Canadian Healthcare Facilities by MediaEdge

Canadian

HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY

Volume 38 Issue 4

Fall/Automne 2018

A GREEN OUTLOOK

Markham Stouffville Hospital views sustainability as facility-wide responsibility, one that staff has embraced

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CONTENTS

CANADIAN HEALTHCARE FACILITIES Volume 38

Issue 4

Clare Tattersall claret@mediaedge.ca EDITOR/RÉDACTRICE

PUBLISHER/ÉDITEUR Kelly Nicholls kellyn@mediaedge.ca PRESIDENT/PRÉSIDENT

Kevin Brown kevinb@mediaedge.ca

SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR

Annette Carlucci annettec@mediaedge.ca

PRODUCTION MANAGER/ DIRECTEUR DE PRODUCTION

Rachel Selbie rachels@mediaedge.ca

CIRCULATION MANAGER/ Anthony Campbell DIRECTEUR DE LA circulation@mediaedge.ca DIFFUSION

DEPARTMENTS

SUSTAINABLE HEALTHCARE

6 8

22 Northern Comfort Building operator certification training course improves technical skills of First Nations facilities personnel

Editor’s Note President’s Message

10 Chapter Reports

24 A Stellar Performance New Brunswick hospital recognized by esteemed NRCan program

CHES AWARDS 14 A Dose of Green Markham Stouffville Hospital takes many measures to achieve environmental sustainability, garnering it positive reception from CHES 16 Full of Energy Ralph Mayfield’s storied career fuelled by passion in environmental conservation 18 Three’s a Charm Ontario chapter’s streak continues with President’s Award win

CANADIAN HEALTHCARE FACILITIES IS PUBLISHED BY UNDER THE PATRONAGE OF THE CANADIAN HEALTHCARE ENGINEERING SOCIETY. SCISS JOURNAL TRIMESTRIEL PUBLIE PAR SOUS LE PATRONAGE DE LA SOCIETE CANADIENNE D'INGENIERIE DES SERVICES DE SANTE.

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

PRESIDENT VICE-PRESIDENT PAST PRESIDENT TREASURER

MAINTENANCE & OPERATIONS 26 Boiler for Hire Temporary, portable rental equipment benefits hospital’s bottom line, minimizes downtime 28 A Lesson in Value Une leçon de valeur

SECRETARY EXECUTIVE DIRECTOR

Preston Kostura Roger Holliss Mitch Weimer Craig B. Doerksen Kate Butler Donna Dennison

CHAPTER CHAIRS

Newfoundland & Labrador: Colin Marsh Maritime: Helen Comeau Ontario: Jim McArthur Quebec: Mohamed Merheb Manitoba: Tom Still Saskatchewan: Jim Allen Alberta: Peter Jarvis British Columbia: Steve McEwan FOUNDING MEMBERS

PATIENT PERSPECTIVE

H. Callan, G.S. Corbeil, J. Cyr, S.T. Morawski CHES

30 A Touch Away Runnymede Healthcare Centre leverages technology to transform patient experience

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Ontario region. Labour Canada has fully “acknowledged” scopefully of Labour Canadathehas work provided inthethescope semi“acknowledged” of annual inspection program. work provided in the semiIn addition, the program. written annual inspection documentation contributes In addition, the written greatly to thecontributes hospital documentation accreditation greatly to programs. the hospital accreditation programs. Further we are always pooling the knowledge resources Further we are always poolingof Infection Control and Engineering the knowledge resources of Groups like CHES, the ventilation Infection Control and Engineering inspection is in a constant Groups likeprogram CHES, the ventilation evolution meet future needs for inspectiontoprogram is healthcare in a constant patients evolutionand to staff. meet future healthcare needs for patients and staff.

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EDITOR'S NOTE

ONCE UPON A STORY ONE OF MY favourite things about being a journalist is ‘meeting’ new people. Though most introductions and subsequent discussions are made via e-mail and phone these days — thanks to technology, which allows us to connect with anyone, anytime, anywhere in the world — I still enjoy hearing about people’s work in healthcare, why they chose the sector, their passion for the industry, as well as their contributions to improving the quality of care to patients. Perhaps that’s why I am so fond of this issue, as it’s filled with stories that hit on all these points. For instance, Full of Energy regales readers with insight into Ralph Mayfield’s storied 35-year career in Canadian healthcare. The recipient of this year’s Hans Burgers award, Mayfield called the state of Georgia home before venturing north to New Brunswick, where he started a greenhouse business. During this time, his passion for the environment matured; however, it wasn’t until he segued into healthcare in the ‘80s that it truly blossomed. You can read all about Mayfield’s long-time contribution to the industry beginning on pg. 16. As another example, CHES National treasurer Craig Doerksen discusses his pursuit of the Canadian Certified Healthcare Facility Manager (CCHFM) designation in A Lesson in Value. Not only does Doerksen walk readers through the process of obtaining the certification, which he received in 2015, but he opens up about how it has helped him in his current role as divisional director of facility management for Health Sciences Centre (HSC) Winnipeg, along with achieving personal growth. While there are many more instances I could cite, I’ll let you peruse the pages to come and discover all the delightful nuggets of information that I’ve been privy to. If you are interested in sharing your own story or that of your organization, please contact me. I’d love to hear from you!

Clare Tattersall claret@mediaedge.ca

Reproduction or adoption of articles appearing in Canadian Healthcare Facilities is authorized subject to acknowledgement of the source. Opinions expressed in articles are those of the authors and are not necessarily those of the Canadian Healthcare Engineering Society. For information or permission to quote, reprint or translate articles contained in this publication, please write or contact the editor. Canadian Healthcare Facilities Magazine Rate Extra Copies (members only) 25 per issue Canadian Healthcare Facilities (non members) 30 per issue Canadian Healthcare Facilities (non members) 80 for 4 issues A subscription to Canadian Healthcare Facilities is included in yearly CHES membership fees.

6 CANADIAN HEALTHCARE FACILITIES

La reproduction ou l’adaptation d’articles parus dans le Journal trimestriel de la Société canadienne d’ingénierie des services de santé est autorisée à la condition que la source soit indiquée. Les opinions exprimées dans les articles sont celles des auteurs, qui ne sont pas nécessairement celles de la Société canadienne d’ingénierie des services de santé. Pour information ou permission de citer, réimprimer ou traduire des articles contenus dans la présente publication, veuillez vous adresser à la rédactrice. Prix d’achat du Journal trimestriel Exemplaires additionnels (membres seulement) 25 par numéro Journal trimestriel (non-membres) 30 par numéro Journal trimestriel (non-membres) 80 pour quatre numéros L’abonnement au Journal trimestriel est inclus dans la cotisation annuelle de la SCISS.

PRESIDENT'S MESSAGE

WORDS OF APPRECIATION THIS YEAR, as many prior, I had the privilege to attend multiple events and provincial conferences, culminating with the 2018 CHES National Conference in St. John’s, Nfld. I’d like to congratulate Colin Marsh and the planning committee on a job well done. The province has the most beautiful scenery and its population a heart of gold. Without a doubt, Newfoundland and Labrador is a great place to visit if you’ve never had the opportunity to do so. Though the conference is now behind us, CHES continues to offer many educational sessions. I encourage you to visit the website where I’m sure you’ll find an offering that meets your needs. I would like to highlight one of the many committees that works behind the scenes in our organization. The corporate/associate member advisory council was established four years ago, to provide recommendations to the CHES National executive on a variety of issues, including corporate/associate membership programs; improvements in corporate/associate membership awareness; initiatives to retain, sustain and increase the membership base; value-added services; sharing corporate/associate membership knowledge; and marketing opportunities for the corporate/associate membership program. Recently, the council selected a new chair, Christa Brown. Other committee members include Paul Weingartner (vice-chair), Gordon Burrill, Eric De Amorim, Jamie Dudley, Chris Lowe, Luis Rodrigues and Ken Sunderman. Congratulations are in order for this year’s CHES award winners: Markham Stouffville Hospital (Wayne McLellan Award of Excellence in Healthcare Facilities Management), Ralph Mayfield (Hans Burgers Award for Outstanding Contribution to Healthcare) and the Ontario chapter (President’s Award). I’d also like to applaud Ontario chapter chair Jim McArthur and his committee for formulating the submission to host the 2022 International Federation of Hospital Engineering (IFHE) conference in Toronto. A substantial amount of work went into the presentation and CHES is fortunate that its bid was selected. Part of CHES’s hosting duties involves having a member sit on the IFHE executive committee for a six-year term. Steve Rees was chosen through an expression of interest. He will serve as vice-president from 2018-2022, when he will assume the role of president. As I am now in my final year as CHES National president, I look forward to meeting both new and familiar faces at the various educational events and activities that the Society and its local chapters have planned leading up to the 2019 CHES National Conference in Saskatoon.

