The federal government names 16 sectors as being so vital to the United States that the inability of one of these sectors to function well or at all would “have a debilitating effect on security, national economic security, national public health or safety, or any combination thereof.”

With its mission to not only “do no harm,” but also to help heal society, it’s easy to conclude why the health care and public health sector falls on this exclusive lineup. From helping patients manage annual checkups and chronic diseases to serving as a bulwark and haven during natural disasters and mass casualty events, the health care system must remain healthy itself in order to serve communities.

This is where resiliency of the physical environment comes in. But as hospitals increase investments to shore up facilities, external threats to that infrastructure increase in parallel.

In fact, news reports poured in over the holiday season of gunfire attacks on two power substations in Moore County, N.C., causing extensive damage and leaving tens of thousands without power.

As word of the Moore County attacks broke, news organizations released a memo from federal law enforcement officials revealing that substations in Washington and Oregon were also previously attacked. The memo states attacks were made using “hand tools, arson, firearms and metal chains possibly in response to an online call for attacks on critical infrastructure.”

The Moore County incident left tens of thousands of its customers without power for days, and even forced local clinics, urgent care centers and primary care offices to shut down temporarily. Moore Regional Hospital, however, remained open and ready to serve a surge of patients (including those who simply needed a place to charge medical devices after losing power at home) thanks to its emergency power supply system (EPSS).

Emergency power is a hospital’s life-saving measure when the local electrical grid fails. Ensuring the EPSS kicks in within seconds to keep lights on and medical equipment functioning, protects patients’ lives and the hospital itself from potential legal woes. It’s also a matter of regulatory compliance, leaving zero room to fail.

Unfortunately, however, the recent flurry of attacks to local electrical grids is just one of the many threats impacting local utilities of which hospitals should be aware.

For instance, U.S. natural disasters have increased in both strength and frequency in recent years, with floods and severe storms increasing the most when compared to other weather disasters. Even milder or warmer climates such as California and Texas have recently faced powerful winter storms triggering outages.

Coupled with these external factors are a host of internal ones that more directly compromise a hospital’s EPSS. With the number of components that it takes for an EPSS to function — e.g., automatic transfer switches, circuit breakers, fuel storage, etc., — the failure of one component can jeopardize an entire system.

Before waiting for an event — whether natural or man-made — to test the health of an EPSS, it’s vital that health care facilities invest in a process to ensure their system remains reliable at all times.

The Motor and Generator Institute (MGI) recommends hospitals conduct a six-step All Hazards Risk and Compliance Assessment to eliminate any single points of failure, and strongly advises hospitals work with an experienced technician during the assessment.

Keeping hospitals up and running in the face of external and internal threats is a lofty task, but one that the literal health of a nation depends upon. Conducting a risk assessment to ensure a hospital’s EPSS is functioning correctly positions it to serve its community despite local outages.