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Electrical Systems for Hospitals: Designing for Reliability, Safety, and the Future

By Kelsey Rowe, PE, CLD

September 26, 2025
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Designing electrical systems for hospitals is not the same as designing for an office, school, or commercial space.

In those buildings, an outage might be an inconvenience. In a hospital, it can be the difference between life and death. That reality drives every design decision, code requirement, and redundancy strategy.

Why Hospitals Are Different

In healthcare facilities, reliability and redundancy are non-negotiable. Power systems are designed not just to meet demand, but to protect lives. Codes and standards reflect this reality, setting higher expectations than almost any other building type.
Exterior view of the DeKalb Health Outpatient Hospital at dusk.
Exterior view of the DeKalb Health Outpatient Hospital at dusk.

Governing Codes and Standards

Hospital power systems are guided by some of the most rigorous standards in the industry:

  • NEC Article 517: Defines performance requirements for healthcare electrical systems.
  • NFPA 99: Establishes wiring methods and reliability expectations specific to healthcare.
  • NFPA 101 (Life Safety Code): Provides additional layers of protection for patients and staff.

These codes work together to ensure resiliency, safety, and continuity of care—even in the face of failures or emergencies.

The Essential Electrical System (EES)

Hospitals operate under an Essential Electrical System (EES), a structured approach to separating and prioritizing loads:

  • Life Safety Branch – Emergency egress lighting, fire alarm systems, smoke evacuation, nurse call, and essential receptacles at patient care locations.
  • Critical Branch – HVAC serving critical spaces, suction pumps, sterilizers, and medical gas systems.
  • Equipment Branch – Larger equipment and building support systems.

This separation ensures that in an emergency, the most vital systems receive power first, while non-critical loads can be shed.

Hospital Power Architecture

Most hospitals are served by dual utility sources whenever possible. Backup power systems supplement utility service, with strict separation of critical versus non-critical loads. This layered approach to redundancy keeps facilities running—even under stress.
Van Wert Health Surgery & Inpatient Expansion patient room
Van Wert Health Surgery & Inpatient Expansion patient room

Emergency & Backup Power Systems

Backup power in hospitals is more than just a generator in the basement. It’s a carefully engineered system that ensures continuous care:

  • Emergency Power Supply Systems (EPSS): Maintain power to sensitive systems with controlled transfer times.
  • Uninterruptible Power Supply (UPS): Protects imaging and surgical equipment from power disturbances.
  • Isolation Power Systems: Required in wet procedure areas to reduce the risk of patient shock.
  • Generators: Sized with redundancy, equipped with fuel storage, and governed by NFPA 110 for run time requirements.
  • Automatic Transfer Switches: Seamlessly move loads between normal and emergency power.

Together, these systems provide layers of resiliency that patients and providers rely on every day.

Physical Installation Requirements

Beyond design, installation details make all the difference:

  • Separation & Fire-Rating: Life safety equipment must be enclosed and separated to protect against failures.
  • Grounding: Properly bonded systems reduce the risk of electric shock.
  • Receptacle Identification: Clear labeling helps staff know instantly which outlets are powered by backup systems.

These details, while sometimes overlooked, are critical for long-term safety and functionality.
Van Wert Health Surgery and Inpatient Center Surgery Expansion Patient Rooms
Van Wert Health Surgery and Inpatient Center Surgery Expansion Patient Rooms

Design Challenges

Healthcare design presents challenges not often seen in other projects:

  • Limited Shutdown Opportunities: Hospitals operate 24/7, making system upgrades complex.
  • High Load Demands: Imaging equipment, surgical systems, and labs push electrical demand far beyond office levels.
  • Selective Coordination: Protection systems must be finely tuned to avoid cascading outages.
  • Space & Routing Constraints: Older facilities often lack the physical space for new electrical gear.

These realities demand creativity, technical precision, and close coordination across disciplines.

Future Trends in Hospital Power

The future of hospital electrical systems is evolving quickly, driven by technology, sustainability, and resiliency demands:

  • Cybersecurity for Power Systems
    Hospitals are increasingly aware that their power systems are connected to networks—and therefore vulnerable to cyberattacks. Protecting generators, switchgear, and building automation systems from digital threats is becoming just as critical as protecting them from physical failures. A cyber breach could disable life safety systems just as easily as a power outage.
  • Renewable Energy & Microgrids
    As healthcare facilities seek to reduce carbon footprints, renewables like solar and wind are being tied into hospital infrastructure. Microgrids allow hospitals to “island” themselves from the utility grid during outages, providing cleaner, more resilient energy sources that reduce dependence on traditional fuel storage.
  • Predictive Maintenance
    Instead of waiting for equipment to fail, hospitals are leveraging AI and sensor technology to monitor equipment health in real time. Predictive maintenance means issues like breaker wear or generator performance drops can be addressed proactively, minimizing downtime and avoiding costly shutdowns.
  • Smart Load Management
    In the event of a power shortage, smart load management systems can automatically prioritize critical medical equipment and life safety systems while temporarily shedding non-essential loads. This creates a dynamic, responsive approach to resiliency, rather than relying solely on static design.
  • Electrification & Decarbonization
    Healthcare campuses are joining the broader push toward decarbonization. This includes electrifying equipment that once relied on fossil fuels, integrating electric vehicle infrastructure, and pursuing net-zero energy goals. The shift requires careful planning to balance sustainability initiatives with the uncompromising need for reliability.
Solar Panel Close Up
Solar Panel Close Up

Closing Thoughts

  • Designing electrical systems for hospitals is about more than meeting code. It’s about protecting people at their most vulnerable moments. Every outlet, switch, and circuit plays a part in patient safety.
  • As technology advances, hospitals will continue to push for power systems that are not just reliable, but also resilient, sustainable, and secure. For engineers, this challenge is both technical and people-first.

Ready to power what matters most? Whether you’re planning an upgrade, expansion, or long-term infrastructure strategy, our team brings decades of healthcare-specific experience designing essential electrical systems that protect patients and keep facilities running. Reach out today to discuss how we can support your facility’s power resiliency goals.

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