Providence Kodiak Island Medical Center is located on Kodiak Island, a large island on the southern coast of Alaska. It is a critical access hospital accredited by the Joint Commission. This accreditation and certification are recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. It is also designed as a Level IV trauma center by the State of Alaska Department of Health and Social Services, meaning they can provide initial evaluation, assessment, stabilization, and transfer of critical patients to higher level trauma centers.
On the morning of January 29, 2024, Operating Room staff performed routine pressure checks and noticed a lack of pressure in both OR1 and OR2. Pressure is essential in ORs since it’s essential to infection control measures, surgical procedures, including emergencies could not be performed.
Tyler Steele, Maintenance Supervisor and Codi Allen, Project Manager quickly went to work, performing intense troubleshooting. They discovered two failed fire/smoke dampers, part of the challenge was that these were not included in any of the hospital as-builts, meaning there was no documentation of these dampers. Upon troubleshooting, Tyler was able to identify multiple wiring and calibration issues. He was able to quickly replace one of the dampers which brought OR2 online to be available for emergency surgery as needed.
Closeup of the failed smoke damper. 
Access to the failed damper 
Access panel cutout
To access the second faulty damper, an access door needed to be cut into OR1 by a professional carpenter due to its location. Dale Rahn, Executive Director, Real Estate Operations, was able to locate 2 access doors and a carpenter in Anchorage, a roughly 250-mile flight.
Once supplies and the contractor were on the island, they immediately got to work, cutting out the ceiling for an access door. The OR staff called facilities and let them know that they had an emergency c-section coming in which would require work to be stopped. All vibration operations were halted, tools and parts were removed from the pre-op and post-op area to accommodate patient recovery, and OR1 was vacated for patient privacy.
Once the patient recovered, the team was able to get back to work in the late hours of the night. Tyler stayed behind until the next morning to ensure the fire/smoke damper was replaced and tested. EVS and the OR team were able to perform a terminal clean and open both ORs for patients.
“…once the team was informed of the emergent procedure communication was swift and precise to Tyler Steele to pause work being done in the unit. The information was received, and the team followed the plan appropriately, which allowed for a successful emergent procedure with minimal downtime for contractors and the work being performed… There was continuous and frequent communication between all members of the team to update on the ever-changing situation as issues came up.” Heather Crivello, Supervisor, Surgical Services RN
Despite challenges such as undocumented dampers, flying parts and contractors to the remote island, and work stoppages. Tyler, Cody, and Dale were able to keep at least one OR available on Kodiak Island. The actions of these caregivers ensured emergency surgery patients would not need to be flown to Anchorage to receive care.
“There are a lot of other people that made this emergency project a success, which included local leadership, Infection Prevention, Quality, the OR team. But I really want to thank Codi Allen for his intense troubleshooting efforts while working with our control’s contractor, Tyler Steele for going above and beyond to make sure the OR team got their operating rooms back online to see patients in such a short time, and our leader, Dale Rahn for making resources available to us that we did not have locally.” Victor Weaver, Senior Manager, Facilities.