Canadian Healthcare Facilities | Winter 2016

Canadian

HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY

Volume 36 Issue 1

Winter/Hiver 2015/2016

HIGH HOPES

PM#40063056

St. Michael's Hospital embarks on ambitious redevelopment

ASCO invites you to explore 3 to 18 cycle and 30 cycle power transfer switches 88%* of engineers agree — Selective coordination requires choice, not compromise Selective coordination demands the ability to choose. After all, since no two emergency and backup power systems are alike, why settle for a cookie-cutter selective coordination design?

ASCO Power Transfer Switches: • • •

Achieved industry first 3-cycle rating Qualified 18-cycle performance on core 3-cycle switch, another industry first Satisfy the demands of unique applications with a 30-cycle option

• • •

Truly optimize selective coordination for what the application requires (typically an 18-cycle transfer switch) Provide a cost effective solution by utilizing 3 to 18 cycle ratings Are certified to UL-1008, 6th edition (April, 2011) test criteria

Compare power transfer switches for selective coordination applications. Then, select ASCO. www.EmersonNetworkPower.com/ASCO, (800) 800-ASCO (2726), ascoapu.com, customercare@asco.com * Results reflect the opinions of more than 300 engineers polled in a recent Webcast exit survey.

ASCO Power Switching & Controls Just another reason why Emerson Network Power is a global leader in maximizing availability, capacity and efficiency of critical infrastructure.

Emerson and ASCO are trademarks of Emerson Electric Co. or one of its affiliated companies. ©2015 Emerson Electric Co. CS101 ASCO Power Technologies

E M E R S O N . C O N S I D E R I T S O L V E D.

™

Portable Room with HEPA Filter

Rent or Purchase New or Used

FH3X R2 Retractable & Robust

Ideal for:

The most robust unit on the market

Work in a hospital environment (asbestos, dust, bacteria)

Conceptions M.G.’s portable room enables safe working in ceilings and walls under negative pressure. The dimensions of our portable rooms vary in terms of their surface area and height in order to meet different needs and building constraints (size of corridors, doorways, elevators, etc.).

NEW!

Air-Conditioned Units

• Simplified work & maintenance • Increased sanitation & security on work sites • Reduced site preparation time

General or specialized contractors

TECHNICAL SPECIFICATIONS • Silent fan, 49 dba, 150 cfm • 110 volt input, internal specification grade electrical outlet • Standard pre-filter, HEPA filter (99.97% efficiency at 0.3μm) • Work space: - FH3166 31” x 66”, up to 11’ work height - FH3378 33” x 78”, up to 11’ work height • Adjustable working height • Heavy-duty aluminum structure • Aluminum anti-slip floor • 2 fixed wheels, 2 swivel wheels with Heavy Duty Blickle footbrake • Rubber seal at the top • Lateral access • Heavy-duty zippers at openings • Transparent windows on 4 sides • 2 full access openings for working in ceilings or walls (comes with flaps) • Fireproof vinyl available in 5 colours: burgundy, blue, grey, beige, green • 2 flap openings of 8” to 10” to access tools, pipes, or other accessories in the ceiling OPTIONS • CFM differential reader – filter status • Windows at top or bottom of the enclosure • Floor drain • Personalized logo • Power pack for autonomy

Free Transport with purchase or 1-month rental

1 -8 8 8 -6 5 1 -2 8 3 9

www.conceptionsmg.com

CONTENTS

CANADIAN HEALTHCARE FACILITIES Volume 36

Issue 1

Kevin Brown kevinb@mediaedge.ca PUBLISHER/ÉDITEUR

EDITOR/RÉDACTRICE Clare Tattersall claret@mediaedge.ca SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR

Annette Carlucci annettec@mediaedge.ca

NATIONAL SALES/ REPRÉSENTANTE COMMERCIALE CANADA

Stephanie Philbin stephaniep@mediaedge.ca

PRODUCTION MANAGER/ Rachel Selbie DIRECTEUR DE rachels@mediaedge.ca PRODUCTION

12 DEPARTMENTS

SAFETY & SECURITY

6

8

18 A Dangerous Time Tackling growing violence in healthcare facilities

Editor's Note President's Message

10 Chapter Reports

24 The Gold Standard CSA Z8002 sets out core requirements for managing healthcare facilities

PRODUCTION COORDINATOR/ COORDINATEUR PRODUCTION

CIRCULATION MANAGER/ Maria Siassini DIRECTEUR DE LA marias@mediaedge.ca DIFFUSION 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

HEALTHCARE DEVELOPMENT 12 Breaking New Ground St. Michael’s Hospital sets sights on becoming Canada’s premier critical care hospital 14 National Treasure McGill University Health Centre's Glen site makes history

EMERGENCY PREPAREDNESS & RESPONSE 26 A Flood of Memories Alberta Health Services recounts 2013 natural disaster that took province by storm 28 Treading Water Steps to stay afloat when H20 supply is disrupted 30 Prescription for Disaster Failure to have proper crisis plans in place can have cataclysmic results

Karlee Roy karleer@mediaedge.ca

VICE-PRESIDENT PAST PRESIDENT TREASURER SECRETARY EXECUTIVE DIRECTOR

Mitch Weimer Preston Kostura Peter Whiteman Craig. B Doerksen Sarah Thorn Donna Dennison

CHAPTER CHAIRS

Newfoundland & Labrador: Brian Kinden Maritimes: Robert Barss Ontario: Roger Holliss Manitoba: Craig B. Doerksen Saskatchewan: Al F. Krieger Alberta: Tom Howard British Columbia: Steve McEwan FOUNDING MEMBERS

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

4 Cataraqui St., Suite 310, Kingston, Ont. K7K 1Z7 Telephone: (613) 531-2661 Fax: (866) 303-0626 E-mail: ches@eventsmgt.com www.ches.org Canada Post Sales Product Agreement No. 40063056 ISSN # 1486-2530

Committed to service excellence

Structural Restoration Structural Engineering Building Science Parking Facility Design

Read Jones Christoffersen Ltd. Engineers 4 CANADIAN HEALTHCARE FACILITIES

rjc.ca

performance solutions

A healthcare facility is more than just

a building, it saves lives.

Facility Development Solutions

Patient Safety Solutions

Operations Performance Solutions

Our coaches are experts in Infection Prevention & Control and Environmental Hygiene; together, we deliver solutions that accelerate your teams' performance and strengthen patient-safety.

HPS Tel: 905.361.8749 | Email: info@hygieneperformancesolutions.com | www.hygieneperformancesolutions.com IPAC Tel: 226.228.5550 | Email: info@ipacconsulting.com | www.ipacconsulting.com

EDITOR'S NOTE

HEALTHY DEVELOPMENT 2015 WAS A BUSY YEAR for hospital construction. Several high profile projects were completed, many of which have graced the pages of this publication. Of note is the new Humber River Hospital, which reached substantial completion in May. Five months later, on Oct. 18, North America’s first fully digital medical facility opened its doors.

Around that time, Five Hills Health Region readied itself for the opening of a new regional hospital in Moose Jaw, Sask. The $100-million project is the first to be built using the integrated lean project delivery process in Canada. Most recently, on Dec. 13, Halton Healthcare closed the doors on its Oakville Trafalgar Memorial Hospital to move to its new Oakville Hospital location — marking the end of one of the largest healthcare redevelopments in Ontario, and the beginning of a new era of healthcare delivery in the region.

In this issue we look at two healthcare developments — one newly opened while the other just broke ground. National Treasure delves into one of the largest construction projects and patient transfers in Canadian history. Covering an area of 20 city blocks, McGill University Health Centre’s newest addition, fondly called the Glen site, is also considered one of the most innovative academic health centres in North America. Also innovative is the St. Michael’s Hospital redevelopment project (pg. 12), which includes a new patient care tower, renovated emergency department and significant upgrades to improve the existing hospital space. Upon entire completion in 2019, St. Michael’s will achieve its goal of becoming the premier critical care hospital in the country.

From here we turn to a growing problem in healthcare facilities: acts of violence.

A Dangerous Time explores this issue and how staff can reduce the risk of such incidents occurring.

Continuing with the topic of workplace safety, we explore CSA Z8002, Operations and Maintenance of Health Care Facilities (pg. 24). Published in 2014, the first edition of this standard details the requirements for managing equipment and systems in all types of healthcare facilities to ensure the safety of building occupants.

Rounding out this issue, we look at the impact the great flood of 2013 had on Alberta Health Services facilities in the Calgary zone (pg. 26), water disruption best practices (pg. 28), and the importance of emergency management and business continuity planning (pg. 30).

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.

905.727.1901

www.thermogenicsboilers.com

PRESIDENT'S MESSAGE

DRIVEN TO SUCCEED 2015 WAS MARKED by great achievements for CHES, which is a testament to the leadership of now past president, Peter Whiteman, and the National board. Highlights include: introduction of a new CHES chapter in Saskatchewan; launch of the Canadian Certified Healthcare Facility Manager (CCHFM) program; ongoing success of the Canadian Healthcare Construction Course (CanHCC); appointment of our first two official CHES representatives to CSA Group subcommittees; and a number of outstanding chapter conferences. In particular, the 2015 CHES National Conference in Edmonton was a resounding success and has set the bar higher for future conferences.

