Archives

Oak Forest Hospital of Cook County

Healthcare is a big issue. From insurance to the quality of care provided by physicians and hospitals alike healthcare has invaded our everyday lives. For most of us experiencing a hospital stay it is probably only going to be a short one. For some, healthcare services can be long-term. Located on 340 acres of spacious grounds in southwest Cook County, the Oak Forest Hospital of Cook County has been providing a wide range of short- and long-term care to its surrounding communities.

Governed by the Cook County Board of Commissioners the hospital provides comprehensive rehabilitation, acute, and long-term healthcare services. In short, the goal of the staff is to enhance the quality of life of their patients by delivering quality care, increasing their independence and releasing them to a life as full and rich as possible. Staffed by more than 1,500 physicians, nurses and highly trained technicians, the hospital is also a clinical site for medical students and clinicians from throughout the United States. Affiliated with the Cook County Bureau of Health Services, Oak Forest Hospital is the only licensed and accredited disease hospital in Illinois.

The history of this remarkable place is as colorful as that of Chicago itself. Designed by architects Holabird & Roche in 1908, Cook County began construction of what was to be known as a "poor farm", a place for the city's indigent to receive shelter and food. By the time the doors opened in 1910 Oak Forest Institutions, as it was then known, housed a daily population of 1,694 residents. With the onset of the Depression, by 1932 the residential population of Oak Forest Institutions had grown to over 4,300. The institution helped support itself through the work of the residents producing farm goods, bakery goods and with an industrial shop on the premises.

With the introduction of Public Aid in 1940, residents began returning to their communities. As the population of Oak Forest dwindled, the grounds were now used for chronically ill patients. Eventually the farm buildings were razed and by 1954 a new recreation and medicine building had opened and the hospital ended its conversion to an infirmary. In 1957 the campus was officially changed to Oak Forest Hosptial and by the end of the 50s they were concentrating solely on chronically ill patients and those with physical disabilities.

Beginning a multimillion dollar renovation project in 1976 all patient rooms have been fully modernized to include central air, color TV and a state-of-the-art patient call system. Oak Forest Hospital is now divided into separate levels of care: Acute Care patients requiring continuous management of a serious illness or disease. These include but are not limited to a medical/surgical unit, Intensive Care Unit, and the Ventilator Care Program; Sub-acute Care patients requiring frequent medical, diagnostic and therapy services with continuous care; Long-term Skilled Nursing Care requiring direct nursing supervision. These patients are not as severely ill as the sub-acute patients but need more than the lowest level of care, the Long-term/Intermediate. This class of patients has a long-term illness or disability that will require only minimal medical supervision.

In addition, Oak Forest also houses a complete Rehabilitation Unit, providing inpatient therapy to residents with physical and cognitive disabilities. Working with many patients recovering from a stroke, the staff provides physical, occupational, speech, recreational, and vocational therapies as well as nursing and psychological services. The staff also provides care to AIDS patients, a brain injury rehab program, and pain management programs. They were also one of the first hospitals in the state to establish a ventilator care program.

Oak Forest Hospital of Cook County supports a full range of outpatient services. These include diagnostic tests, treatment clinics, therapy and social services. They have introduced new programs in oncology. Keeping abreast of current societal concerns, Oak Forest has recognized the increasing incidence of violence in U.S. communities. Taking into consideration the upswing in gun violence, they have instituted a "My Life, My Choices" program, consisting of long-term care patients who speak to teens, relating their experience, the consequences, and encouraging them to turn away from this lifestyle choice. What does it take to run a 1.2 million square foot property consisting of 47 buildings? According to Chief Engineer Tom Kennedy, teamwork. "Maintaining this facility is done through the efforts of the Heating & Operating and Skilled Trades Departments. It is a team effort," relates Tom. Working 24 hours a day, 7 days a week, Tom's department maintains the powerhouse, building equipment, the public water supply and handles problems encountered in the functioning of building systems. Reporting to Terry Sullivan, Associate Administrator of the Physical Plant, Tom accounts every day for all work being done by his department. This is no small accomplishment. Tom, a 24-year veteran of Oak Forest Hospital has plenty of experience in handling day-to-day situations between his department and the rest of the mechanical crews. What makes the departments outstanding in their field is the tremendous job done on the vast amount of systems that are encountered in each of the 47 buildings.