Preston Kostura President, CHES National

EARN CONTINUING EDUCATION CREDITS FROM CHES Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Fall 2018 issue of Canadian Healthcare Facilities and passing a quiz based on articles in the issue. Once you’ve read the issue from cover to cover, simply go online to www.surveymonkey.com/r/Y6PT77X to take the quiz. CHES members who pass the quiz will be able to claim one contact hour (0.1 CEU) on their CanHCC or CCHFM certificate renewals.

8 CANADIAN HEALTHCARE FACILITIES

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CHAPTER REPORTS

ALBERTA CHAPTER

SASK ATCHEWAN CHAPTER

Fall is well upon us. With the change in seasons came a return to routines. For the Alberta chapter, this meant holding regular executive meetings once again and planning education opportunities for members, including the 2019 Clarence White Conference and Trade Show. I’m looking forward to what we can accomplish this year. I’ve had the fortunate opportunity to help the Saskatchewan chapter plan the 2019 CHES National Conference, as a member of the CHES National conference and education planning committees. I consider myself lucky to work with experts in the field, like J.J. Knott, Gordon Burrill and Peter Whiteman, to name a few. I will use this experience and lessons learned to improve our chapter’s annual conference and trade show. In September, I attended the 2018 CHES National conference in St. John’s, Nfld. This was an especially memorable occasion as I got to return to my roots and take in a taste of ‘home,’ being a Newfoundlander myself. More than 20 Alberta chapter members made the trek east to partake in this year’s conference. I’d like to thank Newfoundland and Labrador chapter chair Colin Marsh and the entire conference planning committee for the phenomenal event. —Peter Jarvis, Alberta chapter chair

The summer was a busy yet exciting time for healthcare facilities personnel across the province. CHES members worked diligently to operate their respective facilities and complete typical summer projects, while participating in the important task of transitioning to a single provincial health authority. The Saskatchewan chapter was also busy preparing for its annual conference and trade show, Oct. 21-23, in addition to planning the 2019 CHES National Conference, to be held in Saskatoon, Sept. 22-24. Working on two conferences simultaneously has been good for the executive team, which has developed a healthy level of enthusiasm and renewed energy. I have little doubt that the end result will be success in both endeavours. I’m sure fall will come and go as fast as summer did. As these next couple months unfold, I anticipate there will be continued opportunities to engage others in CHES and am excited to see where that takes the chapter. —Jim Allen, Saskatchewan chapter chair

MARITIME CHAPTER The chapter is well on its way in planning the fall education day, which will be held Nov. 20, at the Best Western Glengarry in Truro, N.S. All CHES Maritime members as well as non-CHES frontline maintenance workers in healthcare and long-term care are welcome to register for the event. Revenue generated from this year’s spring conference enabled the chapter to cover the travel expenses of the executive committee to the 2018 CHES National Conference in St. John’s, Nfld. It was an excellent learning and networking opportunity, and provided leadership growth to executive team members. The chapter’s spring conference will be held at the Delta hotel in Moncton, N.B., May 5-7. Planning is well underway. The Maritime chapter continues to balance its books while offering several financial incentives to its members in the way of student bursaries, contribution to Canadian Certified Healthcare Facility Manager (CCHFM) exam fees, webinars, fall education sessions and other rebates. —Helen Comeau, Maritime chapter chair

10 CANADIAN HEALTHCARE FACILITIES

BRITISH COLUMBIA CHAPTER It was another incredibly hot, dry and smoke-filled summer in B.C. For the second year in a row, the province broke records for highest temperatures, longest drought and worst fire season, and the government issued another state of emergency. The 2018 B.C. chapter conference in Whistler was a great success and planning is well underway for next year’s event in Penticton, B.C., which, again, will be followed by the Canadian Healthcare Construction Course (CanHCC). The host hotel is the Penticton Lakeside Resort. Call for abstracts are now posted. The conference theme is, ‘Safety First: Our Mandate for Responsible Healthcare,’ which aligns with the industry’s primary objectives. The education committee sponsored two B.C. chapter members to attend the 2018 CHES National Conference in St. John’s, Nfld. We continue to support our many college bursaries and members with education grants. This year, the chapter sponsored the Lieutenant Governor Safety Awards, presented by Technical Safety BC (formerly the BC Safety Authority). The awards recognize individuals and organizations who demonstrate exceptional leadership, achievement or innovation in technical safety in the province. —Steve McEwan, British Columbia chapter chair

CHAPTER REPORTS

NEWFOUNDLAND & LABRADOR CHAPTER The Newfoundland and Labrador chapter is proud to have hosted the 2018 CHES National Conference. The conference not only provides the opportunity to network with peers, meet vendors that we only communicate with via phone, and see the latest and greatest in healthcare infrastructure technology, but it reminds us of the reason we chose to work in this industry — the patients. I was very excited leading up to the conference, especially because it’s been nine years since the chapter organized the national event (though many CHES members still recall it as if it happened yesterday). The planning committee organized a jam-packed educational program filled with extremely knowledgeable speakers from across the country. This year’s facility tour was of Eastern Health’s new Nuclear and Molecular Imaging facility. Designed to LEED (Leadership in Energy and Environmental Design) silver certification, it houses the province’s first positron emission tomography/computerized tomography (PET/CT) scanner, which offers improved assessment, diagnosis and treatment of certain types of cancer, cardiac disease and some neurological disorders. The facility is also equipped with a geothermal heat recovery system, redundant HVAC and electrical systems, and multiple radiation safety systems. This time last year, I wrote that our executive team was full. I am saddened to say that 2018 has presented some challenges for the chapter. We are in the process of recruiting a secretary after a retirement, and recently our vice-chair decided it was time to step aside. As a result, we are looking for nominations again to fill these vacant seats. The local economy has steadied, resulting in a fairly stable chapter membership. Given that we have placed a lot of time and effort into planning this year’s National conference, we have not focused on increasing membership. Now that it’s behind us, the chapter will resume its recruitment push of vendors/suppliers, consultants and others to improve membership enrolment. The Newfoundland and Labrador chapter is sitting in a solid financial position. As a result, the executive team decided to support local members this year by reimbursing hotel costs up to $150 per night for a maximum of two nights during the conference, as well as the cost of any member’s companion to attend the gala banquet. This is in addition to subsidizing the companion program, which is estimated at $1,600. In total, the chapter expects to spend up to $15,000 on this year’s conference. —Colin Marsh, Newfoundland & Labrador chapter chair

