CHF FALL 2014 by MediaEdge

Canadian

HealthcareFacilities Journal of Canadian Healthcare Engineering Society

Volume 34 Issue 4

THE GREEN ISSUE

PM#40063056

INSIDE

2014 CHES Awards Energy Benchmarking Climate Disruption and Healthcare HIRF 2014-15: Are You Ready?

Fall/automne 2014

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contents

Canadian Healthcare Facilities Volume 34

Number 4

CANADIAN HEALTHCARE FACILITIES IS PUBLISHED BY UNDER THE PATRONAGE OF THE CANADIAN HEALTHCARE ENGINEERING SOCIETY

PUBLISHER

Steve McLinden e-mail: stevem@mediaedge.ca

EDITOR

Matthew Bradford e-mail: matthewb@mediaedge.ca

ADVERTISING SALES

Sean Foley MediaEdge Communications 416-512-8186 e-mail: info@mediaedge.ca

ARTICLES 12 14 16

2014 CHES National Conference Review Believe that you can make a difference CHES Lifetime Membership Award Profile Rick Anderson CHES Hans Burgers Award Profile Per E. Paasche CHES Wayne McLellan Award Profile: Kingston General Hospital

Energy Benchmarking Tools for Ontario healthcare facilities engineering

Climate Disruption and Healthcare On the frontlines

SENIOR DESIGNER

Annette Carlucci

DESIGNER

Jennifer Carter

PRODUCTION MANAGER

Rachel Selbie

SCISS JOURNAL TRIMESTRIEL PUBLIÉ PAR MEDIAEDGE COMMUNICATIONS INC. SOUS LE PATRONAGE DE LA SOCIÉTÉ CANADIENNE D’INGÉNIERIE DES SERVICES DE SANTÉ

RÉDATRIC INTÉRIMAIRE

Matthew Bradford e-mail: matthewb@mediaedge.ca Sean Foley

PUBLICITAIRE

MediaEdge Communications 416-512-8186 e-mail: info@mediaedge.ca PUBICITÉ

Annette Carlucci

COORDINATEUR DE PRODUCTION

Rachel Selbie

CHES Canadian Healthcare Engineering Society

28 Lightening the Financial Burden on Senior Living Facilities A US solar powered case study

Steve McLinden e-mail: stevem@mediaedge.ca

ÉDITEUR

SCISS

Société canadienne d'ingénierie des services de santé

PRESIDENT

Peter Whiteman

VICE-PRESIDENT

Mitch Weimer

PAST PRESIDENT

J.J. Knott

TREASURER

Robert Barss

8 Message from the President

SECRETARY

Randy Cull

EXECUTIVE DIRECTOR

Donna Dennison

10 Chapter Reports

CHAPTER CHAIRMEN

Maritime: Robert Barss Alberta: Preston Kostura B.C.: Steve McEwan Ontario: Allan Kelly Manitoba: Craig Doerksen Newfoundland & Labrador: Brian Kinden

DEPARTMENTS 6

Publisher's Message

11 CHES Awards: Call for Nominations

HIRF 204-15 is Coming: Will you be ready?

FOUNDING MEMBERS H. Callan, G.S. Corbeil,

J. Cyr, S.T. Morawski CHES

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

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Publisher's Message

Greening Canada's healthcare, celebrating CHES successes The move towards greener healthcare has inspired new products, innovations, and practices throughout the industry. Every year, Canadian Healthcare Facilities attempts to provide a snapshot of these initiatives in our Green Issue, and I believe we've hit our mark once again (with your help, naturally). Where to begin? How about with a tribute to the award winners from this year's 2014 CHES National Conference, all of which have – among their many other achievements -contributed greatly to the greening of Canada's healthcare system. These include Per E. Paasche, who was honoured posthumously with the Hans Burgers Award for Outstanding Contribution to Healthcare Engineering; the team with Kingston General Hospital's energy project, who took home CHES' Wayne McLellan Award for Excellence in Healthcare Facility Management; and Rick Anderson, who received CHES' Lifetime Membership Award for his work within CHES and the industry as a whole. Our investigation into energy management also includes Robert Hutton's report, “Energy Benchmarking: Tools for Ontario healthcare engineering”, sustainability expert Tom Rand's, “Climate Disruption and Healthcare”, and Ted O'Shea's review of a US costsaving initiative in, “Lightening the Financial Burden on Senior Living Facilities.” Please also read with interest Robert Hutton's second contribution, “HRIF 2014-15 is Coming: Will you be ready?” for an in-depth guide to the Ministry of Health's Healthcare Infrastructure Renewal Fund. Last but far from least, congratulations to everyone who helped make this year's CHES Annual Conference such a success. The event provided a crucial “meeting-of-the-minds” for CHES members and associates, and gifted everyone with a wealth of new ideas, inspirations, and new industry partners. Interested in sharing a story of your own? Want to comment on something you read here? Please feel free to send an ideas and feedback to me at stevem@mediaedge.ca. Sincerely, Steve McLinden Publisher stevem@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. 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. 6 Canadian Healthcare Facilities

