It wasn't exactly a surprise this spring when the American Society of Civil Engineers (ASCE) once again awarded poor grades to the United States in its Report Card for America's Infrastructure. Although the country's D+ grade was actually an improvement over the D handed out by the ASCE in its last report in 2009, the ASCE still estimated that it would take a whopping $3.6 trillion to get our infrastructure up to an acceptable level by 2020.

While many of the areas studied only may be useful to hospitals when they are assessing emergency-management scenarios, the low grades given to the nation's power grid and water systems are on the minds of many health facilities professionals who are working to stay operational through a variety of situations.

In fact, one conclusion that can be drawn from data generated over the past few years in Health Facilities Management's (HFM's) annual Hospital Construction Survey is that infrastructure improvement projects are getting a great deal of attention even while the number of new-construction projects has been middling.

The surveys, conducted in association with the American Society for Healthcare Engineering and published in HFM's February issues, show hospitals dedicating new resources to replacements and upgrades of critical infrastructure like electrical switchgear and transformers, generators, plumbing, chillers and boilers.

In addition, ongoing investments are being made in electronic infrastructure such as wired and wireless data systems, building controls and automation, alarms and security systems, and electronic health records.

The nation as a whole can learn a lot from the careful planning and smart investments being made by its hospitals as they work to keep patients safe, even when fragile outside systems fail.