2018 CHES National Conference in St. John's, Nfld. Photos courtesy Kent Waddington.

FALL/AUTOMNE 2018 11

CHAPTER REPORTS

MANITOBA CHAPTER Planning is underway for the 2019 Manitoba Education Day. To be held Apr. 23, the theme is, ‘Innovation and Technology.’ Call for abstracts is now open. If you have any questions or concerns, or you would like to volunteer, please contact any member of the executive team. The Manitoba chapter is focused on improving its education day. We are working to include students in our membership and have connected with Red River College. CHES provides a unique opportunity for students who are interested in a career in healthcare facility management and project management. There is a lot of interest and we are exploring possibilities. The chapter sponsored a session at the Manitoba Building Expo. George Harrison of Crosier, Kilgour and Partners Ltd., and Health Sciences Centre Winnipeg’s Gerry Berard gave a presentation on ‘Roofing: Standards and Inspections.’ The cost of attendance to the session, luncheon and trade show was covered by the chapter for all CHES Manitoba members. To encourage members to excel in their field, the chapter will financially support those who wish to take the Canadian Certified Healthcare Facility Manager (CCHFM) self-assessment exam for the first time. The cost of the practice exam is $115. Details are on the Manitoba chapter section of the CHES website. —Tom Still, Manitoba chapter chair

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In early June, the Ontario chapter hosted its spring conference in Collingwood, Ont. The conference was well-attended and included a few members from other chapters. I’d like to thank conference chair Ron Durocher as well as the entire planning committee for organizing an excellent event. Preparations are already underway for the 2019 spring conference in Hamilton, June 2-4. Immediately following this year’s chapter conference was the provincial election. A new majority PC government came into power and introduced some immediate changes that could affect CHES Ontario members and facilities. These included scrapping the cap and trade agreement, and initiating a hiring freeze across the public service as well as a non-essential travel ban. We hope to have a dialogue with the new government about the negative impact cancelling cap and trade will have on healthcare facilities. Some members of the executive team are taking the lead on this initiative. An education day is planned for Nov. 8. To take place in Cambridge, Ont., the focus will be on CSA standards (morning) and drone technology (afternoon). I am proud to announce that the bid to host the 2022 International Federation of Hospital Engineering (IFHE) conference in Toronto was successful. A contingent of five CHES members travelled to Brisbane, Australia, in early October to make our presentation to the IFHE board, where we received the good news. —Jim McArthur, Ontario chapter chair

CHES SCISS CALL FOR NOMINATIONS FOR AWARDS Canadian Healthcare Société canadienne d'ingénierie Engineering Society

des services de santé

2016 2016 CALL FOR NOMINATIONS AWARDS Hans Burgers Award Wayne McLellanFOR Award of Excellence For Outstanding Contribution to 2019 Hans Burgers Award Healthcare Engineering

In Healthcare Facilities Management

2019 Wayne McLellan Award of Excellence in Healthcare Facilities Management DEADLINE: DEADLINE: April 30, 2016 April 30, 2019

for Outstanding Contribution to Healthcare Engineering DEADLINE: April 30, 30, 2016 DEADLINE: April 2019

To nominate: To nominate: To nominate: Please useform the posted nomination To nominate: Please use the nomination form posted on the Please use the nomination on form posted on the  Please use the nomination form posted on CHES website and refer to the Terms CHES website and refer to the Terms of Reference. the CHES website and refer to the Terms of of Reference. the CHES website and refer to the Terms of Reference. Reference. Purpose: To recognize hospitals or long-term care facilities that Purpose: The award shall be presented to a resident of Canada Purpose have demonstrated outstanding success in completion of a major asPurpose a mark of recognition of outstanding achievement in the field  To recognize hospitals or long-term care The award shall of behealthcare presentedengineering. to a resident of capital energy efficiency program, environmental facilities that project, have demonstrated outstanding Canada as a mark of recognition of outstanding stewardship program or team building exercise. success in completion of a major capital achievement in the field of healthcare project, energy efficiency program, Award sponsored by engineering. environmental stewardship program, or by Award sponsored team building exercise. Award sponsored by Award sponsored by

For nomination forms, terms of reference, criteria and past winners www.ches.org / About CHES / Awards For Nomination Forms, TermsNational of Reference, and past winners Send nominations to: CHES Officecriteria, ches@eventsmgt.com Fax: 613-531-0626 www.ches.org / About CHES / Awards Send nominations to; CHES National Office ches@eventsmgt.com Fax: 613-531-0626

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CHES AWARDS

Markham Stouffville Hospital's Allan Kelly and Elena Pacheco with Honeywell's Luis Rodrigues (centre).

A DOSE OF GREEN Markham Stouffville Hospital takes many measures to achieve environmental sustainability, garnering it positive reception from CHES

arkham Stouffville Hospital (MSH) may not be the newest hospital in Ontario, but it’s on track to become one of the most environmentally friendly. Comprised of three sites, totalling more than 1 million square feet, the community healthcare facility has a progressive greening and sustainability program, which earned it this year’s Wayne McLellan Award of Excellence in Healthcare Facilities Management. “I couldn’t be happier,” says MSH plant maintenance manager Allan Kelly, who, along with vice-president of support services and transformation Elena Pacheco, accepted the award on behalf of MSH. “Everyone is very proud of the measures the hospital has taken to improve sustainability, and this award really validates the efforts being made.” 14 CANADIAN HEALTHCARE FACILITIES

Since opening its doors in 1990, MSH has steadily raised its environmental performance and reduced energy, water and waste costs, while maintaining or exceeding high quality patient care. Some of its green initiatives leading up to the award win include: rescheduling more than 40 air handling units to meet occupancy needs, resulting in more than 1.2 gigawatts (GW) of power savings; retrofitting the hallway and corridors in two buildings with LED lights, which has amounted to 204,791 kilowatt hours (kWh) in energy savings; and conducting a steam trap audit and changing out more than 30 defective traps, producing a savings of 94,146 cubic metres of gas. Energy efficiency projects implemented thus far have saved more than $400,000, with monies invested

back into additional conservation measures as well as patient care. Results to date, not including water, have also shown a reduction of 354 tonnes of greenhouse gas emissions. Four additional projects, which the hospital recently received funding for, will further minimize MSH’s carbon footprint by 1,918 metric tonnes. “Finding money to improve energy and utility costs can be challenging,” says Kelly. “In a hospital environment, these types of projects rarely get priority during capital spending discussions, so we explored alter native funding opportunities, which brought us to OntarioBuys.” Established in 2004, the provincial government initiative provides financial resources to projects that help broader public sector organizations adopt

CHES AWARDS

innovation, achieve benefits and improve operational efficiency in supply chain and back office processes. Projects must meet, or demonstrate how they will meet, specific criteria in o r d e r t o q u a l i f y f o r f u n d i n g. OntarioBuys typically pays for up to 75 per cent of eligible project costs; however, projects that emphasize innovation or leading-edge themes may qualify for 100 per cent coverage. “We were awarded $900,000 in December 2017, which was exactly the dollar amount we were looking for,” says Kelly, who joined MSH exactly two years prior. “It was probably one of the best Christmas presents I’ve ever received.” The four projects, selected by MSH’s e nv i ro n m e n t a n d s u s t a i n a b i l i t y committee because of their potential to reduce energy consumption and ease of implementation, are on track to be concluded by the Mar. 31, 2019, deadline. They include lowering air exchanges in operating rooms from 20 to six during unoccupied hours (11 p.m. to 7 a.m.), which is estimated to save 950,000 kWh; reducing kitchen exhaust and ventilation; replacing existing fluorescent tubes (approximately 300) with on-demand LED lighting in areas that are lit 24-7; and converting the hospital from an open loop to a closed loop water cooling system, which will increase r e s o u rc e e f f i c i e n c y a n d r e d u c e