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Message from the President

Making a difference in an “Environment of Excellence” Having recently returned from the CHES National Conference in Saint John, New Brunswick I’m continually re-invigorated and inspired by the role facilities management plays in healthcare service delivery, and how we have such a positive impact on patient lives. This year’s conference theme was Environment of Excellence: The Patient Perspective. The keynote speaker, Hélène Campbell, was a wonderfully enthusiastic young woman who underwent a double-lung transplant a few years ago and did a terrific job of tying her positive patient experience and the operation and maintenance of healthcare facilities together in a manner that touched everyone in attendance. Her presentation reaffirmed the truth that the patient's experience is not the cause of our work, but the purpose of our work. Facilities management stakeholders across Canada struggle with budgetary constraints. They're always finding new ways of doing more with less, and all for the betterment of the patient. This was the message that resonated throughout the conference. We owe the conference planning committee a sincere pat on the back for coordinating and scheduling such a world-class conference. All of the speakers delivered their message to a receptive audience in a manner that continually drove home the theme of achieving positive outcomes. No doubt, a big “thank you” goes out to the conference planning chair, Ralph Mayfield, and the whole team who contributed countless hours to make this such a successful event. The sustainability of our healthcare system will come through the hard work and dedication of everyone involved in healthcare service delivery, and we will succeed. As we work towards this goal, I encourage everyone to work hard and play hard.

Kindest regards,

Peter Whiteman CHES National President

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MANITOBA CHAPTER

BC CHAPTER

ALBERTA CHAPTER

Chapter Reports Greetings from the province of Alberta. I would like to congratulate Ralph Mayfield and his team for a great 2014 CHES National Conference in Saint John, New Brunswick. Planning is well underway for the annual Clarence White Conference and Tradeshow, the title of which will be Serving Our Clients Through Innovation and Technology. A tremendous amount of work has gone into the planning of this conference, and I would like to send a heartfelt thank you to everyone who has stepped up to help with this major event. If you are in the Red Deer area from November 24 to 25, 2014, please stop by. Planning is also progressing well for the CHES National Conference that will be held in Edmonton from September 20 to 22, 2015. The theme

for the conference is HEALTHCARE: Keeping pace with Technology, and the keynote speaker will be Don Bell, co-founder of WestJet. Guests will also enjoy our gala banquet with entertainment provided by wellknown hypnotist, entertainer, and speaker, Wayne Lee. On the political side of things, Alberta has a new premier, Jim Prentice. As well, our former health minister, Fred Horne, has been replaced by former Edmonton mayor, Stephen Mandel. Politically speaking, the only consistent thing in healthcare is change! All the best and I look forward to seeing you before our CHES National Conference in Edmonton!

I’m pleased to announce the CHES BC Chapter hosted another very successful conference in Penticton. There were approximately 350 attendees, and all 90 exhibitor booths and sponsorships were sold out. In addition, we created two new sponsorship categories to help with the grassroots program to offset costs for day passes, travel, and accommodations for the frontline membership. During the conference banquet, we acknowledged our longtime BC members. 17 awards were given out including 12 for 15 years; 4 for 20 years, and 4 for 25 years. This year, we also added the Canadian Healthcare Construction Course into our Penticton conference, with 46 guests in attendance. Our executive team is currently planning the 2015 Chapter Conference, which is returning to beautiful Whistler, BC from June 7 to 9, 2015. The theme of the conference will be Transforming Healthcare through Technology. We are also hoping to host the Canadian Healthcare Construction Course from June 10 to 11, and I'm pleased and excited to announce

