases, making it difficult for workers to evacuate patients after the storm passed. The new Jefferson County hospital has reinforced stairwells, battery-powered lights and hooks on the wall that can be used to ease patients down with sleds and ropes.

Since it's next to a large creek and just miles from the Mississippi River, the hospital in Jefferson County is more vulnerable to floods than tornados. Contractors built a wall around the hospital, complete with drawbridges that raise up to keep water out. The interior of the building has a membrane inside to protect it from a flood.

State building codes largely do not require a lot of hospital-specific rules to use materials and methods to protect against tornados.

“It’s not a technical issue, it’s a cost-benefit issue,” Gould said. “If a hospital would like to design for tornadic wind load or some type of extreme wind load, it has to go outside the regular building code.”

For example, there’s no law in Missouri that requires hospitals to have tornado-proof glass in their ICUs. Farnen acknowledges Mercy doesn’t retrofit old buildings with the new materials.

Follow Sarah on Twitter: @Petit_Smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.