operational costs, saving MSH $60,000 a year in water alone. The first three projects have been procured through an innovative process based on value, while the fourth has been obtained through a traditional procurement model solely based on price. Upon completion, MSH will become the energy services company and manage these projects with its own resources, which will help keep costs down. “Each project will have a significant environmental impact,” says Kelly. “Take the kitchen exhaust fan that sucks 15,000 cubic feet of air per minute out of the kitchen and pushes it outside,” he continues. “By installing smart technology, the speed of the exhaust fan will be reduced by 40 per cent when not in use. This will provide significant energy savings.” MSH’s green program and the success it has achieved would not have been possible without the hard work and dedication of its corporate services department, comprised of facilities, environmental services, food services, biomedical services, patient transport, security and waste management. These core services staff members not only implemented the strategies outlined by senior leaders but also gave feedback and provided frontline insight into how the program could be improved. Fo r e x a m p l e , w h e n M S H i m p l e m e n t e d re a l - t i m e bu i l d i n g

analytics five years ago, it was the maintenance team that monitored and interpreted the results produced by the new software. As a result, there were many improvements made throughout the hospital, including clearing up s c h e d u l i n g i r r e g u l a r i t i e s, s t a t i c pressure and fan speed optimization in air handling units, and resolving tem perature s en s or failures an d unnecessary damper cycling. “Staff members (such as these) are the eyes and ears of the hospital and because they’re here 24-7, they know what works and what doesn’t,” says Kelly. Employee buy-in has also played an important role in ensuring the success of the hospital’s sustainability strategy. MSH has taken a number of steps to raise awareness of, and engagement in, its green initiatives. This includes holding an annual bike to work day, a spring hospital property cleanup event and a Greening and Sustainability Expo to coincide with Earth Day. The expo brings together external vendors, hospital partners and staff, physicians and volunteers to learn about how they can be more ‘green’ in their day-to-day activities and to celebrate the hospital’s earthy-friendly achievements. “Employees play a crucial role in transforming sustainability strategy into a reality,” says Kelly. “If they’re on board and they feel accountable for the results, then this will affect positive change.”

LEEDing the Way When Markham Stouffville Hospital (MSH) embarked on a major expansion project nine years ago, it decided to not only add a 385,000-square-foot building to the existing hospital but to also construct a central utility plant off-site that supplies thermal energy, electricity and emergency power through Markham District Energy. This partnership with a community-based utility provider is not only unique — MSH is the first hospital in Ontario to embark on such an endeavour — but it is a great example of working with leaders in the industry to use energy more efficiently. The project was evaluated according to LEED (Leadership in Energy and Environmental Design) Canada new construction standards, earning 35 points towards MSH’s LEED silver designation, which it achieved in summer 2015.

FALL/AUTOMNE 2018 15

CHES AWARDS

FULL OF ENERGY Ralph Mayfield’s storied career fuelled by passion in environmental conservation

n Sept. 17, Ralph Mayfield was recognized for the second time in two years at the CHES National conference. On this occasion, however, his Horizon Energy Network peers remained in their seats while Mayfield took to the stage to accept the 2018 Hans Burgers Award for Outstanding Contribution to Healthcare Engineering. “It was very exciting,” says Mayfield, who is part of the six-member team that was acknowledged in 2016 with the Wayne McLellan Award of Excellence in Healthcare Facilities Management. “I am grateful that my colleagues deemed I was worthy of this honour, which is a crowning achievement in my career.” This says a lot as Mayfield’s work in the New Brunswick healthcare system has been recognized at the provincial level. In 2014, he received the Premier’s Individual Champion Award for Energy Efficiency. Under Mayfield’s leadership, Horizon Health Network’s Saint John Regional Hospital (SJRH) reduced energy consumption by 2.7 million equivalent kilowatt hours per square foot or approximately $227,000 in 2013, compared to 2011. “It was really a collaborative effort,” says Horizon’s director of facilities, engineering and property management about the accomplishment. “In any job, you’re only as good as the people who support you.” Mayfield’s passion to make healthcare facilities operations as efficient as possible was evident early on in his 35-year career. Shortly after joining Sussex Health Centre (SHC) in 1983, the then-maintenance manager installed an energy management system to monitor, control and optimize energy performance, which paid for itself in six months. However, it was in 1994, when Mayfield oversaw the installation of an open loop ground source heating system at SHC that he began to realize his full potential. The Aquifer Thermal Energy Storage (ATES) system — only the second in Canada at the 16 CANADIAN HEALTHCARE FACILITIES

Hans Burgers award recipient, Ralph Mayfield, with Hassaan Khan of Johnson Controls.

time — improved the hospital’s energy performance from a 1:1 to a 1:6 ratio since it was an all-electric building. “What this means is that for every kilowatt of electrical input, you get six kilowatts of electrical output,” says Mayfield, noting that the project was nominated for a Natural Resources Canada (NRCan) energy award in 1996. This marked the beginning of a long list of energy projects championed by Mayfield. It also heralded a promotion to engineering and maintenance regional manager for the Atlantic Health Sciences Corp., one of four health authorities that merged 10 years ago to form Horizon, which operates a dozen hospitals across New Brunswick. In his new role, Mayfield had the opportunity to apply already proven energy savings measures across the entire hospital network as well as embark on new conservation ventures, something he was excited to do with the goal of improving patient comfort. “Beginning in 2002, we switched from oil to natural gas to heat our buildings, undertook a major T-8 lighting retrofit project and started to

replace pneumatic thermostats with direct digital controls,” says Mayfield. These measures, among others, and their results garnered Horizon’s SJRH the Energy Star label in 2018. Energy Star certified buildings perform in the top 25 per cent of buildings nationwide, based on weathernormalized source energy use that takes into account occupancy, hours of operation and other key metrics. Only buildings that earn a score of 75 or higher on NRCan’s one to 100 energy performance scale and are verified by a licensed professional engineer or registered architect can use the certification mark. SJRH obtained a score of 88. “It’s a wonderful feeling to earn the rating, especially since the hospital is the first healthcare facility in Canada to receive it,” says Mayfield, who notes that improving energy efficiency is an ongoing effort and more can be done. Most recently, SJRH installed two photovoltaic panels on its roof as part of a small (20 kilowatt) pilot project. The solar panels have been designed so they can be adjusted and optimized seasonally, thereby harvesting as much energy from the sun in all seasons. Mayfield says he’d like to

CHES AWARDS

eventually put enough on the roof to take care of at least half of the hospital’s electrical requirements. “When I began to oversee operations (at SJRH), the hospital was using 52.8 equivalent kilowatts per square foot and now it’s using 45.8 equivalent kilowatts per square foot,” he notes. “My goal is to reach 45 equivalent kilowatts per square foot before I retire.” The 69-year-old says this could come as early as next year but he hasn’t yet come to a final decision. “When you like what you’re doing, it’s not work anymore,” he says. “I couldn’t have asked for a better profession.” Though it wasn’t what Mayfield originally set out to do. After graduating with a second degree in civil engineering technology from Southern Tech, a division of Georgia Tech, in 1975 (Mayfield also holds a bachelor of science from the American University of Puerto Rico), he moved with his wife, Wanda, from Atlanta to Anagance, N.B. There, he started a greenhouse business with his father-in-law, growing 30,000 pounds of tomatoes and 12,000 pounds of cucumbers per week. Business was booming until the energy crisis in the late ‘70s took its toll, doubling and even tripling the cost of production. Mayfield and his father-in-law were forced to close the company’s doors but as it would happen, another one opened for the environmental enthusiast. Around the time that he landed his first job in the healthcare sector, Mayfield got involved in the Canadian Healthcare Engineering Society (CHES) on the advice of George Seely, who would later win a Hans Burgers award, too. He, along with a number of colleagues in Atlantic Canada, created the Maritime chapter, which Mayfield would later serve as chair of for three consecutive terms (2002-2009). Recognizing the value of CHES membership and the correlation in delivering quality healthcare, Mayfield has held various other leadership roles, including New Brunswick vice-chair (1992-2002) and chair of four CHES National conferences. He

was also involved in the creation of a bursary be better served. This led to two years of program in memory of Per Passche and separation talks, culminating in the creation played a key role in the formation of the of the Newfoundland and Labrador chapter Newfoundland and Labrador chapter. Then at the 2009 CHES National Conference in part of the Atlantic chapter, the province St. John’s, Nfld. was not receiving the full benefit of its “We awarded all the conference revenue CHES membership, says Mayfield. that would’ve gone to CHES Atlantic to the “Due to demographics, members from new Newfoundland and Labrador chapter Newfoundland and Labrador were unable to help it get started,” says Mayfield, noting to participate in educational sessions, this amounted to $20,000. While Mayfield's role in CHES has conferences and trade shows,” he explains, noting CHES Maritime became CHES diminished in recent years, he is still a Atlantic when Newfoundland and Labrador staunch advocate of the organization, often joined in 1995, but then reverted to its encouraging others to become involved original name when the province seceded because of its intrinsic value. “CHES has been a tremendous support from the chapter in the late 2000s. Mayfield approached Bill Squires, a for me throughout my career,” he says. “It CHES member from Newfoundland, at the has provided endless networking and enriched my knowledge 2007 CHESMcGregorAllsop_GTA_June_2016_FINAL.pdf National Conference in opportunities, 1 2016-06-23 10:16 AM Calgary, to discuss how the province could and skills in healthcare engineering.”