At present, the B.C. Chapter conference team is hard at work planning the 2016 CHES National Conference in Vancouver. By all accounts so far, it is shaping up to be another success. The team is busy pouring over abstract submissions for the education sessions and developing interview questions that will help in the selection of the keynote speaker.

CHES continues to evolve at a great pace, driven by the strength and enthusiasm of its members. Our membership base is so strong now that we are seeing great competition for local chapter and National executive positions.

Several members have worked tirelessly behind the scenes to help drive our major accomplishments. Of note are Jeff Smith and Robert Barss, chair and Maritime Chapter representative of CHES’s professional development committee, respectively. They deserve recognition for their multi-year commitment to bringing the CCHFM designation program to completion. As the CHES executive liaison to the committee for the past two years, I know how much time and effort they put into this endeavour.

Not to be outdone, Saskatchewan’s Al Krieger and Peter Whiteman concluded almost five years of work to create a fruitful partnership with the Health Facility Resource Council (HFRC) of Saskatchewan. This concluded with a resounding vote by HFRC members to join CHES as our newest chapter.

Considerable work continues to be done to further CHES’s goals and objectives with partner organizations. We are working with the CSA Group to develop some of the best healthcare facility standards in the world, as well as in an advocacy role. While members have long been involved with the association, we recently took the next step with CSA to provide official CHES representatives for some of the standards. Ontario Chapter chair, Roger Holliss, and B.C. Chapter chair, Steve McEwan, are our representatives on the subcommittees for CSA Z7396.1, Medical Gas Pipeline Systems, and CSA Z8002, Operation and Maintenance of Health Care Facilities, respectively. I’d also like to congratulate Gordon Burrill, who served as CHES National president from 2003-2005, in his resounding appointment as the chair of the CSA technical committee for healthcare facility engineering and physical plant.

As you read this edition of Canadian Healthcare Facilities, please remember the journal relies heavily on information and articles from our membership. Please take some time to submit your editorial pitches to the MediaEdge team.

Mitch Weimer President, CHES National

8 CANADIAN HEALTHCARE FACILITIES

professional performance reports

Ch

artin Professio g nal lookin g ch

arts

Extract intelligence from your archived building data and make informed operational decisions with Reliable Controls ÂŽ RC-Reporter ÂŽ .

This fully customizable, server-based application allows you to analyse the trend data from any BACnet Internet-connected building, and generate professional performance reports, quickly and accurately. . . . people and technology you can rely on. ™

Member

www.reliablecontrols.com

CHAPTER REPORTS

ONTARIO CHAPTER

NEWFOUNDLAND & LABRADOR CHAPTER

The Ontario Chapter’s vice-chair, Jim McArthur, and I had an introductory meeting with the Firestop Contractors International Association (FCIA) Oct. 29, 2015. The goal of the meeting was to determine if there is value in developing a partnership between the two organizations. FCIA is looking to increase its presence in Canada, specifically Ontario. Overall, the take away was positive. There are plans to meet again in 2016, to share calendars so that each association can potentially participate in the other’s conferences.

The Ontario Chapter was approached to participate in PM Expo in Toronto, Dec. 2-4, 2015. The chapter’s secretary, John Marshman, and I accepted the offer to take part in a seminar — The Building Engineer of Tomorrow: How this Role is Evolving?

— that addressed the unique aspects of healthcare construction and renovation in Ontario.

The Ontario Chapter continues to support energy-saving initiatives with another financial contribution to the Healthcare Energy Leaders Ontario (HELO) program.

We are currently developing a CSA Z8002, Operation and Maintenance of Health Care Facilities, training day for Ontario Chapter members, to take place some time in early 2016.

The 2016 CHES Ontario Chapter Conference & Trade Show is progressing well now that we have locked in a location — Bingeman’s Conference Centre in Kitchener, Ont. The organizing committee and various subcommittees are making good headway, including coordinating a unique “Oktoberfest in spring” element.

The theme of the upcoming conference: Leading through Change.

—Roger Holliss, Ontario Chapter chair

The Newfoundland & Labrador Chapter has been operating with a vacant vice-chair position for some time now. We called for nominations on a number of occasions but were unsuccessful. It was decided at our last chapter executive meeting that current secretary, Colin Marsh, will assume the role of vice-chair. As a result, we now have a vacancy in the secretary position. We will call for nominations for this position in the coming months.

Our 2016 Professional Development Day will be held May 29-30 in St. John’s, Nfld. Planning for the event is ongoing so if there are specific topics that you’d like to see, please e-mail your suggestions to chesnl@outlook.com.

It is with great excitement that I inform you the chapter will host the 2018 CHES National Conference in St. John’s, Nfld. Over the coming months, we will be looking for members to sit on a planning committee for the conference. 2018 will be the second occasion that we have hosted the CHES National Conference. The last time was in 2009.

—Brian Kinden, Newfoundland & Labrador Chapter chair

SASK ATCHEWAN CHAPTER It was a busy fall for the Saskatchewan Chapter. Our annual general meeting, conference and trade show was held in Regina Oct. 25-27, 2015, at the Hilton DoubleTree. The event was well-received, with more than 40 delegates and 34 vendors in attendance. We were fortunate to have four significant sponsors this year: Stuart Olson, Hippo CMMS, Saskatchewan Masonry Institute and Aqua Air Systems Ltd. We thank them for their generosity. The trade show was also open to invited guests of vendors as well as the local healthcare community, with a free lunch for those who registered. This proved to be successful as the trade show was very busy. The conference kicked off with a tour of the new heliport at Regina General Hospital. The educational sessions were diverse but primarily targeted alternative project delivery methods. There are several different methods currently in use in Saskatchewan’s healthcare system so this was very relevant.

The Saskatchewan Chapter’s conference committee is already planning the 2016 conference and trade show, which will be held Oct. 23-25, in Saskatoon, at TCU Place. The focus will be rapidly changing technology in healthcare.

The chapter will host the 2019 CHES National Conference. The location and venue have not yet been determined but planning is currently underway.

—Alan F. Krieger, Saskatchewan Chapter chair 10 CANADIAN HEALTHCARE FACILITIES

MANITOBA CHAPTER The Manitoba Chapter offered two educational opportunities in 2015, the most recent in conjunction with the Manitoba Building Expo. On Oct. 6, the chapter presented an education session at the industry event, which is a partnership of the Building Owners and Managers Association (BOMA) Manitoba, Winnipeg Construction Association and the Mechanical Contractors Association of Manitoba. The Manitoba Chapter also supported the event by covering the cost of member attendance at the CHES-sponsored seminar, keynote luncheon with retired Gen. Rick Hillier and trade show. Ian MacDonald of RJ Bartlett Engineering Ltd. spoke to more than 30 chapter members and a dozen other conference attendees about fire safety in buildings under construction and during renovation. You can view the presentation slides at www.ches.org/chapters/ manitoba.html. I provided an overview of the impact the March 2013 fire had at the Health Sciences Centre (HSC) Winnipeg. As you probably recall, the fire was deliberately set at the construction site of HSC’s new diagnostic imaging centre, located adjacent to Children’s Hospital.

The 2016 Education Day is scheduled for April 28. The theme is “Energy Savings: Building Upon Past Success.” A committee comprised of the chapter executive, members and industry partners is in the final stages of selecting topics and speakers.

The Manitoba Chapter’s annual general meeting will take place in conjunction with the education day. There will likely be proposed bylaw changes to reflect current management practices.

These will be shared via e-mail prior to the meeting to provide members the opportunity to vote before or on April 28. We will elect new officers to the executive at this time as well. Please keep your eyes open for nomination information, which will also be sent via e-mail.

—Craig B. Doerksen, Manitoba Chapter chair

CHAPTER REPORTS

BRITISH COLUMBIA CHAPTER

MARITIME CHAPTER

Planning for the 2016 CHES National Conference in Vancouver is well underway. Most of the sponsorship opportunities are filled and more than half the booths are already booked. We are very pleased and excited to host the upcoming national conference at the Vancouver Convention Centre. I hope everyone is able to set a little time aside to visit this world-class city.

The B.C. Chapter has renamed the Okanagan College education bursary in honour of Graham Baker, for his long-time dedication and support of education during his involvement with CHES. On Nov. 19, 2015, chapter secretary, Sarah Thorn, and Graham’s wife, Coralynn, attended the awards ceremony at Okanagan College in Kelowna, B.C., to honour the student by celebrating with donors, other award recipients and the college foundation. The 2015 grant recipient — the first to be awarded the bursary under Graham’s name — is studying power engineering.

—Steve McEwan, British Columbia Chapter chair

The Maritime Chapter hosted a successful Education Day Nov. 17, 2015, in Truro, N.S. The event attracted more than 80 registrants from across the healthcare sector. Registration was free, with the chapter picking up the cost thanks to the support of several vendors. Session topics covered: testing for and prevention of legionella; infection prevention and control best practices; preventive maintenance and insurance; updates to fire codes; and energy management in healthcare facilities.

