NAVIGATING AN UNEXPECTED CRISIS

Hamilton Health Sciences’ COVID-19 pandemic response

By George Pankiw & Dave Thompson

When COVID-19 began its spread across Canada, Hamilton Health Sciences (HHS) and its five hospitals had to respond quickly to adapt to the new realities.

At the start of the pandemic, HHS facilities management (FM) and capital development teams were called upon to provide support to clinical departments for a variety of COVID-related projects. There were copious requests for barriers for patient care areas, cafeterias and screening spaces. Using the ingenuity of the trades staff, many variations of protective screens were developed. Installation of screening booths in main entrances that remained open had to take into consideration the flow of patients waiting to be screened, provision of electrical for the booths and the comfort of staff subjected to cold weather from the opening and closing of doors. New covered shelters were also installed at all sites to protect patients from the elements, which allowed them to wait in relative comfort while maintaining physical separation.

The operational impacts of the pandemic were multifold. One such impact was the

FM team had to attend daily operation briefings and provide updates on the engineering aspects of the COVID response. An upside was getting to know many clinical and medical staff during these briefings that otherwise would not have happened. Other impacts included additional inspection and repair of many new pieces of equipment like beds and stretchers that arrived on a daily basis; addressing restrictions on contractors’ access to all HHS sites and ensuring enough qualified contractors were able to continue to work; dealing with COVID-related illness in staff and ensuring a minimum number of staff were always available; and obtaining required materials and spare parts in a timely manner in the midst of supply chain shortages.

Many major projects were implemented in support of COVID. One was the installation of an additional bulk oxygen tank at Hamilton General Hospital. After an initial meeting between intensive care unit (ICU) medical staff and FM and respiratory teams, it was determined the existing system could not keep up with a potential increase in patients. A design was quickly developed and tendered, followed by installation and connection to the existing pipeline system. An additional benefit of this was the need to ensure Hamilton General Hospital had a backup oxygen tank in case one was ever out of service. Other projects included turning trauma rooms at the hospital’s emergency department into temporary airborne isolation rooms (AIRs); construction of two new AIRs in the ICU; and the installation of a mask reprocessing machine in the hospital’s medical device reprocessing department. This last project was accomplished over the 2020 Easter weekend with HHS’s mechanical contractor WalterFedy and the FM team working on the fly to ensure rapid completion.

HHS was home to one of the mobile health units (MHUs) erected in the province as a rapid response to the pandemic. The MHU had multiple tent structures that were put up in one of the parking lots at the Hamilton General site. The MHU had its own power, HVAC, sanitary and water systems with a direct connection to hospital infrastructure for IT and fire safety. The planning and construction of the MHU created challenges at the site with respect to fire department and ambulance drop-off routes; however, these were resolved by collaboratively working with the City of Hamilton.

Early in the pandemic, HHS worked in partnership with St. Joseph’s Healthcare Hamilton to establish a satellite healthcare facility for non-COVID patients to make room for the increasing number of COVID patients at acute care sites. Working with multiple stakeholders, a downtown hotel was selected as the preferred site. Work swiftly began to improve the lighting, fire alarm and HVAC systems, replace washroom fixtures and improve millwork to suit the patients intended for this facility.

The initial stages of the COVID pandemic were a flurry of activity, which required FM and capital development teams to learn to be flexible and always prepared for the next request. This served the team well then and has readied everyone for the next pandemic, whenever it may be.

George Pankiw, P.Eng, is director of capital development at Hamilton Health Sciences and formerly facility manager for Hamilton General Hospital. Dave Thompson, P.Eng, is a partner with WalterFedy, a multi-disciplinary design and construction firm with offices in Toronto, Kitchener and Hamilton, Ont.