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CHES AWARDS

THREE’S A CHARM Ontario chapter’s streak continues with President’s Award win

t’s something few are ever in the position to achieve and even fewer actually do, but the Ontario chapter beat the odds when it was named the recipient of this year’s President’s Award. “I was ecstatic,” says chair Jim McArthur when he received ‘the’ call that the chapter had three-peat. “I was having a nice dinner with my wife in Niagara-on-the-Lake, Ont., and I immediately excused myself to contact past chair Robert Holliss to share the good news. It’s not easy to win this award and to achieve it three years in a row is very gratifying.” The President’s Award is presented annually to the CHES chapter that demonstrates its commitment to education, administration and representation in the activities of the chapter and national board. Each chapter is scored on accounting practices, conference/education day, membership, chapter executive practices, committee work and additional offerings (from submitting articles to Canadian Healthcare Facilities to providing extra member benefits). Specifically, points are given for activities that benefit members and the work of CHES, such as number of meetings attended in the course of committee work and special education sessions. The winner of the much-coveted award receives two CHES National conference registrations and expenses to a maximum of $2,500 each, a trophy engraved with the victorious team’s names and, perhaps, best of all, bragging rights. “The success of any chapter doesn’t happen without a strong executive,” says McArthur, who recognizes the efforts and contributions of the other seven CHES chapters that Ontario edged out in the friendly competition. “I am proud of our achievement and want to thank everyone on the executive team for their hard work in making this possible.” McArthur is also pleased that the chapter is Canada’s choice to host the 2022 International Federation of Hospital

18 CANADIAN HEALTHCARE FACILITIES

Members of the Ontario chapter executive with Trane's Guy Bourbonniere who presented the award.

Engineering (IFHE) conference in Toronto. In a narrow margin vote of 6-5, Ontario was selected over British Columbia in October 2017, which he says put together a very strong submission. “Vancouver is a beautiful city and would have represented Canada well.” Since its successful nomination, the Ontario executive has worked in earnest with members of other chapters and Tourism Toronto to prepare its bid. The submission was approved in June for presentation at the 25th Congress of the IFHE, Oct. 6-11. A contingent of five CHES members travelled to Brisbane, Australia, where the winner was announced. “Heading to the congress, our bid committee was confident we would be selected to host the 2022 event,” says McArthur, who acknowledges the competition was fierce, with Canada up against the U.S. and South Africa. “After a two-stage voting process, which eliminated South Africa after the first

round, Canada was victorious in a count of 14-6 against the U.S.” Energized by the outcome, McArthur and the rest of the executive team will continue to work diligently on behalf of the chapter membership to advance its agenda. This includes ensuring Ontario is represented on all six CHES National committees and subcommittees, as well as developing new and deepening existing ties with other organizations, including the Canadian Centre for Healthcare Facilities, International Association for Healthcare Security and Safety, AdvantAge Ontario and American Society for Health Care Engineering, with the goal of sharing ideas and attracting more members to CHES. The chapter will also continue to offer a second education day in the fall and support members’ kin by offering five $1,000 scholarships per year to those enrolled in a full-time post-secondary technology program in the province.

FALL/AUTOMNE 2018 19

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SUSTAINABLE HEALTHCARE

NORTHERN COMFORT Building operator certification training course improves technical skills of First Nations facilities personnel By Kent Waddington

ucked away along the western shoreline of James Bay are the remote First Nations communities of Attawapiskat, Kashechewan, Fort Albany, Moose Factory and Moosonee, where, until recently, access to building engineering expertise was severely limited. Because of this, the Weeneebayko Area Health Authority (WAHA), which provides medical services along the coast, had to rely upon expensive outside fly-in help to assist with even routine technical building issues. As part of WAHA’s mission to provide a holistic approach to healthcare that reflects both Western and traditional approaches to medicine, and to promote healthier lifestyles within the communities it serves, the health authority recognized the need to address the impact its facilities were having on the environmental health of the James Bay and Hudson Bay communities and, accordingly, public health. More energy-efficient and better maintained buildings would be a major step in helping WAHA meet its environmental obligations and ensure it was prepared when called upon to deliver services to local residents. 22 CANADIAN HEALTHCARE FACILITIES

Scattered across the five communities, there are more than 19 healthcare facilities plus multiple housing units in the WAHA portfolio (plus ambulance bases, nursing stations and clinics), complete with steam and hot water heating systems, chillers, dehumidification and humidification systems, and a wide variety of control systems, lighting technologies and mechanical subsystems. As part of a multi-year initiative with the Canadian Coalition for Green Health Care and Healthcare Energy Leaders Ontario (HELO), and with funding from the Independent Electricity System Operator, WAHA had energy audits conducted on all buildings, initiated numerous lighting and building envelope upgrades, and has embraced the training of staff to increase their capacity to deal with many of the facility-related issues that were previously outsourced to costly technicians in Timmins, Ont., and elsewhere. Working around staff scheduling, unpredictable northern weather, ongoing building maintenance needs and being sensitive to local indigenous cultural

events, such as the spring and fall hunt, the Coalition and HELO delivered the eight-module Building Operator Certification (BOC) training course to WA H A’s F i r s t N a t i o n’s f a c i l i t y management staff. The competency-based BOC training offered First Nation’s facilities personnel the opportunity to improve their technical expertise and job skills to transform WAHA’s facilities into more comfortable, energyefficient and environmentally-friendly places of treatment. “We were excited when the Coalition requested our help in developing and deploying the BOC course in a remote northern First Nations community,” says Mathieu Côte, executive director of the Canadian Institute for Energy Training, which is responsible for BOC training in Canada. “It was a first for us and we are very pleased with the results of having knowledgeable and empowered building operators now in the James Bay communities. We look forward to working with the Coalition and HELO team again to continue to bring

Newly minted graduates of Canada’s first remote northern First Nation’s building operator certification (BOC) training program. LEFT TO RIGHT: Mervin Weistche, Marcel Brazeau, Jean Arsenault, Sterling Trapper, Paul Corston, Wade Rickard, and BOC training instructor and HELO lead, J.J. Knott.