One of the unique features of this facility is the fact that it is considered to be a community water supply. As such they must be in compliance with the Illinois Environmental Protection Agency (IEPA) regulations. One of these requirements is that at least one properly certified water supply operator be employed. Tom is the Certified Water Supply Operator designated in responsible charge. Lead engineer Floyd Weier is also certified.

City of Chicago water flows from the Jardine Water Plant to a pumphouse owned and operated by Oak Forest Hospital at Halsted Street and the Cal-Sag Channel. There, a 5,000 gallon surge tank (air gap) holds water to prevent backflow and fluctuations in water pressure. Monitored by the central automation computer, water level is maintained by a float valve assembly. From here three centrifugal pumps, 1 at 300 gpm, 1 at 700 gpm and 1 at 1,000 gpm move the water through 10 miles of 12" pipe to two reservoirs at the hospital holding a total of 4 million gallons of water. From the reservoirs water is chlorinated to kill bacteria and viruses causing disease or illness, and pumped to an elevated tank holding 250,000 gallons of water for domestic use and fire storage. Water is treated by softening and/or chemicals before being used in the boiler and chilled water systems. Due to cold weather conditions the elevated tank is heated by two heat exchangers at ground level to prevent freezing.

The water distribution system meets state, federal and local code requirements. Upon entering each building the service separates into a high-pressure sprinkler at 65 psi and domestic water service at 45 psi. The fire pumping capacity is rated at 3,500 gpm.

Along with following strict IEPA codes, Oak Forest is also required to follow all rules mandated by the Safe Drinking Water Act. To fully meet these requirements they must enforce three major policies of the Act. 1) They must collect water samples, take them to a certified lab for analysis and send results to the IEPA. Oak Forest tests for Bacti/Coli twice per month from three sample sites and has contracted with the State of Illinois to perform the testing. 2) Lab results, name of the person collecting the samples, dates and locations must be kept on file with the hospital. 3) The public must be informed of any violations found.

In 1979 a $100 million renovation of the hospital took place to fully modernize the facility. This is when a central automation computer was installed in the new powerhouse. The current system, a Honeywell DeltaNet, is due to be upgraded soon. At the present time over 90% of the hospital is covered by nearly 4,000 analog points feeding information directly into the computer. Watched closely by the computer operator , the central automation computer monitors pump function, water temperature, discharge air temperature, fire alarms, and much more. Fans as well as the water system can also be controlled from here. An integrated alarm system will warn of the exact location of potential problems on the campus.

Four Nebraska boilers, 2 rated at 1,750 HP and 2 rated at 1,250 HP are fueled according to hospital demand. Their primary function is to maintain an adequate steam supply for heating the buildings and supplying steam processes in areas such as the laundry room.

Boilers are monitored 24 hours a day, 7 days a week year round by the Lead Engineer, and a Mechanical Assistant. Each boiler is equipped with automatic and manual operating controls as well as safety devices that will shut the boilers off in the event of dangerous conditions such as a high-pressure buildup. All of these devices are checked and calibrated annually as well as dismantling, cleaning and inspecting the boilers. Each boiler is capable of burning natural gas as well as #2 diesel fuel, although the diesel fuel is used as a secondary fuel. An oil tank farm adjacent to the powerhouse consists of three tanks with a holding capacity of 20,000 gallons each. Under a maximum load this would be enough fuel to supply the hospital for about a week. The boilers are kept ready to fire with oil at any given moment and as such each shift checks the oil, valves and piping.

As mentioned earlier the boiler load is most dependent upon the weather and the day of the week. In extremely cold weather with the laundry operating a steam load of 50,000 pounds of steam per hour is common. Weekends and holidays in the same weather can bring the steam load down to about 40,000 pounds per hour. Two boilers on line with one ready on stand-by will supply the load needed. Summer brings about a large decrease in steam load. With the laundry operating about 12,000 pounds will be called for while weekends and holidays only call for 8,000 pounds. In this case they will run only one boiler with one available on stand-by.

From the elevated tank city water goes through a series of treatments before actually reaching the boilers. The first stop is the boiler water softeners. Here calcium and magnesium are removed from the water. Passing through a multi-port valve on the top of the softener tank, the water flows into a bed of softening minerals where the hardness is removed by a process known as ion exchange. At the same time sediment is also filtered from the water. Soft water then leaves the tank and flows into the dealkalizers. Boiler water softeners regenerate approximately every 30,000 gallons. To accomplish this they must follow three steps: 1) reverse the flow of the mineral bed to backflush the equipment. 2) Rinse ordinary salt, or brine, into the tank to fully restore the softening capacity of the water. 3) Repack the mineral bed through flushing. The softener has now been restored and is ready to work again. From the softening tank the water enters a dealkalizer. Here carbonate, bicarbonate and hydroxide alkalinity is removed. The dealkalizers will need to regenerate about every 20,000 to 26,000 gallons.

