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Electrical equipment requires regular repair or maintenance, yet this critical work is often deferred in hospitals because it is difficult to gain approval to turn off the power. With NFPA 70E-2012: Standard for Electrical Safety in the Workplace becoming more stringent and the increasing recognition that electrical system maintenance is an emergency management issue, hospitals are facing the inevitability of more electrical power shutdowns. This ASHE Monograph examines a comprehensive approach to managing power shutdowns in light of the growing complexity of hospital infrastructure and operational constraints. All hospitals will need to turn off their electrical power systems for modification and maintenance at some point. The comprehensive and proactive utility management program (UMP) approach described in this monograph allows a hospital to use lessons learned from actual shutdowns to improve its electrical infrastructure, power system reliability, and staff training regarding what to do when power is lost.