high-quality energy management education and training to First Nations and remote northern communities, to help build internal capacity and to reinforce existing energy management knowledge and skills among First Nation’s community members.” WAHA currently spends millions of dollars on energy each year, sometimes three to four times the rate in southern Ontario. As electricity prices rise and patient needs change, this amount will continue to increase. Between 2013 and 2016, the energy charge rates in northern Ontario increased on average of $0.04 per kilowatt hour (kWh). By improving the energy efficiency of its medical and support facilities, WAHA has begun to reduce greenhouse gas emissions, decrease operational costs and enhance the quality of care it provides to citizens in the communities it serves. Increasing the technical expertise of its staff has enabled WAHA to develop a dedicated and committed team that is taking ownership of issues and advantage of opportunities. Staff have also begun to not only deal with a growing list of technical concerns now within their

understanding, but are developing energy management projects and leading the charge on initiatives that will improve building integrity and climate change resiliency while reducing demand for energy. Thanks to WAHA leadership’s early commitment to making a positive change to its energy culture and the enthusiasm of its First Nations facility staff, WAHA is eliminating energy waste wherever possible through infrastructure improvements, policy and process changes, improved operations management, and embracing best practices and technology changes. Now that a ‘lead from within’ mentality is being nurtured by senior management, recent graduates of the BOC course have developed a long list of successful projects that are helping to significantly reduce WAHA’s yearly energy expense. The installation of a new summer boiler at Weeneebayko Hospital has reduced fuel consumption by five per cent overall. Steam trap audits were also completed and corrections made to systems accordingly. As well, condensate return lines from community housing steam distribution systems were redesigned, reconstructed, steam traced and reinsulated, contributing to a 40 per cent gain in condensate return to the boiler systems. Lighting retrofits and replacements have been completed resulting in a reduction in electrical consumption of 600,000 kWh annually, and a concomitant annual savings of $90,000. Windows and doors were replaced at Weeneebayko Hospital, which has resulted in a reduction of 76,000 litres of fuel oil and 41,000 kWh of electricity consumption, providing an annual savings of $121,000. A new energy and expense tracking system has also been installed with training provided to the finance department to assist in variance

highlighting and expense monitoring. Purchasing processes have similarly been updated to emphasize energy efficiency criteria for equipment purchases and design with emphasis on Energy Star, as well as adding consideration for reuse and recycling. Future projects being pitched to management and investigated for viability include efficiency upgrades to oil-fired heating appliances; development of a robust cleaning and preventative maintenance plan for all electric motors; upgraded electrical infrastructure in, and new siding and wall insulation on, multiple WAHA buildings; numerous electrical and mechanical upgrades throughout the building stock; and upgrades to the maintenance shop to better serve WAHA’s internal needs. WAHA is also working with the Coalition to establish additional training and networking opportunities to help enhance current skill levels in multiple topic areas. “The BOC training program has led to a new sense of pride and ownership among WAHA’s First Nations facility staff who are now confident to tackle a much broader spectrum of building maintenance and retrofit tasks,” says HELO’s lead and BOC instructor J.J. Knott, who delivered the training in Moose Factory, Ont. “Their previous reliance upon outside technical support has been replaced by enthusiasm, competence and a newfound determination to make their buildings more energyefficient and climate change ready, while ensuring the best possible treatment facilities for the communities they serve.” Kent Waddington is the communications director and co-founder of the Canadian Coalition for Green Health Care. He can be reached at kent@greenhealthcare.ca. FALL/AUTOMNE 2018 23

SUSTAINABLE HEALTHCARE

LEFT TO RIGHT: Horizon Health Network's Jeff Carter, Blaine Lynch and Ralph Mayfield, along with Service New Brunswick's Kate Butler, display Saint John Regional Hospital's grand achievement — 2018 Energy Star certification.

A STELLAR PERFORMANCE New Brunswick hospital recognized by esteemed NRCan program By Kate Butler

orizon Health Network’s Saint John Regional Hospital (SJRH) has achieved Energy Star certification to become the first healthcare facility in Canada to be honoured with the rating. Administered by Natural Resources Canada (NRCan), the Energy Star program provides certification to buildings and consumer products that meet certain standards of energy efficiency. This is the first year NRCan has officially certified buildings in Canada, which perform in the top 25 per cent nationwide.

ON THE RIGHT TRACK

For the past four years, SJRH has inputted energy data into NRCan’s Energy Star Portfolio Manager to 24 CANADIAN HEALTHCARE FACILITIES

determine where it ranked against similar buildings across the country in terms of energy performance. The free, easy to use, web-based benchmarking tool utilizes metrics like energy use intensity (EUI) and a one to 100 energy performance scale. The EUI is trended year-over-year, as is total greenhouse gas emissions. The energy performance scale is simple to understand and communicate. A score of 50 represents median energy performance, while a score of 75 indicates the building is a top performer. Only buildings that earn this score or higher, are verified by a licensed professional engineer or registered architect, and are Energy Star-certified commercial and institutional buildings can use the certification mark.

The Energy Star score is calculated based on metered data entered in the portfolio manager and verified annually. The consecutive 12-month energy data by fuel, type of healthcare facility, year of construction and size, occupancy (including number of beds and staffing full-time equivalents), hours of operation, regional weather and other key metrics, such as whether the hospital has a MRI machine, laboratories and data centres, are all taken into consideration. Building operations and standards are also confir med. Energy efficiency measures that are implemented as the facility strives for better energ y performance should have no or only pos itive im pac ts on th e in door environmental quality of the healthcare facility. For example, an acceptable

SUSTAINABLE HEALTHCARE thermal environment is still maintained, relative humidity requirements are adhered to, fresh air ventilation rates are met as per code, and patients and staff have acceptable illumination levels. In 2018, SJRH received a score of 88. An improvement over previous years, this was the result of various energy-efficient projects, such as installing occupancy sensors in washrooms and administration areas, replacing pneumatic thermostats with digital ones and reprogramming operations, upgrading lighting and lighting controls, retrofitting air handling units and optimizing operations. The hospital’s EUI for the same year is 1.77 gigajoules of energy per square m e t re ( G J / m 2 ) , we l l b e l ow t h e national average and only achievable with the cooperation and dedication of SJRH facilities, engineering and property management staf f who worked together to ensure projects were implemented and energy reduction measures sustained. OBSERVE AND REPORT

When SJRH began utilizing the Energy Star Portfolio Manager in 2014, the

benchmark (in year one) was used as the baseline score and a target for increased energy performance was determined. The initial score was 82. Even with a score above 75 — the minimum required to become Energy Star certified — SJRH staff determined there was room for improvement. The continued increase in score year after year, combined with recent certification, has helped engage staff. Proud of their achievements, they remain motivated, which is key when continually seeking opportunities to improve operations in order to better patient care. Energy Star Portfolio Manager graphically showcases the improvement in EUIs over the years, the reduction in greenhouse gas emissions and the increase in Energy Star score, which is an effective way to communicate hospital performance, especially to those not directly involved in energy management, such as senior level staff and members. Dashboards and tables can be easily generated to be used by a wide range of audiences, whether it be staff at the operations centre or management at their weekly meeting.

The tool is also a reliable mechanism for annual reporting. It produces carbon dioxide equivalent emission reports that are customized to each province and can be reported — a must for New Brunswick healthcare facilities as Horizon strives to meet the province’s Climate Change Action Plan, which mandates all gover nment facilities report their greenhouse gas emissions by 2020. NOTE OF UNDERSTANDING

Even if a facility is not eligible for Energy Star certification, the benefits are clear. Canadian hospitals spend more than $1 billion annually in energy and have the highest energy intensities of all building types — over twice that of an average office building, according to an NRCan study. Understanding a site’s EUI and Energy Star score is the first step to better energy management, which, in turn, leads to improved patient and staff comfort, as well as reduced operating costs. Kate Butler is executive director of energy management with Service New Brunswick’s health services division. She can be reached at kate.butler@snb.ca.