The 2015 recipient of the $1,000 Per Paasche bursary was Kyle Bouchie, son of Maritime Chapter member, Joe Bouchie. Joe is the environmental director at R.K. MacDonald Nursing Home in Antigonish, N.S. The Maritime Chapter has been actively encouraging participation of New Brunswick’s Vitalité Health Network. The response has been reassuring and we are hopeful it will lead to an increase in membership and involvement.

The conference planning committee is working on the program for the 2016 CHES Maritime Chapter Spring Conference & Trade Show to be held May 15-17 in Moncton, N.B. It is also in the process of developing a planning manual.

Following the conference, the chapter will host a Canadian Healthcare Construction Course (CanHCC) May 18-19.

Members are encouraged to speak with their contractors regarding attendance at this program.

The Maritime Chapter has been able to balance its books while offering several financial incentives to its members. Assets are approximately $46,000.

The chapter executive has approved the following motion: Should a Maritime Chapter member hold the chair position of a National committee at the time of a CHES National Conference, the chapter will reimburse the member for expenses so that he/ she can attend the conference and lead the only annual committee face-to-face meeting as well as participate in other conference meetings, as required. This policy will be reviewed and approved annually by the chapter executive.

—Robert Barss, Maritime Chapter chair

ALBERTA CHAPTER I’d like to thank again everyone who supported the 2015 CHES National Conference in Edmonton. We are looking forward to the next national conference and know the B.C. Chapter will do us proud.

The Alberta Chapter executive is expected to meet in early 2016, to plan for the year ahead. The executive team is considering moving the chapter’s yearly conference to spring (from late October). We will look at how this will impact the 2016 Clarence White Conference & Trade Show. At this time, we don’t have a date for the event. We will update members once plans are confirmed..

Alberta Health Services will have a new CEO in 2016. We will introduce the new incumbent to CHES and all the benefits we can continue to provide. With change comes opportunity, and it looks like 2016 will be full of both.

—Tom Howard, Alberta Chapter chair

BOTTOM LEFT: Celebrating National Healthcare Facilities & Engineering Week in the Maritimes. Left to Right: Shawn Langley, Daniel Moore, Mike Eisnor, Randall Harnish and local chapter chair, Robert Barss. BOTTOM RIGHT: Ian MacDonald of RJ Bartlett Engineering Ltd. spoke candidly during the CHES-sponsored seminar on fire safety during construction and renovation at the 2015 Manitoba Building Expo.

WINTER/HIVER 2015/2016 11

s

HEALTHCARE DEVELOPMENT

BREAKING NEW GROUND St. Michael’s Hospital sets sights on becoming Canada’s premier critical care hospital

By Kate Manicom

D

owntown Toronto’s St. Michael’s Hospital, which sees 750,000 ambulatory and diagnostic visits and performs more than 30,000 surgeries annually, has begun an ambitious redevelopment project to transform patient care. It includes a new 17-storey patient care tower, renovated and expanded emergency department, new front entrance with a spacious light-filled lobby, and renovated ambulatory care areas. Senior-friendly design, infection prevention and control measures, and patient safety are critical to the plans.

BUILDING UP AND OUT

The Peter Gilgan Patient Care tower has been specifically designed to care for critically 12 CANADIAN HEALTHCARE FACILITIES

ill patients —from those requiring emergency surgery to patients being treated in the orthopedics unit. It will also have enlarged in-patient facilities for oncology and respirology, and expanded intensive care units (ICU) for coronary and medicalsurgical patients. The tower’s new operating rooms will be large enough to include stateof-the-art medical imaging equipment, such as CT scanners and angiography.

Renovations to existing hospital space will nearly double the size of the emergency department and replace the 100-year-old Shuter wing with a new three-story structure on the corner of Bond and Shuter streets.

Originally designed to accommodate 45,000 patient visits per year, the emergency department now sees more than 75,000 a

HEALTHCARE DEVELOPMENT

s TOP LEFT: View of the interior of the Element Financial Atrium from the second floor. TOP RIGHT: Inside the hospital's new light-filled lobby located at the corner of Queen and Victoria streets.

year — a number that continues to grow with the downtown Toronto population.

The emergency department will be renovated to meet the needs of St. Michael’s unique patient population — which ranges from trauma victims to people with mental illness and other vulnerable residents of the inner city — and to accommodate changes in technology (the department was last renovated in 2000). It will include larger and more private patient treatment areas, on-site diagnostic imaging, including a CT scanner, and a larger rapid assessment zone — a special section for more efficient diagnosis and treatment of lower acuity patients.

One of the most notable changes will be the addition of a dedicated mental health area — a quiet, soothing and secure section, physically separated from the rest of the emergency department. It will be staffed 24-7 by dedicated, specially trained crisis workers and healthcare providers.

SENIOR-FRIENDLY AND SAFE

St. Michael’s took the opportunity to integrate best practices in infection prevention and control measures and seniorfriendly design into the redevelopment project to improve patient safety and enhance the care experience.

All in-patient rooms in the new tower will be single-occupancy. This not only reduces the transmission of healthcare-acquired infections but also provides more privacy for patients. All rooms will have dedicated comfortable space for families and caregivers, which enables them to be more involved in care, leading to better patient outcomes. The

rooms will also have greater access to natural light, which has been shown to promote overall health and reduce the risk of falls.

Hospital planners applied Code Plus Senior Friendly Design standards to meet the unique needs of elderly patients and visitors.

These evidence-based guidelines take into consideration how well a physical environment is equipped to address the developmental needs of older adults and promote safety, independence and functional well-being for aging patients and visitors.

An important feature incorporated into the design is rubber flooring, which is matte.

Shiny floors can appear to some, particularly those with dementia, as being wet, causing confusion. Rubber flooring is also non-slip, which helps to prevent falls, and reduces noise and echoes, creating a quieter and calmer environment.

The atrium in the new patient care tower, which is intended to be the heart of the hospital, will bring 10-storeys of natural light into the building, improving visibility when entering and exiting. Maintaining a gradual change in lighting is important in helping reduce confusion, disorientation and problems with depth perception.

The project will also include improvements in areas of the hospital that see high levels of older patients, such as the coronary ICU and the orthopedic in-patient unit. For example, while the current orthopedic in-patient unit has narrow hallways that are obstructed by equipment, its future home in the new tower will be more spacious. Wider corridors, larger patient rooms and fully accessible washrooms will help orthopedics patients

recovering from surgeries affecting their mobility to better navigate the hospital.

FINDING THE WAY

In addition to the transformations in care that will be generated by the redevelopment, the project also includes improvements in the way patients, visitors and staff will navigate the hospital.

These changes will be evident from the moment people arrive at the newly created main entrance to the hospital. Walking through, they’ll find themselves in a lightfilled, welcoming lobby with information desk front and centre for those who need help finding their way. Digital wayfinding tools will also be available to bolster communication.

From here, a new pedestrian highway will run throughout the first floor. This artery will connect the new lobby with the historic Bond Street lobby, and improve wayfinding between the hospital’s wings.

Along with better navigation across St. Michael’s will be improved access to the hospital’s upper levels with the installation of 10 new elevators. With separate, designated elevator banks for visitors and ambulatory patients, patient transfer and hospital services, people travelling among the hospital’s 17 storeys will be able to reach their destinations quickly and easily.

Kate Manicom is a communications advisor at St. Michael’s Hospital, one of two adult trauma centres in the Greater Toronto Area (GTA). St. Michael’s is also a teaching and research hospital fully affiliated with the University of Toronto.

WINTER/HIVER 2015/2016 13

HEALTHCARE DEVELOPMENT

NATIONAL TREASURE Montreal’s MUHC hospital makes history

By Elizabeth McPhedran

W

hat should the future of healthcare in Montreal look like?

This was the question that focused the attention of McGill University Health Centre’s (MUHC) leadership more than 20 years ago when they began planning a new health centre. Accustomed to working in turn-of-the-century buildings where medical practices had outgrown the spaces in which they were performed, they visualized building a consolidated, modern, healthcare facility. The goal was to provide quality acute services across the age spectrum in order to meet the present and future needs of health care. The outcome: One of the largest construction projects and patient transfers in Canadian history.

This new hospital complex, fondly referred to as the Glen site, was built on the former Glen railway yards in Montreal’s Notre-Dame-de-Grâce neighbourhood. It is now home to three legacy hospitals — Royal Victoria Hospital, Montreal Children’s Hospital and Montreal Chest Institute — as well as the new Cedars Cancer Centre and the Research Institute of the MUHC. Before the moves, these legacy hospitals had been providing, cumulatively, 350 years of 14 CANADIAN HEALTHCARE FACILITIES

renowned experience at independent sites in Montreal.

TOURING THE GLEN

The site itself is tremendous, covering an area of 20 city blocks. The facility is 2.5 million square feet and contains more than 12,500 rooms. At its highest point, the building reaches 14 floors and is accessible via 58 elevators.