An underground water storage tank, or hotwell, approximately 50 feet in diameter will hold 125,000 gallons of water consisting of 80% condensate return and 20% makeup water. Two transfer pumps rated at 330 gpm each, located in the sub-basement, move the water from the hotwell through a series of polishers, designed for use with high temperature water, that remove ground water infiltrations accumulated in the hotwell.

Water then enters a condensate receiver in the boiler room. Water is also collected here from the local low pressure steam returns and the deaerator overflow. Oak Forest Hospital has been able to maintain a high level of efficiency by using hot condensate return water that has already been chemically treated to prevent corrosion and scale buildup. The water level in the tank is constantly monitored and regulated by Mercoid level switches which in turn control the on/off function of the pumps to maintain an adequate water level.

A deaerator is used to heat the boiler feedwater with steam and to remove 99% of the oxygen from the water. Sodium sulfite is used to remove the rest. From here, three boiler feedwater pumps, one rated at 125 gpm and 2 rated at 250 gpm, pump the water through an economizer into the boiler. The economizer raises the temperature of the boiler feedwater through the use of boiler exhaust gases, utilizing every means possible to maintain a high level of efficiency in the plant. Presently they have been able to sustain an 85% efficiency level under high load conditions.

Three Trane centrifugal chillers, 1 at 1,500 tons and 1 at 800 tons, operate using R11 refrigerant, considered to be a group one, the safest, refrigerant. Honeywell RP920C Pneumatic temperature controllers regulate chilled water temperature delivered to the hospital. Temperature is maintained at a +/- 2 degrees of setpoint.

A cooling tower manufactured by Baltimore Aircoil Company, (BAC), contains four cells processing a capacity of 10,500 gallons or a maximum load of 4,350 tons. Each cell is powered by a 50 HP motor. Three Bell & Gossett condenser water pumps, 2 at 200 HP and 1 at 100 HP, then circulate the water through the chilled water piping system. This two-pipe system consists of a chilled water supply and chilled water return route, two and three-way valves, pumps and controlling devices. Primary pumps are located in the chiller room and 35 secondary pumps are located throughout the hospital, usually considered to be part of the air handling unit in each individual building. All of these pumps are monitored by the computer operator and maintained by Heating and Operating and Skilled Trades staff. The chilled water makes three passes through the chiller before entering the distribution system and then ultimately returning through the return piping. In the event of a leak there are 13 chilled water vaults located at strategic points to enable the engineer to valve off the problem area for repairs.

Along with maintaining the above equipment the Heating & Operating and Skilled Trades Departments are also responsible for ventilation, heating, and cooling of the hospital. Under the control of the Central Automation Computer, these systems will run according to preset modes. Dampers are regulated to control the correct mixture of outside and return air; mixing valves on the hot water supply are adjusted to maintain a constant water temperature; hot water as well as chilled water circulating pumps are switched on or off to meet the need; and exhaust fans are programmed through here also.

Nowhere else is power more important than a hospital. The loss of power can be devastating. To alleviate this concern Oak Forest Hospital has two independent feeds from Com Ed, one from South Chicago and one from Joliet. In the unlikely event that both lines would be lost eight (8) Cummins emergency generators stand ready to be put in operation. Six at 500 kilowatts each, one at 350 kilowatts, and one at 1,200 kilowatts will cover every important area of the hospital. An automatic transfer-over switch (ATO) starts the engines within about 10 cycles.

Tom Kennedy is a man of many tasks. In addition to taking command of an undaunting task such as the hospital he enjoys golfing and taking care of his grandson Liam in his spare time.

Patient care is no easy task as any healthcare professional will tell you. Taking care of the mechanical operations of a place of this size is also no easy task. The number of regulatory agents that must be answered to is amazing. But Chief Engineer Tom Kennedy, Assistan Chief Engineers Jerry Donnelly and Jack Reidy, and 11 operating engineers along with mechanical assistants in the heating & Operating Department of Oak Forest Hospital make it look just that. Easy.

Archives