Despite implementing several proactive measures to protect facilities from the bitter cold that descended on Boston Feb. 4–5, the extreme weather conditions pushed the hospital’s infrastructure past its limit in many areas, as seen above in the A Building, where teams worked tirelessly over the weekend to mitigate flooding from burst pipes.

Karen Fiumara, PharmD, was rounding through the hospital on Saturday night, Feb. 4, to check on areas affected by the record-breaking cold in Boston that weekend. When she opened the door to an office in the A Building she had visited earlier in the day, she couldn’t believe her eyes.

Just hours prior, the same space was filled with several inches of standing water and littered with debris after ceiling tiles had collapsed under the weight of a water leak. It was one of more than 75 areas across the Brigham where extreme weather conditions caused burst pipes, overhead sprinkler malfunctions, outdoor equipment failures and other damage to facilities.

Fiumara, who served as the first of two incident commanders after the Hospital Incident Command System (HICS) was activated in response to the campus-wide event, encountered a dramatically different scene when she returned that evening.

“It was like a fairy had been there and waved a magic wand,” said Fiumara, vice president of Patient Safety. “What our Engineering, Environmental Services, Environmental Affairs, Police and Security, VPNE, Infection Control and many other teams accomplished that night — I don’t even understand how they did it. The work they did in such a short time to identify and minimize the damage that had occurred was simply unbelievable.”

Sarah Tsay, MPH, director of Emergency Preparedness, was left with a similar impression after witnessing how staff responded to the challenging series of weather-related events.

From left: Claudia Molina, Digna Candelario and Maria Gonzalez Baez (foreground) and Jean Honorat (background) of Environmental Services, pictured above in OR 16, were among the staff who responded to more than 75 areas affected by last weekend’s record-breaking cold.

“It was nothing short of Herculean,” she said. “Looking back at this event, I’m just overwhelmed by how extraordinarily professional, thoughtful and dedicated all of these groups were to maintaining patient safety.”

A deep freeze and strong winds descended on New England starting late on Friday and into Saturday, with Boston temperatures reaching a low of minus 10 degrees and frigid winds making it feel like minus 37 degrees at one point on Saturday.

In anticipation of the strain the weather would place on facilities, the Brigham’s Engineering team proactively took several measures to minimize the impact. Even so, the extreme conditions of that weekend pushed infrastructure past its limit in many areas, and multiple teams worked nonstop on Saturday and Sunday to mitigate multiple, simultaneous issues as they arose.

“One of the most challenging types of events to manage in an emergency response is one like this that’s dynamic and rapidly unfolding,” said Scott Goldberg, MD, MPH, medical director of Emergency Preparedness and director of Emergency Medical Services for the Department of Emergency Medicine. “The team was trying to keep track of all that was happening and respond to new events at the same time.”

Despite the challenges, the hospital remained fully operational throughout the weekend with minimal impact to patient care on the main campus — a reflection of the teamwork and dedication of everyone involved, said Loay Kitmitto, director of Environmental Services.

“It is in our DNA to rise up and respond in these situations,” said Kitmitto, whose team worked tirelessly to remove water and debris, as well as clean and sanitize affected areas. “It makes me smile knowing how committed we all are to providing the very best care to our patients, no matter the circumstances.”

As a result of the many teams’ collaborative, swift and skillful response, the hospital did not need to cancel or reschedule any surgeries or procedures, nor were any patients discharged due to the event.

Sean Gouvin, who recently joined the Brigham as director of Engineering, said it was humbling and affirming to be part of such an extraordinary effort.

“As a new person to the organization, it was pretty remarkable to see how all the teams came together,” he said. “Minimizing disruptions to patient care was our No. 1 priority. Considering what we were facing, to have the successful outcome we did — I was really taken aback. Everyone here cares about this place.”

Rapid Response

The first sign of problems became apparent around 5 a.m. on Saturday, when a nurse administrator reported that several areas of the hospital were experiencing significant temperature fluctuations. A few hours later, staff in the Infusion Center in the Hale building reported a foul odor, later discovered to be caused by a malfunctioning air handler on the building’s roof that had failed due to the cold. Staff quickly mobilized to transport patients to Braunwald Tower 3D so they could continue receiving infusion treatments.

While that response was underway, reports started rolling in of sprinklers releasing water in the Emergency Department and first floor of Shapiro Cardiovascular Center due to burst pipes. From there, the pace and volume of incidents increased rapidly, and teams in Incident Command and throughout the hospital worked tirelessly to triage the events.