Each of the facility’s 500 single-patient rooms comes with a private washroom, large windows, fold-out sofa for comfortable family stays and ample space for healthcare teams to work.

The Glen site also houses $255 million worth of cutting-edge new equipment that allows employees to carry out their tertiary and quaternary care mandate.

Moreover, the building is LEED (Leadership in Energy and Environmental Design) silver certified — a reflection of MUHC’s commitment to serving as an example of responsible environmental stewardship within the healthcare sector.

BUILDING A SUPERHOSPITAL

Designing a building of this size was a herculean endeavour. Hospital planners

spent years meeting with experts to ensure the new space met the latest standards in hospital care and scientific research. Among these experts were 800 MUHC employees, who were consulted throughout every step of the process in order to build an environment that reflected their departmental needs. Not only did this allow staff to feel more at home in their new environment but it also was an exercise in reflection and cooperation that brought many interdisciplinary teams together.

The planning department also visited several academic health centres around the world in search of inspiration. Seeing the ways in which other modern hospitals conceptualized their environments allowed the MUHC to explore different models and define best practices along the way. It was also a chance to learn from the mistakes made by other institutions and, as a result, sidestep possible pitfalls.

Once consolidated, the plans were handed over to the McGill Healthcare Infrastructure Group, a consortium led by SNC-Lavalin who is the private partner responsible for the project’s design, construction, financing and maintenance for 30 years. Construction began in June 2010,

Is your air in need of intensive care?

Ensure optimal indoor air quality with state-of-the-art solutions from Clinicair.

Today’s buildings are so sealed to the elements that dust, humidity, volatile organic compounds and hidden gases gets trapped inside.

And unless treated properly and regularly, this air can become a reservoir for potentially unsafe contaminants and irritants for workers and visitors alike. Trust Clinicair to provide state-of-the-art services specially designed to have everyone breathing easier.

• Medical Grade Duct Cleaning • Indoor Air Quality & Mould Testing • Superior Filtration Solutions

Contact Clinicair today to schedule medical-grade duct cleaning and indoor air quality assessment services from Canada’s only professional air quality specialists.

For a free estimate call 905-465-3312 Toll Free: 1-877-318-3588 • clinicair.ca CLINICAIR IS PROUD TO OFFER PROUD MEMBER OF

s

HEALTHCARE DEVELOPMENT

A convoy of ambulances and other reserved vehicles transported more than 270 patients during five separate move days to the new MUHC Glen site.

took just over four years to complete and cost a total of $1.3 billion dollars.

PREPPING FOR OPENING DAY

With final construction complete in November 2014, and the first patient move less than six months away, the task of activating the site began.

The aim of any activation period is to ensure the new hospital is fully functional before it begins clinical operations. In order to carry out this task, staff identified as “early activators” were selected to go to the Glen site and inspect their respective areas to confir m everything was in working order. From light switches to equipment, every last detail had to be tested and deemed ready before patients arrived.

Another important part of hospital activation was training and orienting the 8,500 staff. Daily general orientation sessions and site tours were organized for 200 staff at a time over a span of several months, in addition to numerous departmental and equipment-specific training sessions.

Clinical simulations were vital to the activation process. Simulations comprised of interdepartmental groups that mimicked flow during critical situations from one area of the hospital to another to determine best practices and optimal routes. For example, they helped to identify the fastest route from 16 CANADIAN HEALTHCARE FACILITIES

an in-patient room to the intensive care unit, and which elevator should be used in an emergency by the code blue team.

Throughout the simulations, important protocols and responsibilities were discussed, refined and validated to ensure readiness before the move.

During the entire process, staff was guided by Health Care Relocations (HCR), a Canadian company hired by the MUHC that specializes exclusively in the transfer of healthcare facilities.

Two years of preparation with HCR went into this move, over which time its team of employees assisted with activation services, physical relocation of equipment, and patient transfer planning and execution. In all, HCR called the Glen site the most complex undertaking in its history.

THE BIG MOVE

Physically moving three fully functioning hospitals and their patients from one location to another required 16 months of meticulous planning and training. In the weeks leading up to each hospital move, certain clinical activities progressively diminished in order to reduce the number of patients to be relocated. This also gave each department time to transfer equipment and set up in the new facility. Though activity levels slowly

decreased, staff maintained the same medical care throughout the move.

Each hospital’s patients were transferred in a single day and the process used for each hospital followed the same formula, with patient safety being the number one priority.

Starting at 5 a.m. on a Sunday, the new hospital officially opened its doors while the emergency department at the former hospital simultaneously closed. Throughout the patient transfer process, both sites were fully operational and able to provide care, with working operating rooms, a birthing centre, laboratories, medical imaging capacities, a pharmacy and admitting services open until the last patient had left the building.

Beginning at 7 a.m., one patient was transferred every three minutes using a fleet of ambulances and medical transfer vehicles. The health of every patient was evaluated before departure, and each was accompanied in the ambulance by a nurse and, if necessary, a respiratory therapist or physician. From bed to bed, the trip took on average 30 minutes to complete (depending on the hospital). Police were positioned along the route to manage traffic flow and ensure the safe passage of medical vehicles.

As many as 2,500 staff members were on hand at any given time to help coordinate different aspects of the move. In total, there were 20 teams of hospital workers wearing colour-coded T-shirts to identify their role and help manage logistics flow. During the transfer, social workers were ready to liaise with families and notify them of the arrival of their relative at the new site.

In total, the MUHC safely transferred 273 patients during five separate move days with the help of 12,000 staff. These events represent a historic undertaking, the final chapter to a successful project and a great investment in the future of health care for the people of Montreal and Quebec.

Elizabeth McPhedran is a communications officer at the McGill University Health Centre.

SAVE THE DATE! The CHES 2016 National Conference will be held in Vancouver BC at the Vancouver Convention Centre (VCC), September 11-13, 2016. The VCC features a harbor front location and breathtaking views of one of the most beautiful settings in the world.

A block of rooms has been reserved at the Pan Pacific Vancouver at the rate of $189 plus applicable taxes single/double occupancy. The Pan Pacific is located “on the water” with spectacular water & mountain views and walking distance from cosmopolitan restaurants, world class shopping and countless entertainment options.

The theme of the 2016 conference is “RISKY BUSINESS: Is Healthcare Sustainable?”

The CHES 2016 Education Program is still under development but will once again feature dual tracks with talks on relevant industry topics from high-profile experts in the field.

Join us for the CHES President’s Reception and Gala Banquet again in 2016! The banquet will celebrate the accomplishments of our peers with the 2016 Awards presentations, while enjoying great food and entertainment with friends.

We look forward to seeing you in Vancouver in 2016!

For more info visit our website at www.ches.org Follow us on Twitter!

@CHES_SCISS

SAFETY & SECURITY

A DANGEROUS TIME Tackling growing violence in healthcare facilities

By Don MacAlister

T

here is mounting evidence that violence in the healthcare sector is on the rise. According to recent research released by the International Association for Healthcare Security and Safety (IAHSS), the violent crime rate per 100 U.S. hospital beds increased by 25 per cent from 2012 to 2013, while the rate of disorderly conduct incidents rose 40 per cent during the same time period.

In Canada, approximately one-third of nurses report being physically assaulted over the course of a year, according to a Statistics Canada survey.

The World Health Organization reports that most violence is perpetrated by patients and visitors. Healthcare workers most at risk include nurses and other staff directly involved in patient care, emergency room staff and paramedics.

Between eight and 38 per cent of healthcare workers will suffer physical violence at some point in their careers.

Violence may occur anywhere in a hospital but it is most frequent in the emergency department and on in-patient 18 CANADIAN HEALTHCARE FACILITIES

mental health wards, where patient behaviour is less predictable and, in the case of the emergency department, sometimes fuelled by alcohol and/or drugs. Residential care facilities are especially at risk for violence as a result of the increasingly high residentto-staff ratio and number of cognitively impaired residents who are more likely to assault staff and other residents than their cognitively intact counterparts.

DEEP IMPACT

To reduce the potential for violent incidents, healthcare facilities should develop and implement a workplace violence program.

This type of program is required in most jurisdictions by the regulatory agency that governs workers’ safety. Accreditation Canada, the independent inspecting body that does peer reviews, also requires processes be in place to mitigate the risk of violence. The healthcare facility must have a policy that defines its position on violence.

Risk assessments must be conducted, and violent incidents reported and tracked.

Investigations related to worker injuries or

near misses must be conducted with findings often resulting in changes to some aspect of the workplace violence program.

Perhaps no aspect of the workplace violence program is more important than staff training and education on preventing and managing aggressive behaviour. Staff, including security personnel, need to be trained for the level of risk associated with their work area. This helps employees recognize warning signs of potential aggressive behaviour and intervene early in an escalation of behaviour, where possible, using both verbal and non-verbal techniques.

The training also focuses on personal safety, allowing staff to avoid physical injury until support can arrive.

