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Purpose <p>Hospitals play a pivotal role in disaster response; however, operational continuity is frequently compromised by earthquake damage to non-structural components. While structural retrofitting is well studied, systematic management strategies for the diverse array of medical equipment remain under-researched. This study addresses this gap by developing a classification and decision-making workflow for seismic retrofitting modes, integrated with the Plan–Do–Check–Act (PDCA) cycle, to provide a low-cost, replicable approach to enhancing hospital resilience.</p> Methods <p>The study was conducted at Mennonite Christian Hospital in Hualien, Taiwan, a high-seismicity region. A design protection target of 0.68&#xa0;g (peak ground acceleration, PGA) was adopted to exceed regulatory requirements. A decision logic tree was used to classify equipment by weight, installation location, and aspect ratio (H/B). Four retrofitting modes were defined: Structural Strengthening (Mode 1), Displacement-Limiting (Mode 2), Overturning-Prevention (Mode 3), and Simple Fixation (Mode 4).</p> Results <p>The inventory identified 51 high-risk items among critical life-support and high-value equipment, all of which underwent retrofitting. Effectiveness was evaluated by comparing equipment damage from the 2018 Hualien Earthquake (<i>M</i><sub><i>L</i></sub> <i>6.2</i>) and the 2024 Hualien Earthquake (<i>M</i><sub><i>L</i></sub> <i>7.2</i>). Despite the 2024 event reaching shaking levels comparable to the 0.68&#xa0;g design target, equipment losses decreased from approximately USD150,000 (2018) to USD 16,000 (2024).</p> Conclusions <p>An incremental seismic rehabilitation strategy guided by a standardized decision workflow can substantially reduce non-structural seismic risk. By improving resource allocation and preventing failures of critical systems (e.g., RO water and X-ray units), the proposed approach supports a shift from equipment-level protection to broader organizational resilience, providing a practical reference for hospitals in seismic regions.</p>

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Development of a classification and decision-making workflow for seismic retrofitting modes of hospital medical equipment: the case of Taiwan

  • 期刊论文

  • 发表日期：

    2026年3月13日

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  • Shi-Yi Wu,
  • Shih-Hung Chang,
  • Mei-Fen Chen,
  • Kang-Ping Lin

摘要

Purpose

Hospitals play a pivotal role in disaster response; however, operational continuity is frequently compromised by earthquake damage to non-structural components. While structural retrofitting is well studied, systematic management strategies for the diverse array of medical equipment remain under-researched. This study addresses this gap by developing a classification and decision-making workflow for seismic retrofitting modes, integrated with the Plan–Do–Check–Act (PDCA) cycle, to provide a low-cost, replicable approach to enhancing hospital resilience.

Methods

The study was conducted at Mennonite Christian Hospital in Hualien, Taiwan, a high-seismicity region. A design protection target of 0.68 g (peak ground acceleration, PGA) was adopted to exceed regulatory requirements. A decision logic tree was used to classify equipment by weight, installation location, and aspect ratio (H/B). Four retrofitting modes were defined: Structural Strengthening (Mode 1), Displacement-Limiting (Mode 2), Overturning-Prevention (Mode 3), and Simple Fixation (Mode 4).

Results

The inventory identified 51 high-risk items among critical life-support and high-value equipment, all of which underwent retrofitting. Effectiveness was evaluated by comparing equipment damage from the 2018 Hualien Earthquake (ML 6.2) and the 2024 Hualien Earthquake (ML 7.2). Despite the 2024 event reaching shaking levels comparable to the 0.68 g design target, equipment losses decreased from approximately USD150,000 (2018) to USD 16,000 (2024).

Conclusions

An incremental seismic rehabilitation strategy guided by a standardized decision workflow can substantially reduce non-structural seismic risk. By improving resource allocation and preventing failures of critical systems (e.g., RO water and X-ray units), the proposed approach supports a shift from equipment-level protection to broader organizational resilience, providing a practical reference for hospitals in seismic regions.