“We didn’t know where the next thing was going to happen,” Fiumara recalled. “We were responding and planning in parallel, and that was difficult, but I had the good fortune to be working with so many smart and capable colleagues, including Rob Munroe of Emergency Preparedness. He is the most articulate, unflappable, organized, clear thinker you would want by your side as incident commander.”

As new leaks and failures were discovered, Engineering teams contained and repaired the damage with exceptional speed, skill and precision, Gouvin said.

“Our mechanical, electrical and plumbing infrastructure is one of the heartbeats of this organization. To know that our Engineering crews were able to keep our critical, life safety infrastructure running when these systems were severely compromised is a testament to the experience these folks have in understanding the complexity of these systems,” he said.

Kevin Slattery, director of Police, Security and Commuter Services, reflected on the teamwork and dedication his staff demonstrated, with the weekend’s response co-led by Larry Nialetz, deputy chief of Field Services and Exterior Operations, and Peter Kelly Jr., deputy chief of Distributed Campuses, Communication and Training.

“So many members of our department stepped up and went above and beyond to support each other and the hospital in these emergency situations. Many officers, supervisors and managers came in from home to help. They worked extra shifts to ensure we had sufficient staffing to get through this crisis,” Slattery said. “We received assistance from our colleagues in Valet, who also went above and beyond — taking on additional responsibilities to help us manage the situation.”

Before Police and Security supervisors arrived on scene on Saturday night, Lead Officer Sal Pontes managed the team’s response. Amid unpredictable and potentially disastrous circumstances, Pontes demonstrated exemplary professionalism and composure, Nialetz said.

“Upon our arrival, Officer Pontes was able to accurately brief us on the current status of the floods, and he was able to position other officers in strategic locations where pipe bursts were continuing to happen, as well as respond to the various scenes throughout the hospital, guiding our Engineering Department to the locations,” Nialetz said.

The sub-zero cold snap also created challenges across the distributed campus. Brigham and Women’s Harbor Medical Associates clinics in South Weymouth had to close on Monday, Feb. 6, so that Environmental Affairs and operations teams could assess and address the resulting water damage and other potential safety issues.

“The Harbor operations leadership team, led by Regional Director of Operations Kris McCue, jumped in on Sunday to contact and reschedule nearly 600 patients for Monday to a different Harbor location,” said Cindy Peterson, MBA, vice president of Regional Ambulatory Operations and Business Development.

‘This Is What We Train For’

In her seven years at the Brigham, Labina Shrestha, MM, T-CHEST, operations manager of Environmental Services, has never seen this severity of flooding at the hospital but always knew her team would be ready to respond to an event like this.

Douglas Lafata-Hernandez, lead environmental service aide, removes water from the 75 Francis St. lobby.

“This is what we train for,” said Shrestha. “We came together to support one another, with the goal of making sure the spaces were safe and clean for our patients and staff. Our team members were self-motivated, and they empowered one another to do their very best. It was wonderful to see how much pride they all took in their work, no matter the task.”

Robert Seeley, MS, CSP, Environmental Health and Safety manager, and Jon Boyer, ScD, CIH, director of Environmental Affairs, assessed affected areas to identify potential hazards in the environment and advised on the steps needed to make areas safe again.

“The scale of this event was larger than almost any facilities event I’ve seen here at the Brigham, but in a way, our role was not so different from what we do every day,” Boyer said. “We come when people call us to provide collaborative, competent services around risk management, health and safety. Rob was the first on the scene for our team and did a great job providing detailed, measured information at points when our critical knowledge and skills were necessary.”

The timing of the weather event — a weekend — also created challenges. Although facilities teams brought on additional staff in anticipation of possible issues, it quickly became clear that more operational support was needed as the situation became more complex. Colleagues from across the Mass General Brigham system heeded the call for help, along with staff from CBRE, a commercial real estate vendor.

“We were able to call on our colleagues at the system level, including project managers to help keep track of incidents and additional engineers to relieve staff who had been working nonstop and needed to rest,” Goldberg said.

And while repairs are still ongoing, the extraordinary weekend response made all the difference as more employees, patients and visitors returned to the main campus on Monday.

“For me, one of the most rewarding parts of this entire event was showing up on Monday morning,” Goldberg said. “Besides a whole bunch of dryers, it felt like business as usual.”