At a Glance: What is this About?
- Designing Disaster-Resilient Healthcare Facilities
- Hurricane Helene: Highlighted the need for disaster-resilient healthcare facilities across the Southeast.
- Inland Vulnerability: Even inland areas are vulnerable, proving resilience is needed beyond coastal areas.
- Operational Challenges: Acute care hospitals faced power outages and water damage.
- Case Study: MUSC Children’s Hospital was designed for hurricane and earthquake resilience.
- Structural Resilience: How to use reinforced structures and impact-resistant materials.
When Hurricane Helene devastated North Carolina in 2024, it became clear that designing disaster-resilient healthcare facilities is essential — not just for coastal hospitals but for medical centers across the Southeast. Approximately half of the reported deaths took place far inland North Carolina, with the Buncombe County region, and its largest city Asheville, being severely impacted — proving that disaster-resilient healthcare facilities shouldn’t just be built on the coast.
Flooding in Western North Carolina caused by Hurricane Helene. (Adobe Stock Image).
All 22 acute care hospitals in the affected region faced disruptions, including extended power outages and water damage. HCA Healthcare’s Mission Hospital, the region’s largest hospital and the only trauma center, remained open despite having no running water. It was a nightmare scenario for the brave staff who served hundreds of emergency patients while dealing with supply shortages and sewage backups. Western North Carolina communities are still recovering from the catastrophic flooding that washed away roads, homes and businesses.
Destructive hurricane’s Helene and Milton in 2024, followed by the California wildfires less than three months later in January of 2025, are only some of the latest major natural disasters which have increased dramatically in the US; in the 1980s there was an average of three billion-dollar disasters per year, from 2014 – 2023, the average per year was over 17.
Designing disaster-resilient healthcare facilities means hospitals and other healthcare facilities can stay open during disasters to provide life-saving care. In the face of increasing natural disasters, the resilience of healthcare facilities has become more critical than ever.
What Defines a Disaster-Resilient Healthcare Facility?
The term “disaster-resilient” applied to healthcare facilities, like hospitals, refers to the ability of the facility to withstand and quickly recover from natural disasters and other emergencies. Keeping healthcare facilities operational during crises is a matter of life or death. Resilient design ensures that hospitals can function effectively, protecting both patients and staff.
Case Study: How MUSC Children’s Hospital Was Designed and Engineered for Disaster Resilience
MUSC’s Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion in Charleston, SC, combines advanced design with disaster resilience. Located on the Charleston Peninsula, a coastal city that faces significant threats from hurricanes, flood surges, and seismic activity, the hospital was specifically designed to withstand environmental risks while ensuring the safety and continuous operation of critical healthcare services. “The building is built to handle both a hurricane and an earthquake… at the same time,” said MUSC Senior Program Director, Gopi Omraju.
MUSC Shawn Jenkins Children’s Hospital in Charleston, South Carolina. Designed by McMillan Pazdan Smith in association with Perkins & Will. Also pictured at top. (James Steinkamp Photography).
Structural Resilience: Engineered for Extreme Conditions, How MUSC Used Reinforced Structures and Impact-resistant Materials
Charleston’s vulnerability to hurricanes and storm surges required a hurricane-resistant design capable of withstanding Category 4 storms. The hospital’s structural elements, including reinforced concrete and steel framing, were engineered to resist high wind loads, while impact-resistant windows provide additional protection against debris. The steel beams that make up the building’s structure are sprayed with fireproofing, while the hospital’s facade uses advanced cladding systems to prevent water intrusion, even under severe weather conditions.
One of the key features of the hospital’s resilience is its earthquake-resistant design. Because the hospital is in the Charleston Seismic Zone, the building is equipped with base isolators and reinforced structures. These allow the building to absorb and dissipate seismic energy, reducing the risk of damage during an earthquake. Because the building is constructed to withstand seismic forces greater than the surrounding buildings, patients and staff would be able to stay in the facility, rather than having to evacuate.