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MAINTENANCE & OPERATIONS

BOILER FOR HIRE Temporary, portable rental equipment benefits hospital’s bottom line, minimizes downtime By Paul Ingham

or many hospital facility managers, replacing an existing boiler is a once-in-a-career event. The pressure to get it right can be intense, particularly when dealing with older infrastructure. For the team at Memorial Hospital in Orillia, Ont., the key concern was finding a way to properly gut and retrofit the existing boiler room while maintaining uninterrupted operation. Conservative time estimates suggested the project would take four to six months. However, given the complexity posed by the 60-year-old building’s space restrictions, the hospital needed a solid contingency plan. CRITICAL EVALUATION

The first step in completing a boiler retrofit is to conduct a thorough assessment of the facility. Working collaboratively with the hospital’s facilities manager, the contractor and boiler manufacturer determined that 26 CANADIAN HEALTHCARE FACILITIES

Memorial’s existing boiler room presented significant space restrictions, making a standard oneboiler-at-a-time replacement impossible. A f t e r d eve l o p i n g p e r fo r m a n c e specifications for the project, the team concluded that a temporary, portable rental boiler was an ideal solution for the hospital’s needs. But why rent a boiler? A TEMPORARY FIX

Hospital boiler facility upgrades can be costly and difficult. Until five years ago, it involved both significant funding and daunting logistics in order to ensure the hospital remained online and in leg al compliance. Historically, hospitals often built new boiler rooms simply because on-site replacement just didn’t seem feasible and downtime wasn’t an option. (Situated in hospital basements, older boiler rooms contained equipment so

large that the infrastructure had to essentially be built around it.) Temporary rental boilers fix these problems. They can supplement or re p l a c e ex i s t i n g o n - s i t e b o i l e r s, allowing for renovations, retrofits and replacements with more energy and space-efficient boilers to take place. (Newer equipment often takes up half the space of older boilers, leaving proper room for access and maintenance.) As well, rental boilers can often have the facility back online as quickly as it takes to get the equipment on-site, provided funding and connection points are available. POLICY UNCERTAINTY

Agi n g b o i l e r s c a n b e e s p e c i a l l y challenging for older hospitals. All h e a l t h c a r e f a c i l i t i e s h ave f i s c a l constraints but older ones can also face policy uncertainty. Policy-makers may decide that retrofits are unnecessary because a new hospital is

TIME’S UP

in the planning stages. Then, a few years later, governmental priorities change and the older hospital may be expected to defer capital expenditure for several years longer than expected. Here, temporary boilers may be a solid solution. Even in situations of p o l i c y u n c e r t a i n t y, h o s p i t a l administrators and facility managers can ensure their boilers remain up and running. And if a replacement is necessary, no costly expansions are required; the temporary boilers can assume the burden until the work is done or even take the place of the boiler plant and run until the hospital’s future is decided. END-OF-LIFE SOLUTION

Temporary boilers also offer a solution to hospitals slated for replacement. Even when the commitment is firm, building a hospital is a difficult task that is prone to setbacks. If the old boiler is breaking down but the new

building is delayed, administrators and policy-makers can face tough decisions about renovating a building that is already slated for demolition. These soon-to-be-closed hospitals can save a lot of time and money by arranging for long-term rental boilers. With a few simple alterations — a concrete pad and installation of fixed connection points — equipment can be brought on-site and used reliably and within government guidelines for years on end. They can completely replace the existing facilities until it is time to move. Paul Ingham is vice-president of sales and marketing at Thermogenics Inc., a leading manufacturer of coil tube steam and hot water boilers, steam and hot water systems and related equipment used primarily in industrial, commercial and institutional applications in North America. The company also has a fleet of rental boilers. Paul can be reached at 905-727-1901 or info@thermogenicsboilers.

When should facility managers start considering boiler replacement? Telltale signs include: downtime starts to become a serious problem; regular breakdowns result in increasing reliance on backups; frequency of service calls rises and the time it takes to get back online does, too; more time and money is spent on retrofits as older parts become irreplaceable because they’re unavailable or obsolete; and utility companies flag the facility’s outsized energy draw. It is important, however, not to wait until replacement reaches a critical level. Facility managers should work with vendors and consultants well in advance to create emergency plans and solutions without the huge capital injection needed to build a whole new boiler room. Consultants should also be part of the process early on as they often have knowledge on accessing grants and programs that can help defray the cost of retrofits and upgrades. Activating funding can be difficult and time-consuming as hospitals are complex operations that must answer to both administrators and Biomedical_CHF_Winter_2017_FINAL.pdf policy-makers. This can lead to serious delays in emergency resolution.

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MAINTENANCE & OPERATIONS

A LESSON IN VALUE

Une leçon de valeur By/Par Clare Tattersall

he CHES National Conference is a huge draw and once again Craig Doerksen was in attendance at the esteemed event. This year, however, it felt a bit different. It wasn’t the location, which changes each year, or the unique education program. Rather, it was Doerksen’s sense of pride and accomplishment as he recalled successfully completing the first-ever Canadian Certified Healthcare Facility Manager (CCHFM) exam three years ago. “I was one of four people to write the exam right after the 2015 CHES National conference and the only one that passed in that first sitting,” recalls the divisional director of facility management for Health Sciences Centre (HSC) Winnipeg. “Since then, the CCHFM program has become an integral part of the conference, with each session covering content that supports the CCHFM topic areas and a general session highlighting the program itself.” Today, a total of 11 CHES members have obtained the designation but it hasn’t been easy. However, with hard work comes great reward, which Doerksen can attest. “It validated my 27 years’ experience in the healthcare sector and I anticipate it has provided a level of comfort to my employer knowing that the care of one of Canada’s largest hospitals is in the hands of someone thoroughly evaluated in their healthcare expertise,” explains Doerksen, who is now CHES National treasurer. “The exam also helped me recognize not only my strengths but my weaknesses, and to turn those into learning opportunities so that I can better myself.” The CCHFM certification program is designed to test a welldefined body of knowledge representative of professional practice in healthcare facilities management. The exam is composed of 100 multiple choice questions that cover five broad topics, each weighted differently: compliance (25 per cent); planning, design and construction (18 per cent); maintenance and operations (28 per cent); finance (15 per cent); and administration (14 per cent). 28 CANADIAN HEALTHCARE FACILITIES

e prestigieux congrès national de la SCISS attire énormément de monde. Craig Doerksen y était encore une fois, mais, cette année, c’était légèrement différent. Pas à cause du lieu, qui change chaque année, ni du programme pédagogique. C’était plutôt à cause de la fierté et du sentiment d’accomplissement qu’il ressentait à l’idée d’avoir réussi, trois ans auparavant, le tout premier examen de gestionnaire d’établissement de santé certifié au Canada (CCHFM en anglais). “J’étais l’une des quatre personnes à avoir passé l’examen juste après le congrès de 2015. Et la seule à l’avoir réussi,” se souvient le directeur de la gestion des installations du Health Sciences Centre (HSC) à Winnipeg. “Depuis, le CCHFM a été intégré au congrès, chaque session couvrant une matière en appui à ses thèmes, plus une session générale mettant en valeur le programme lui-même.” Aujourd’hui, onze membres de la SCISS détiennent ce titre. C’est difficile, mais le travail acharné aboutit à une grande récompense, comme peut l’attester Doerksen. “Cela a validé mes 27 années d’expérience. J’espère que mon employeur en sera rassuré, sachant que les soins de l’un des plus grands hôpitaux du Canada sont entre les mains de quelqu’un dont l’expertise a fait l’objet d’une évaluation approfondie, explique-t-il. L’examen m’a aussi aidé à reconnaître mes forces et mes faiblesses. J’y ai vu des opportunités de perfectionnement.” Doerksen est aujourd’hui trésorier national de la SCISS. Le programme de certification CCHFM vérifie un ensemble de connaissances bien définies et représentatives de la pratique professionnelle. Il se compose de 100 questions à choix multiples qui couvrent cinq grands sujets, chacun ayant une pondération différente : conformité (25 pour cent); planification, conception et construction (18 pour cent); entretien et exploitation (28 pour cent); financement (15 pour cent); et administration (14 pour cent). On peut le passer dans l’un des quatorze centres d’examen à travers le pays. La note de passage est de 70 pour cent.