That support is often in the form of a code white team — staff, including security personnel where possible, that is specially trained to manage and, if necessary, physically restrain the aggressor until the behaviour is controlled. Ideally, this is a multi-disciplined team, bringing diverse skills and experiences to the situation. The code white team should train and practice together, debrief after

IS YOUR BOTTOM LINE FEELING THE HEAT?

TAKE AIM ON ENERGY AND HEAT LOSS.

Properly installed mechanical insulation saves energy and tons of money. Schedule an energy audit with one of our techs.

We can quickly show you the savings and payback using data from the thermal imaging gun which is uploaded to the 3e Plus Energy Software.

IS YOUR FACILTY WASTING MONEY?

The

PAYBACKS IN AS LITTLE AS 3 MONTHS! WE’RE SHOVEL READY TO SAVE, ARE YOU?

INSULATION SAVES AMERICA VALUABLE ENERGY

855-88-ISAVE

www.iSAVETEAM.org

Team

SAFETY & SECURITY each incident and annually refresh training. Including security in team training is important, not only to help ensure a cohesive response in a code white situation but also to embed a patient-centric philosophy rather than a police-centric focus in their response to aggression.

CAUSE FOR ALARM

Other risk mitigation measures can be built into an organizational response to prevent and manage violent behaviour.

Flagging patient electronic records or charts, or denoting the patient name on the room entry log are methods commonly used to let staff know a particular patient may have a propensity for violence, allowing them to take appropriate precautions. In a large healthcare organization, an electronic medical record that is flagged through the admitting process at one hospital can be leveraged across multiple institutions, mitigating risk if a patient goes to more than one site seeking treatment.

Infection Control Sink Designed specifically to minimize splashing and reduce the spread of infectious disease.

ADA Compliant

WILLOUGHBY WICS SERIES

Offset drain position keeps water from splashing directly into drain and aerosolizing contents of the trap.

Oversized backsplash has coved edges and helps to keep water contained and flowing toward drain.

Sloped rear basin wall minimizes splashing of water stream and creates circuitous flow to drain.

Aquasurf® solid surface color options:

Sandstone

Bone

Red Coral

Black Granite

White Granite

Grey Granite

Glacier White

Nocturnal Blue

Sea Green

800.428.4065 | www.willoughby-ind.com 20 CANADIAN HEALTHCARE FACILITIES

© 2014 Willoughby Industries Inc.

» Information sheet and REVIT files are available at willoughby-ind.com

The risk assessment may also drive the requirement for duress or panic alarms, allowing staff working in higher risk areas to immediately generate a call for assistance and response from security and/or the code white team. Depending on the system, these alarms may be carried by staff and/ or fixed in accessible locations. Critically, these devices must be regularly tested and maintained.

LETHAL WEAPON

For security and facilities professionals, the hospital’s physical environment plays an important role in mitigating the risk of violence. The IAHSS’s Security Design Guidelines for Healthcare Facilities provide guidance for the use of duress alarms, security cameras and access control technology, as well as assist hospital planners with the creation of zones of separation to mitigate safety and security risk, including violence.

The emergency department guideline, for example, emphasizes the separation between the front-of-house (public area) and back-ofhouse (treatment area), and describes appropriate design measures to ensure the safety of staff in each of those spaces. A seclusion room is also recommended, reflecting the need to have enough space outside a room to allow a code white team to safely operate.

Given recent world events, there is increasing emphasis on healthcare facilities being able to respond in the rare but catastrophic event of an active shooter. The philosophy “run, hide, fight” that is prevalent in most active shooter plans does not fit well in a healthcare setting where many patients are non-ambulatory. Instead, the focus is on developing a strong restricted access plan, referred to in some organizations as lockdown. Hospital leadership should have the capacity to secure their facility from external access and, ideally, be able to secure specific areas of the building, through a series of secured pods or compartments. In many hospitals, much of this is already in place with already securable paediatric and maternity units, intensive care units, operating room suites and mental health units.

Don MacAlister is COO for Paladin Security, the largest provider of healthcare security services in Canada. Don is a certified healthcare protection administrator (CHPA) and has worked in both public and private sector healthcare emergency management and security for more than 25 years.

Canadian Healthcare Construction Course Presented by the

Canadian Healthcare Engineering Society in partnership with ASHE.

Saskatoon SK – January 26-27, 2016 Moncton NB – May 18-19, 2016 Vancouver BC – September 14-15, 2016 Toronto ON – October 20-21, 2016 Check website www.ches.org for other dates & locations that may be offered in the future.

Registration is available online.

For further information:

CHES National Office Tel: 613-531-2661 | Fax: 866-303-0626 ches@eventsmgt.com | www.ches.org 4 Cataraqui Street, Suite 310 Kingston ON K7K 1Z7 Canada

www.ches.org

SUSTAINABILITY

Rx FoR Hospital secuRity

Protect your hospital environment. Keep your patients, property, staff and visitors safe with Commissionaires team of dedicated security professionals.

Commissionaires offers: • Security guarding • Parking control • Mobile patrol • Access control/reception • Courteous, professional customer assistance You can count on Commissionaires. Many are former military and ex-RCMP, superbly trained and experienced to respond to your security needs.

Call Commissionaires today 877 322 6777 | commissionaires.ca/healthcare

Untitled-3 1

15-02-26 11:24 AM

CHANGE YOUR CURTAINS

Ad: Rx For Hospital Security Publication: Canadian Healthcare Facilities Size: Half page horizontal, Live area: 7.125” x 4.75” + trim and bleed THIS IS FOR PLACEMENT AT TOP OF PUBLICATION Language: English Print: CMYK Created: January 2015 • Insertion date: Spring issue, 2015 Please contact Utopia Communications Inc. 613 837 5201 or donna@utopiacommunications.com if there are any problems.

IN UNDER A MINUTE THERE ARE BETTER WAYS TO USE YOUR TIME.

On The Right Track® cubicle curtains can be replaced in under a minute, without the use of a ladder.

+150K BEDS SOLD

1 MIN

“On The Right Track cubicle curtain system is one of the best new inventions for healthcare of this decade.”

LAURIE DACCARETT CONSTRUCTION MANAGER

22 CANADIAN HEALTHCARE FACILITIES

Take a look at our recyclable options for your highinfection areas.

Call 1(800)361-4964 or visit www.mipinc.com/OTRT.

ADVERTORIAL

What is a school doing in a hospital?

As 2015 draws to a close, major changes are taking place in Canada’s largest hospital network. University Health Network and The Michener Institute for Applied Health Sciences are about to integrate, creating a Canadian first, “Made in Ontario” Mayo Clinic model of education solutions for health care.

E

ducation is one of the three necessary pillars of health care, along with research and clinical practice. Beginning in late 2014, the Boards and leadership teams of Michener and UHN came to see how the Ontario health system will benefit from having health labour force planning informed by experts in education design. This would create the capacity to rapidly adapt health professional training to meet pressing challenges observed in the clinical setting, and to seize new opportunities for innovative health care education solutions identified through research.

Maureen Adamson, President and CEO of The Michener Institute, answers the key questions about integration with UHN: How did the integration conversation get started?

The conversation actually started in the late 1950s, led by our founder, Maureen Adamson, President Dr. Diana Michener Schatz. She was and Chief Executive Officer at ahead of her time in recognizing that The Michener Institute the way allied health practitioners were being taught was out of step with how medicine was being practiced and with the rapid advances in medical and computer technology. Learning from her legacy, we saw the value in bringing education back to the clinical site and creating ‘real-time’ education solutions that can be diffused expeditiously across Ontario.

What did it take to get it done?

As with any major organizational change, getting buy-in requires demonstrating the benefits of change to those who will contribute to a successful outcome. We had little problem convincing anyone this model would strengthen the role of education as a fundamental part of Ontario’s health system, while improving quality care and patient safety. All levels of government have been supportive and enthusiastic, and our respective Boards and executive teams have worked solidly together to design a shared governance model that draws on the strengths of both organizational structures toward our shared goal.

How does this integration benefit the health system?

Strengthening the role of education as a fundamental part of

Ontario’s health system has a number of concrete benefits. It helps ensure quality care and patient safety by translating learnings in the clinical environment very quickly into curriculum for our full-time programs and our continuing education programs for current health care professionals. Similarly, it provides a structure for translating health care research and technological advances into curriculum, which allows us to seize new opportunities for innovative health care education solutions.

This integration also creates the capacity to put students in the clinical setting far earlier, and with more clinical placement opportunities across the system. Michener students will get better access to state-ofthe-art technologies and some of the brightest minds in the applied health sciences professions. Students are groomed to be health care system leaders.

What’s innovative about this health care project?

This is an agile, ‘real-time’ method of education. Michener has been the Ontario health system’s go-to for nimble curriculum design for more than 50 years, and now we’re matching that strength to the real pace of health care innovation and research, meeting health system needs in real time, where and when they arise.

How do you see integration shaping the future of health care in Canada?

