Mac’s Safety Space: Advocacy wins a round—microgrids and sustainable energy

By Steve MacArthur, Hospital Safety Consultant

In what is hopefully another in an ever-more-frequently covered topic (that being, the removal of barriers to compliance by those charged with determining compliance), CMS released information ( ) regarding a categorical waiver that paves the way for the use of microgrids for supplying emergency power to Essential Electrical Systems (ESS).

At present, the 2012 edition of NFPA 99 Health Care Facilities Code, requires emergency power to be supplied by a generator or a battery system. The Categorical Waiver is based on allowances contained within the 2021 edition of NFPA 99 and the 2023 edition of NFPA 70 National Electric Code. Certainly, as I’ve traveled around to various facilities, folks are definitely trying to make the most efficient use of solar and other alternative energy sources, so this sets the stage for an expansion of the use of these alternative energy sources, which should help with whatever might come down the pipeline in terms of requirements relating to environmental sustainability.

As has been the case in the past, adoption of the categorical waiver will require the alternative (or is it alternate? Are they synonymous?) energy source supplying emergency power to be in accordance with the 2021 edition of NFPA 99 and the 2023 edition of NFPA 70, so there will be some homework in the form of analysis. Perhaps the good folks at the American Society of Health Care Engineering (ASHE) will endeavor to shed some light on the subject; clearly sustainability has been a considered focus for ASHE, as well as the American Hospital Association – lots of excellent materials to be found:  and

Speaking of which, The Joint Commission is still working through their version of the requirements relating to sustainability: ( ), so you might want to bop on over and see what’s what with that. I would think that the categorical waiver is going to be helpful from a practical standpoint.

As we discussed the importance of advocacy a couple of weeks ago (, I think (hope?!?) that is another example of a collegial way forward for the enforcement of compliance. We cannot do this alone and working together towards a sustainable approach to compliance (energy isn’t the only thing that can be sustainable) can only help increase the focus on what is meaningful and valuable to the patients for whom we care.

And while we’re on the topic of patients, I am currently reading an excellent book called “The People’s Hospital – Hope & Peril in American Medicine” ( that covers the challenges of providing healthcare, particularly to those individuals with less certain access to health insurance, etc.

Having been in healthcare as long as I have, I can recall some of the historical shifts in how hospitals were operated, but was never really familiar with how it all came to be. Dr. Nuila is a great storyteller and I think you’ll find this a worthy addition to the summer reading list. I’m about half-way through the book (my wife read it first and gave it a thumb’s up) and I am fascinated by all the stories (front, back, sides).

It doesn’t always seem like healthcare can work, but I guess it’s just a question of looking in the right places for inspiration.

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at