Flood Protection: How Strategic Elevation, Waterproofing, and Flood-resistant Materials Safeguard Against Rising Waters
Flood mitigation was a challenge given Charleston’s low-lying geography. Strategically locating the hospital’s operations and patient care at or above the second floor, with an elevated passage connecting reception to the parking deck, protects critical areas and equipment from flooding.
Materials that minimize water damage were used throughout the ground level in accordance with FEMA recommendations. The ground floor is designed with flood proof walls and removable flood panels that can be installed around the perimeter to keep flood waters out. The flood panels extend two feet above the flood level for added protection on this critical access facility.
Disaster-resilient healthcare facilities need efficient stormwater management systems. The hospital’s stormwater management systems were integrated into the design to reduce water buildup on-site. Emergency access routes were also planned to remain operational during extreme weather, ensuring that patients and medical personnel could safely navigate the facility.
Removeable flood panels can be installed around a perimeter to keep flood waters out. (Halkin Mason Photography).
Staying Operational: How Redundant Systems Ensure Uninterrupted Patient Care During Disasters
Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion are equipped with redundant mechanical, electrical, and plumbing systems to maintain full operational capacity during power outages or emergencies. Two backup generators the size of trucks are strategically installed to ensure uninterrupted power to life-saving equipment and critical systems for up to eight days.
The hospital’s helipad is a vital emergency access point designed to accommodate rapid air transport in critical medical situations. Positioned on the rooftop, the helipad is 65 feet in diameter and supports a military-grade aircraft. This ensures the hospital is prepared for a wide range of emergency situations, including disaster relief efforts or mass casualty events.
The reinforced structure meets stringent FAA safety standards. Advanced lighting and guidance systems allow for safe and efficient landings in various weather conditions. This critical feature enables rapid patient transport directly to the hospital’s trauma and emergency care units.
Sustainability Meets Resilience: How MUSC Met LEED Certification, Energy Savings, and Water Conservation
In addition to being disaster-resilient, the MUSC Children’s Hospital was the first built from-the-ground-up hospital in South Carolina to be awarded LEED certification. Due to their intense energy and water usage, it is a challenge for hospitals to meet LEED goals. However, this was a goal aligned with MUSC’s mission to preserve and optimize the lives of all South Carolinians.
Every detail from the types of adhesives and sealants used, to the glare-reducing glass and sound-absorbing finishes were all considered in the project achieving LEED Silver.
Energy efficiency is another important aspect of the hospital’s design. The facility uses energy-efficient systems, such as advanced HVAC and LED lighting, to reduce energy consumption and enhance resilience. Sustainable materials are also used throughout the construction, contributing to the hospital’s overall durability and environmental sustainability.
- The building has an energy cost savings of 8.5%.
- Water is conserved using a combination of low-flow systems and recycled water or closed-loop cooling systems. The building reduces domestic water by 37% and industrial water by 54%.
- More than 50% of the building’s materials are sustainably sourced.
- Landscaping around the building and in its open spaces uses native plants adapted to the local environment.
MUSC Shawn Jenkins Children’s Hospital balcony overlooking the Charleston harbor. (Halkin Mason Photography).
A Holistic Approach to Disaster-Resilient Healthcare Design: Collaboration between Architects and Engineers
Resilience is most effective in healthcare design when taking a holistic approach. This involves integrating various systems and design interventions while engaging all stakeholders and expert consultants early in the planning and design process. In addition to earning LEED certification, this hospital’s design adheres to rigorous FEMA standards. More than 30 stakeholders, including architects and designers from McMillan Pazdan Smith and Perkins+Will, contractors, MUSC project managers, and on-site managers made sure the project met its resiliency goals and stayed on track. The design team also brought in a wide array of disaster resilience consultants to ensure the hospital is always prepared to serve the community, even in the face of extreme local emergencies or natural disasters.
Resilient design is essential for healthcare facilities to ensure continuous patient care during crises. The MUSC Shawn Jenkins Children’s Hospital and Pearl Tourville Women’s Pavilion serve as an exemplary case study, showcasing an innovative and effective disaster resilient design. With expert teams and a holistic approach, healthcare facilities can strengthen resilience and sustainability to better serve their communities.