I see this as beyond health care, to be honest. In consulting with our partners and stakeholders over the course of the summer, we heard that this model of integrating education into the practice setting could benefit all public sectors. We’re taking a systems approach, looking at what capabilities will be required in the health care system of the future and applying our combined expertise to be prepared.

For example, advances in personalized medicine and vastlyincreased access to genetic testing have changed the nature of the diagnostic testing professions. We’ve already redesigned programs and curriculum to prepare that new hybrid health professional for the workplace. Working within the country’s largest hospital network and research hub, we’ll translate the knowledge from our combined expertise and experience into a health work force that is continually ready for evolving health system needs.

SAFETY & SECURITY

THE GOLD STANDARD

CSA Z8002 sets out core requirements for managing healthcare facilities

By Clare Tattersall

N

o one wants to go to hospital but once there patients rightfully expect safe and efficient care.

Responsibility for this extends beyond the hospital’s healthcare practitioners to operations and maintenance personnel who ensure the facility, its systems and equipment perform their intended function. If the built environment and its functions are not performing as they should, then the safety of not just patients but hospital visitors and staff may be seriously compromised.

program, or COMP, which aims to identify healthcare facility equipment and systems that require operation and maintenance and to make sure each element is continuously supported and monitored.

“The program was developed to ensure staff members are not only trained but to make sure testing protocols are being carried out on a regular basis,” says Bill Carson, chair o f t h e s t a n d a r d ’s t e c h n i c a l subcommittee. “This confirms (staff is)

“IT’S HARD TO GET FACILITIES MAINTENANCE STAFF OUT OF THEIR BUILDING FOR ANY LENGTH OF TIME BECAUSE THEY’RE IN SUCH HIGH DEMAND, SO THE COURSE WAS DESIGNED TO BRING TRAINING TO THEM.” In an effort to ensure maximum safety at Canada’s hospitals, the CSA Group developed a standard specifically geared to operations and maintenance staff — facility and maintenance directors, managers, supervisors and maintenance personnel, healthcare facility design engineers, contractors, infection prevention and control personnel, facilities management companies, risk managers and quality systems personnel. Aptly named Operation and Maintenance of Health Care Facilities, CSA Z8002 sets out specific requirements for building and architectural systems, mechanical and electrical systems, building services, interfaces for clinical equipment, isolation and operating rooms, and internal and external operations and maintenance staff. It also establishes a framework for operations and maintenance procedures in all types of healthcare facilities, from hospitals to stand-alone clinics.

At the core of the standard is the coordinated operation and maintenance 24 CANADIAN HEALTHCARE FACILITIES

operating in accordance with design requirements and in a safe manner within the healthcare facility.”

CSA Z8002 joins two other standards — CSA Z8000, Canadian Health Care Facilities: Planning, Design and Construction, and CSA Z8001, Commissioning of Health Care Facilities — to comprise a comprehensive suite of solutions for the full life cycle of a healthcare facility. It is available in two formats, hardcopy and PDF, or facility management personnel can take a standard-based course. Delivered on-site and customtailored to meet the facility’s specific requirements, the training program helps personnel understand the standard and apply it effectively in their buildings. “ I t ’s h a rd t o g e t f a c i l i t i e s maintenance staff out of their building for any length of time because they’re in such high demand, so the course was designed to bring training to them,” explains the chair of the CSA technical committee for healthcare

facility engineering and physical plant, Gordon Burrill, who is also a course instructor. “There are nine modules from which to choose that take staff and expert technicians through the process of developing an effective operations and maintenance plan for each technical area.”

T h e s e a r e a s i n c l u d e : H VAC maintenance; maintaining pressure critical rooms, including isolation rooms; maintenance for medical gas systems; plumbing maintenance; maintenance standard operating procedures for infection prevention; general electrical systems maintenance and arc flash protection strategies; flood response in healthcare facilities; testing and maintaining steam sterilizers in healthcare settings; and generator maintenance.

Each training module is one hour in length. All nine modules can take two days in total to complete.

In addition to this training program, the CSA Group is working with the Canadian Healthcare Engineering S o c i e t y ( C H E S ) t o p r ov i d e a n education session on the standard at the society’s 2016 National Conference in Vancouver. CHES sponsored a workshop on CSA Z8002 in 2014, following that year’s National Conference in Saint John, N.B., and presently provides the top 10 CSA healthcare standards (which includes CSA Z8002) free to CHES members in support of their quest to keep up code compliance.

“Maintenance and operations personnel sometimes struggle to keep current with the massive amount of code and everchanging regulatory requirements,” says CHES National president, Mitch Weimer. “CSA Z8002 is a key standard to help guide them towards overall regulatory awareness. After all, without the awareness of your shortcomings, you cannot take action.”

IRC_CHF_Fall_2015_FINAL.pdf

1

2015-10-13

11:28 AM

Call TODAY!

IRC Building Science Group

1-800-607-5245

Building Science Engineers & Consultants

info@ircgroup.com

ROOF CONSULTING • STRUCTURAL ENGINEERING • BUILDING ENVELOPE ENGINEERING • PAVEMENT CONSULTING

Know Your Building Outside In.

www.ircgroup.com

Serving Canada With Regional Offices From Coast To Coast

䰀漀瘀攀 栀攀愀氀琀栀挀愀爀攀 戀甀琀 昀攀攀氀 氀椀欀攀 礀漀甀ᤠ爀攀 眀攀愀爀椀渀最 琀栀攀 眀爀漀渀最 甀渀椀昀漀爀洀㼀

圀攀 挀愀渀 栀攀氀瀀 ⸀⸀⸀ 䤀昀 礀漀甀 氀漀瘀攀 栀攀氀瀀椀渀最 瀀攀漀瀀氀攀Ⰰ 戀甀琀 栀愀瘀攀渀ᤠ琀 昀漀甀渀搀 琀栀攀 爀椀最栀琀 渀椀挀栀攀 昀漀爀 礀漀甀爀猀攀氀昀 椀渀 琀栀攀 椀渀搀甀猀琀爀礀Ⰰ 礀漀甀 猀栀漀甀氀搀 挀漀渀猀椀搀攀爀 愀 挀愀爀攀攀爀 椀渀 䠀攀愀氀琀栀 䤀渀昀漀爀洀愀琀椀漀渀 䴀愀渀愀最攀洀攀渀琀 ⠀䠀䤀䴀⤀⸀ 䌀䐀ⴀ䔀䐀 洀愀欀攀猀 椀琀 攀愀猀礀 琀漀 琀爀愀椀渀 漀渀 礀漀甀爀 琀椀洀攀 昀爀漀洀 礀漀甀爀 漀眀渀 栀漀洀攀 愀渀搀 琀爀愀渀猀椀琀椀漀渀 眀椀琀栀 挀漀渀ǻ搀攀渀挀攀 琀漀 琀栀攀 渀攀眀 挀愀爀攀攀爀 瀀愀琀栀 礀漀甀ᤠ瘀攀 戀攀攀渀 氀漀漀欀椀渀最 昀漀爀⸀ 圀攀 漀û攀爀 䌀漀洀瀀氀攀琀攀 ˻攀砀椀戀椀氀椀琀礀 ᐠ 洀愀渀愀最攀 猀挀栀漀漀氀 愀爀漀甀渀搀 昀愀洀椀氀礀Ⰰ 眀漀爀欀 愀渀搀 漀琀栀攀爀 爀攀猀瀀漀渀猀椀戀椀氀椀琀椀攀猀 ㈀㐀⼀㜀 猀甀瀀瀀漀爀琀 瘀椀愀 攀洀愀椀氀Ⰰ 挀栀愀琀Ⰰ 漀渀氀椀渀攀 挀氀愀猀猀爀漀漀洀 眀攀戀椀渀愀爀猀 ☀ 琀漀氀氀ⴀ昀爀攀攀 瀀栀漀渀攀 挀愀氀氀猀 䜀爀愀搀甀愀琀攀猀 栀愀瘀攀 愀挀栀椀攀瘀攀搀 愀渀 椀渀搀甀猀琀爀礀 氀攀愀搀椀渀最 猀甀挀挀攀猀猀 爀愀琀攀 漀渀 琀栀攀椀爀 渀愀琀椀漀渀愀氀 挀攀爀琀椀ǻ挀愀琀椀漀渀 攀砀愀洀椀渀愀琀椀漀渀猀 倀爀漀昀攀猀猀椀漀渀愀氀 挀愀爀攀攀爀 琀爀愀椀渀椀渀最 昀爀漀洀 椀渀搀甀猀琀爀礀 攀砀瀀攀爀椀攀渀挀攀搀 椀渀猀琀爀甀挀琀漀爀猀 匀琀愀爀琀 搀愀琀攀猀 愀瘀愀椀氀愀戀氀攀 攀瘀攀爀礀 洀漀渀琀栀 倀爀漀昀攀猀猀椀漀渀愀氀 挀愀爀攀攀爀 瀀氀愀挀攀洀攀渀琀 猀甀瀀瀀漀爀琀 䘀椀渀愀渀挀椀愀氀 愀椀搀 昀漀爀 琀栀漀猀攀 眀栀漀 焀甀愀氀椀昀礀 䤀匀伀 㤀 ㄀ 刀攀最椀猀琀攀爀攀搀 䌀漀氀氀攀最攀 䌀愀氀氀 漀爀 攀洀愀椀氀 琀漀 猀瀀攀愀欀 眀椀琀栀 漀甀爀 䄀搀洀椀猀猀椀漀渀猀 刀攀瀀爀攀猀攀渀琀愀琀椀瘀攀

㄀ 㠀㘀㘀 㐀㐀㘀 㔀㠀㤀㠀 椀渀昀漀䀀挀搀ဠ攀搀⸀挀漀洀 眀眀眀⸀挀搀ⴀ攀搀⸀挀漀洀

WINTER/HIVER 2015/2016 25

EMERGENCY PREPAREDNESS & RESPONSE

A FLOOD OF MEMORIES Alberta Health Services recounts 2013 natural disaster that took province by storm

By Jason Morton

O

n June 19, 2013, heavy rainfall in Calgary and the mountains west of the city caused unprecedented flooding from multiple watersheds. The rain over the mountains melted heavy snowpack virtually overnight. Rivers breached their banks and flooded many communities. The extreme weather event led to the costliest natural disaster in Canadian history and had a major impact on many of the healthcare facilities in the area.