MAINTENANCE & OPERATIONS

“IT IS ESSENTIAL TO UNDERSTAND THE INTENSITY OF THE EXAM MATERIAL, THE BREADTH AND DEPTH OF IT, AS WELL AS THE TIME CHALLENGE.”

Craig Doerksen

“IL EST ESSENTIEL DE COMPRENDRE L’INTENSITÉ DE LA MATIÈRE, SON ÉTENDUE ET SA PROFONDEUR, AINSI QUE LE DÉFI QUE REPRÉSENTE LE TEMPS.”

It can be taken at one of 14 testing centres located across the country. A minimum grade of 70 per cent is required to pass. In preparation of the exam, Doerksen recommends that eligible applicants not only study the certification handbook but take the online practice test, too. “It is essential to understand the intensity of the exam material, the breadth and depth of it, as well as the time challenge,” he says, noting the exam must be completed in two hours. “I took the practice test and it highlighted areas that I needed to study up on like different capital project procurement and administration, which my current job doesn’t touch on. If I hadn’t taken the self-assessment exam in advance of the sit-down, I might not have passed.” Now, as a member of the CCHFM advisory panel, Doerksen is pleased to hear that a number of CHES chapters have agreed to cover the cost of the practice test and, in some cases, the exam as well. At $115 and $300, respectively, this removes barriers to participation and will conceivably increase the number of certified individuals. With time, the hope is that healthcare organizations will view the credential as an asset in the hiring process. “For those considering the CCHFM program, it’s different than the International Facility Management Association’s facility management professional certification program,” says Doerksen, who holds the designation in addition to being an AEE (Association of Energy Engineers) certified energy manager. “It’s hospitalspecific and therefore takes the skill questioning to the next level for those working in the field.” And although similar to the American Society for Healthcare Engineering’s certified healthcare facility manager designation since it was modelled after this program, the CCHFM curriculum contains subject matter that is specific to the Canadian healthcare industry. To maintain the hard-earned credential, CCHFM certificate holders must either successfully pass the exam again prior to the designation’s three-year expiration date or complete 45 contact hours of continuing professional education (CPE). Eligible CPE activities include attending or teaching academic courses, completing online courses and partaking in professional organization conferences. Having just renewed his designation, Doerksen says he was relieved he had the option not to retake the exam but would’ve done so, if required. “Being CCHFM certified is well worth it.”

Pour se préparer à l’examen, Doerksen recommande d’étudier le manuel de certification et de faire l’auto-évaluation en ligne. “Il est essentiel de comprendre l’intensité de la matière, son étendue et sa profondeur, ainsi que le défi que représente le temps,” ajoute-t-il en soulignant qu’on dispose de seulement deux heures. “J’ai passé l’auto-évaluation, ce qui a mis en évidence les domaines que je devais étudier, comme les différents processus d’acquisition et d’administration de projets d’immobilisation, chose à laquelle je ne touche pas dans mes fonctions actuelles. Sans cela, j’aurais pu échouer.” Maintenant membre du comité consultatif du CCHFM, Doerksen est heureux d’apprendre que plusieurs sections de la SCISS acceptent de prendre en charge le coût de l’auto-évaluation et, dans certains cas, de l’examen. À $115 et $300, respectivement, cela élimine les obstacles à la participation. Espérons que cela augmentera le nombre de personnes certifiées. Avec le temps, les organisations de santé devraient considérer ce titre comme un atout dans leur processus de recrutement. “Pour ceux qui envisagent le programme CCHFM, sachez qu’il est différent du programme de certification professionnelle en gestion des installations de l’International Facility Management Association,” prévient Doerksen, titulaire de cette désignation en plus d’être gestionnaire d’énergie certifié par l’AEE (Association of Energy Engineers). “C’est spécifique aux hôpitaux, ce qui signifie que les questions sont nettement plus difficiles.” Et bien que similaire au titre de gestionnaire d’établissement de soins de santé certifié de l’American Society for Healthcare Engineering, puisqu’il s’inspire de ce programme, le CCHFM aborde des sujets spécifiques au contexte canadien. Pour conserver leur titre durement acquis, les titulaires CCHFM doivent soit réussir à nouveau l’examen avant la date d’expiration de leur titre, soit compléter 45 heures d’éducation permanente (EP). Les activités d’EP admissibles incluent la participation ou l’enseignement de cours magistraux, la réalisation de cours en ligne et la participation à des conférences d’organisations professionnelles. Doerksen vient juste de renouveler son titre. Il se dit soulagé de ne pas avoir eu à repasser l’examen, mais il le ferait sans hésiter si nécessaire. “Cela en vaut la peine pour être certifié CCHFM.” FALL/AUTOMNE 2018 29

PATIENT PERSPECTIVE

A TOUCH AWAY Runnymede Healthcare Centre leverages technology to transform patient experience By Carla Wintersgill

stablishing immediate, personal connections and facilitating ongoing feedback are just some of the ways in which technology has helped to transfor m Runnymede Healthcare Centre, and enhance customer service and satisfaction for patients. Outbreak season can be hard on patients who are too ill to receive visitors or whose family members are too sick to visit. Recognizing that families and loved ones play a huge role in a patient’s recovery process, Runnymede has made that connection a priority by arranging Skype and FaceTime calls during such challenging circumstances so patients can still connect face-to-face with their families via video calling. Facilitating instant family and patient feedback is another part of Runnymede’s patient-centred customer service approach. Recently, the hospital introduced real-time patient experience survey kiosks on every floor throughout the facility. Re a l - t i m e s u r vey s e n a bl e Runnymede to hear from patients and families on an hourly, daily or weekly basis, providing the hospital with constant, up-to-date feedback. Surveys are accessible, easy to use and hold benefits for both the hospital and p at i e n t s : Ru n ny m e d e i s a bl e t o measure patient satisfaction immediately, while patients and families have a responsive forum for their voices to be heard. The survey platform allows comments on 30 CANADIAN HEALTHCARE FACILITIES

service and care to be sent directly to responsible departments so they can be addressed in a timely manner. While responses are completely anonymous, patients and family members can choose to self-identify through a video testimonial feature on the survey. Runnymede has also adopted a formalized video storytelling process as a means of improving quality through memorable staff education. Patients and families are able to share stories about their healthcare experiences through videos to be used for internal training purposes. Personal storytelling serves to make concepts real and helps crystallize policy thinking by putting real faces to the standards of care. In its guide to using storytelling in healthcare improvement, U.K.-based charity the Health Foundation notes that stories of real-life events are utilized because they are more memorable than data or lengthy manuals. They provide an established way for board members to focus on quality and patient experience, and they speak strongly to frontline staff who are often the most motivated by their interactions with patients. Recently, Runnymede partnered with OpenLab, a design and innovation centre at the University Health Network, to embark on its first-ever research project to bring immersive virtual reality (VR) to patients at the hospital. OpenLab’s pilot project, VRx, explores and evaluates the potential benefits of using virtual reality with various patient

populations. The VRx prototype is a series of short, immersive 360 degree films designed to provide a calming experience for participating patients. The goal of the study is to see if the experience of viewing simulated natural environments is effective in treating common symptoms of dementia, including depression, anxiety and isolation. Exposing patients to virtual reality could also elicit buried memories that have been previously forgotten and may offer a virtual vehicle that can move patients beyond the walls of the hospital or confines of a bed. From reports to date, the study has the potential to assist in the development of a breakthrough virtual reality-based therapy to help improve mental health and quality of life. The research also provides support for a future study that will look at a possible reduction in antipsychotic and sedative use for this population. As Runnymede moves forward with these initiatives, it is cementing its position as a healthcare leader and demonstrating an ongoing commitment to its patients by leveraging new technologies that will heighten their experience at the hospital and raise the bar on the quality of care. Carla Wintersgill is a communications specialist at Runnymede Healthcare Centre, a 206-bed continuing care and rehabilitation hospital in Toronto’s west end.

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