26 CANADIAN HEALTHCARE FACILITIES

“I’ve been in health care for 28 years and I’ve seen a lot of natural disasters, but I had never seen anything like the flood of 2013,” says Allan Roles, senior director of capital management for Alberta Health Services (AHS), Calgary zone, who recalls how he and his team had little time to react to the fast-moving floodwaters. “Southern Alberta had almost no warning.”

AHS’ capital management team and site staff had to act quickly to lessen the impact of the floods on healthcare facilities

throughout the region. While many facilities were at risk, the two hit hardest were in High River and Canmore, Alta.

HIGH RIVER OVERRUN WITH WATER

As the name suggests, the community of High River had seen flood conditions in years past but, in 2013, the flood impacted the community and High River General Hospital like never before. By the morning of June 20, after more than 300 millimetres of rain had fallen in a 12-hour period, the

EMERGENCY PREPAREDNESS & RESPONSE

floodwaters from the Highwood River approximately half a kilometre away began pouring into the parking lot of the hospital and were moving toward its front doors. At 9 a.m., AHS staff began placing sandbags near the main entrance of the hospital.

“What was amazing to see throughout the province was, as things intensified, staff from all areas — nurses to janitors — dropped everything, stayed calm and worked together,” says Doug McKay, director of rural and community for AHS, Calgary zone. “There were stories of (off-duty) senior physicians and administrators driving into work to help lift sandbags.”

By noon, water levels continued to rise.

Electricity, Internet and phone services in the town went down and the hospital had to run on generator power. A few hours later, the generator itself was at risk of being underwater as staff tried to protect it with sandbags. By late afternoon, the supply of sandbags was exhausted and teams had to use salt bags. At approximately 6 p.m., water began to seep into the facility. While patients remained, all non-essential staff was evacuated from the hospital on the back of a manure truck. Thankfully, the generator was saved.

On June 21, the floodwaters had receded but the town’s sewer system was down, and the quality and safety of potable water could not be guaranteed. A decision was made to evacuate the 150 patients still being cared for at the hospital to other AHS facilities in the area.

By June 22, most of High River was under mandatory evacuation. Only essential services were allowed into the town and the Canadian military was patrolling the streets.

No contractors or AHS staff could get to the hospital to assess damage.

RIDING OUT THE FLOOD IN CANMORE

Meanwhile, almost two hours away, the mountain town of Canmore was dealing with floodwaters that carried in unique challenges.

By June 20, the full impact of the floodwaters that came from the local mountains was beginning to be felt. At 6:30 a.m., portions of the Trans-Canada Highway between Canmore and Calgary were washed out. There was no way to get

any help or supplies into the community from Calgary, an hour away. The floods had also forced the closure of all roads to Canmore General Hospital and water was threatening the facility.

“Canmore was on its own,” says Craig Schultz, director of facilities maintenance and engineering for AHS, Calgary zone.

“Unlike High River, where we could get staff or supplies to come in from other nearby facilities, there was no way in or out of Canmore. They had to find solutions with what limited staff and materials they had on hand.”

At 11 a.m., the floodwaters pushed their way onto the hospital’s loading dock and staff entrance. Three hours later, water had entered the hospital’s basement.

ATCO, a utilities company, provided AHS with water pumps to move water away from the front of the facility; however, there was nowhere for the water to go.

That night, AHS staff and the local fire department worked to try to contain the floodwaters by building a berm system using elongated flexible tubes, called a tiger berm.

At first, it appeared the berm was going to work but, a couple of hours later, all hope disappeared when water broke through.

Two teams of AHS facility and maintenance workers from Calgary and Didsbury, Alta., were waiting at nearby airports to be taken by military helicopter to Canmore to help with flood efforts. At 10 p.m., the military informed the teams they would not be able to transport them as they were too busy airlifting residents out of the High River area.

Not to be deterred, the teams were escorted to Canmore by the RCMP, traversing rough roads en route that had been officially closed. They arrived around 2 a.m. to provide much-needed help.

“These teams were determined to get to Canmore to help their co-workers,” says Shultz. “It was inspiring and I think really helped to boost the morale of the local team who felt stuck and isolated.”

On June 21, the floodwaters continued to surge and there was discussion of evacuating the 125 patients from the hospital. AHS and the province made one final co-ordinated effort to contain the water.

They located concrete construction berms used by the transportation department not

too far away. The concrete berms were carried to Canmore and set up in front of the hospital. To the collective relief of everyone working to protect the hospital, the berms held the water, preventing further flooding at the facility.

AFTER THE WATER RECEDED

Throughout the Calgary zone, many healthcare facilities suffered some flood damage but, for the most part, the damage was contained because of the quick actions and hard work of AHS staff, the provincial government, Canadian military, fire departments and local RCMP. At High River and Canmore General Hospitals, damage was limited to flooring, millwork and drywall. The hospital in Canmore also had damage to a CT chiller.

In High River, there was a substantial loss of contents to the detached workshops and major restoration was required on support office buildings not far from the hospital.

A LESSON WELL LEARNED

The most important lesson learned from the 2013 flood is that no amount of planning can prepare a hospital’s emergency response team for every eventuality during a disaster.

However, ample advanced planning will free up precious time during a crisis situation to focus on the unexpected.

When preparing for disaster, Roles advises to regularly check emergency supplies equipment. It’s important to have an inventory list and to make sure the hospital has everything it needs in case of emergency at least once a year.

If a facility doesn’t have all the necessary equipment or supplies, then it should have a process in place to obtain those materials from other sites, facilities or suppliers when needed. It’s also critical to have a plan in place to communicate if land, Internet and cellphone lines go down.

Should disaster strike, Roles says it is helpful to have representation from the healthcare facility, Province and municipality, along with other disaster management personnel, in an emergency response room to address next steps.

Jason Morton is a senior communications advisor with Alberta Health Services.

WINTER/HIVER 2015/2016 27

EMERGENCY PREPAREDNESS & RESPONSE

TREADING WATER Steps to stay afloat when H20 supply is disrupted

A

ccess to water is often taken for granted. It is only when crisis occurs that its importance is truly realized. For healthcare facilities, loss of this precious resource can have a huge impact on daily operations, patient care and safety.

Here, Mike Hickey, president of MF Hickey Consulting and former director of facilities management and support services with the Northern Health Authority in B.C., discusses steps healthcare facilities should take to prepare for and respond to a total or partial interruption of normal water supply.

What are the potential impacts of a water disruption on a healthcare facility?

Several areas and operational functions can be affected by water loss, including: boilers that provide building heat and steam; food preparation; humidification; water-cooled refrigeration systems; operating rooms; renal care units; laboratories; radiology; water-sealed medical gas pumps; potable water; handwashing and bathing/ showering; laundry and housekeeping services; toilet flushing; medical device reprocessing (MDR); and fire suppression sprinkler systems.

What preventive steps should a healthcare facility take to ensure it maintains services during a water disruption?

CSA Z317.1, Special Requirements for Plumbing Installations in Health Care Facilities, specifies that a reliable and adequate alternative water supply should be provided so that service to the healthcare facility is not significantly interrupted in the event of failure of the primary potable water supply. Methods of compliance can be a second water loop to the site, private 28 CANADIAN HEALTHCARE FACILITIES

water source and/or proven contingency plan with the municipality, including an alternate point of entry for a connection outside the building. Most healthcare facilities have two loops of water entering the building. If there is a water disruption, the facility manager can close the primary loop water source and open up the secondary supply to the building. A common problem on a secondary water loop, however, is failure to regularly exercise the isolation valve. If it is not regularly exercised, it may fail when it is needed most.

It’s also important to have a set of up-todate drawings of all domestic water zone valves in the building. All valves should be numbered and have a corresponding location label. Their physical location should be marked so they are easy to find, particularly if they are positioned in ceiling space or a wall cavity. This can be achieved by placing coloured stationery dots on the suspended ceiling grid or wall. In an emergency situation, the last thing the facility wants is to have maintenance or plumbing staff wasting precious time trying to figure out where the valves are, and which valves control what water supply.

Commonly, a healthcare facility should have a three-day supply of safe potable water on-site for patients and staff. While the World Health Organization recommends storing 10 litres of water per day for each person, every facility needs to determine an appropriate amount since factors such as climate will impact how much will be consumed. The healthcare facility also needs to consider its location for access to the next available replenishment. Average shelf life of bottled water is one year compared to five years for boxed water, making it a more economical option. Regardless, stock should

be regularly rotated to ensure a fresh supply is always maintained.

Communication is key in time of crisis so it’s imperative that a healthcare facility has an emergency management and business continuity plan in place. CSA Z1600 provides healthcare organizations with a framework to manage risks and hazards more proactively.

What steps should a healthcare facility take in the event there is a water disruption?

As part of a risk management review, the healthcare facility needs to identify critical functions and determine their minimum water needs to keep them in operation.

In the event there is a water disruption, the healthcare facility needs to consider water-saving measures and suspend nonessential services. This could include cancelling clinics, adjusting showering/ hygiene schedules, stopping grounds irrigation and/or reducing/shutting down services such as on-site laundry, if feasible.

Healthcare facilities must also identify emergency water source options. Many facilities have arrangements to obtain water from their municipality during a water supply interruption. The municipality should have plans to provide alternate water sources, including arrangements for water trucks to keep the healthcare facility supplied with potable water or techniques to tie into the building’s water supply.

It is also critical to work with the infection control team to ensure the water system provides a clean source of water to areas that need it. There are many processes for sanitizing lines, including hyperchlorination, superheating, copper silver ionization, use of chlorine dioxide gas and flushing of the system.

Want to reduce HAIs?

REAL CONTENT. REAL TRAFFIC. ONTHLY AVERAGES 2015 M

Aseptix 1

+ 000 30,

• World’s first fully automatic UVC room disinfection system • Ideal for patient bathrooms and equipment storage rooms

VISITORS

50,000+

PAG EV

IEW S

MONTHLY AVERAGES 2014

OR S

VISIT 483 12,

23,747 P AG

E V IE

WS

NTHLY AVERAG 3 MO ES 201

VI 11 5,5

RS SITO

18,028 PA

GE V

EARLY 2013

MI RE

BEFORE

IE W S

DEVELOPM EN T

AFTER

Available in Canada at Class 1 Inc. Purchase or lease options

REMI sets the standard for industry coverage. It is informative, timely and trustworthy.

Find out more at www.class1inc.com or email us at info@class1inc.com

Proud to be a founding member

MERGING INDUSTRY LEADING BRANDS

chaircanada.org

class1inc.com

Class 1 Inc. Publication: CHES Size: 1/4 page (3.375” x 4.75”)

REMI_QP_2015.indd 1

CHES

2015-12-21 11:32 AM

SCISS

Canadian Healthcare Société canadienne d'ingénierie CALL FOR NOMINATIONS FOR AWARDS Engineering Society des services de santé

CALL FOR NOMINATIONS FOR AWARDS 2016 2016 Hans Burgers Award

Wayne McLellan Award of Excellence

2016Facilities Wayne McLellan Award of Excellence 2016 HansContribution Burgers Award For Outstanding to In Healthcare Management in Healthcare Facilities Management for Outstanding Contribution to Healthcare Engineering Healthcare Engineering

DEADLINE: April 30, 2016 DEADLINE: April 30, 2016 DEADLINE: April 30, 2016 DEADLINE: April 30, 2016 To nominate: To nominate: To nominate: To nominate: Please use the nomination form posted on the Please use the nomination form posted on the  Please use the nomination form posted on  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 Purpose PurposeTo recognize hospitals or long-term care facilities that have Purpose The award shall be presented to a resident of Canada as a mark hospitals or long-term care The shallof beoutstanding presented achievement to a residentinofthe field of  To recognize demonstrated outstanding success in completion of a major of award recognition facilities that have demonstrated outstanding Canada as a mark of recognition of outstanding capital project, energy efficiency program, environmental healthcare engineering. success in completion of a major capital achievement in the field of healthcare stewardship program, or team building exercise.

Award sponsored by project, energy efficiency program, engineering. environmental stewardship program, or by Award sponsored team building exercise.

Award sponsored by Award sponsored by For Nomination Forms, Terms of Reference, and past winners For nomination forms, Terms of Reference, criteria andcriteria, past winners: www.ches.org / About CHES / Awards www.ches.org / About CHES / Awards Send nominations to: CHES National Office ches@eventsmgt.com Fax: 613-531-0626 Send nominations to; CHES National Office ches@eventsmgt.com Fax: 613-531-0626

WINTER/HIVER 2015/2016 29

EMERGENCY PREPAREDNESS & RESPONSE

PRESCRIPTION FOR DISASTER Failure to have proper crisis plans in place can have cataclysmic results

By Ron Meyers

E

mergency management is more than just quickly responding to a crisis and engaging in disaster recovery. It also requires having plans in place for prevention, mitigation, preparedness, response, recovery and business continuity.

The functions of emergency management cannot exist without those of business continuity. Communities and patients rely on healthcare facilities to ensure continuance of operations in an emergency situation. These facilities may be called upon to respond not only to internal or external incidents that directly impact operations, but also to disruptive events that occur in the community and the resulting patient surge.

NATURAL PARTNERS

Emergency events can occur in many forms, such as natural disasters, power outages, computer viruses and network disruptions.

A business continuity plan provides a roadmap to reduce the impact of an emergency event. Though no plan is able to provide all the answers or ensure every conceivable situation is addressed, having systems and processes in place before a crisis situation occurs is critical to keeping a healthcare facility running.

Continuity planning is the process of ensuring an organization is able to survive an event that causes significant disruption to normal business operations. A successful emergency management plan contributes to a strong business continuity plan. After all, being able to resume operations as quickly as possible means nothing if healthcare 30 CANADIAN HEALTHCARE FACILITIES

workers and patients can’t safely weather the actual emergency event.

The first step in creating an integrated emergency management and business continuity plan is to establish the right framework. It should address the tools necessary to implement and maintain the plan, and the right processes and procedures.

Involvement of senior leadership is vital — they are the decision-makers who set priorities, and provide the required support for the processes and procedures meant to keep everyone safe and life-saving functions operational. When plans, priorities and support are in place, the workforce is ready for training.

TEACHING MOMENT

Staff trained in emergency management and business continuity planning is a healthcare facility’s greatest asset in the face of a crisis situation. Workers who are adequately trained should have a clear understanding of the concepts of risk management and why a business impact analysis is so critical. The business impact analysis is one of the foundations on which emergency and continuity management programs are built. It identifies, quantifies and qualifies the impacts of loss, interruption or disruption of critical activities on an organization, and provides the data from which appropriate continuity and recovery strategies can be determined. A critical activity is any function or process that is essential for the organization to deliver its products and services.

A trained workforce is able to promote the safety of patients and staff; reduce the

potential for costly damage; lessen environmental and other impacts; assist emergency staff in initiating corrective actions; reduce recovery time and associated costs, both financial and human; and help ensure patient and public confidence in the healthcare facility’s ability to successfully manage a crisis situation.

SETTING THE STANDARD

Standards play an important role in helping an organization implement an effective emergency management and business continuity program. CSA Z1600, Emergency Management and Business Continuity Programs, is a good example. It is harmonized with the U.S. National Fire Protection Association’s (NFPA) 1600: Standard on Disaster/Emergency Management and Business Continuity Programs. CSA Group developed and facilitated the writing of the standard to be consistent with Canada’s emergency management framework. It has since created a Z1600 customized training program that is tailored to healthcare facilities and delivered on-site.

Checklists are also critical for healthcare facilities to successfully implement the necessary processes and programs to manage various forms of disasters. The Ontario Hospital Association (OHA) developed a toolkit in response to a need to have a province-wide emergency preparedness and response framework that helps hospitals address all types of emergencies.

Ron Meyers is a project manager for health and safety standards at the CSA Group.

Chem-Aqua provides custom designed programs and control options to minimise the risk of Legionella bacteria and other water borne pathogens

Chem-Aqua Environmental & Healthcare offers expertise in …  Copper Silver Ionization: Proven efficacy, residual protection and easy to maintain.  Safe on site Chlorine Dioxide Generators: Well documented reduction of biofilm and Legionella.  Point of Use Filters: Provides effective barrier in high risk patient areas against Legionella, Aspergillus, P. Aeruginosa and more.

Scientifically Validated 0.2 Micron Filters:  Water Faucets and Shower Heads  In-Line Filters and Hydrotherapy  Ice Machines and Water Features  Rinsing Medical Devices

Find out which is the best solution for you

253 Orenda Road, Brampton, ON, L6T 1E6

CAES@nch.com

1-800-268-0838 x 214