that CHES BC will be hosting the 2016 National Conference in downtown Vancouver at the Vancouver Trade and Convention Centre. This is a great opportunity to showcase this amazing city and push the limits for our national conference. CHES BC executive team was honored to receive the President's Award at this years national conference in Saint John, NB. They have worked very hard this past year and we are very proud to be the first recipients of this prestigious award. It’s an honour to work with such a dedicated team. CHES BC is in the process of establishing a Graham Baker Bursary with Okanagan College and increasing our bursaries at the six colleges throughout BC. There was over $10,000 in education grants awarded to CHES BC members in 2014. Moving forward, education continues to be a priority for CHES BC.

Having just returned from the CHES National Conference in St. John, New Brunswick, both myself and Tom Still, our chapter treasurer, are still talking about how we were challenged by the entire conference to continue providing an environment wherein the priority of patient care is clear through our roles. From the opening plenary session with double-lung transplant recipient Hélène Campbell to the closing panel (which I was pleased to participate in), where we highlighted our “lessons learned” and takeaways, the priority of patients was a major theme. During the following day, both Tom and I were also able to attend the inaugural CSA Z8002 education session. Preparations for Education Day on April 15, 2015, are well underway. This year's theme will be Managing and Maintaining Your Building Envelope. Along with this educational day, we will be inviting many of our industry partners to the trade show and some will be assisting

with technical presentations. Our focus will be of benefit to not only healthcare facilities but many other industry facility managers. Topics will include envelopes, roof systems, roof inspections, roof safety systems, wall systems, doors, below grade waterproofing, and humidity control. We are happy to have the assistance of Kelly Hearson, principal of Crosier Kilgour Partners, assisting us in framing this exciting day. We are also continuing to work with the Canadian Centre for Healthcare Facilities as they plan for a Manitoba session on April 14th, 2015, which will benefit many of our CHES Manitoba members who are also involved in hospital facility planning. Lastly, we are happy to welcome Stephen Cumpsty, director of capital planning and property management of St. Boniface General Hospital to the Manitoba Chapter executive as a member-at-large.

10 Canadian Healthcare Facilities

Preston Kostura, Alberta Chapter Chair

Steve McEwan, BC Chapter Chair

Craig Doerksen, Manitoba Chapter Chair

MARITIME CHAPTER ONTARIO CHAPTER

The 2014 National Conference, held September 28-30, was hosted by the Maritime Chapter in Saint John, New Brunswick. It was a great success with a solid attendance, excellent speakers, and fantastic support from exhibitors and vendors. CHES Maritime paid the registration fee for any CHES Maritime member who wished to attend, and we feel this certainly helped encourage attendance as over 60% of Maritime members took advantage of this offer. The final conference results are not yet available, but we expect a very positive outcome. To encourage educational opportunities for our members, CHES Maritime paid for Maritime members to attend the series of CHES webinars. This initiative has been given much positive feedback from the participants, and this practice will continue for the 2015 webinar series. The chapter’s by-laws were redeveloped into a format in compliance with federal requirements and adopted at the annual meeting in September. The current executive thanks Phil Langford for all of his hard work over the past several years. This year, the CHES Maritime Chapter lost a vital member and champion with the passing of Per Paasche. He will be truly missed. Per was selected as this year’s CHES Hans Burgers Greetings my fellow members. Congratulations to Ralph Mayfield and his team for hosting the 2014 CHES National Conference in Saint John NB. A good time was had by all. CHES Ontario is preparing for the provincial conference to be held in Ottawa on May 24, 2015. I would like to thank Ron for agreeing to be the conference chair. Please send Ron any ideas you have about potential education sessions. The executive will meet in November at the OHA HealthAchive Conference. Minutes of

Award for Outstanding Contribution to Healthcare Engineering winner. His wife Nancy accepted the award on Per’s behalf at an emotional ceremony during the national conference. Regarding bursaries, this past year the chapter continued with an education bursary grant to a family member of a CHES Maritimes member. The bursary was renamed in memory of Per Paasche. A selection committee was established and the recipient was Andrew MacEachern, who will be attending Dalhousie University in Halifax. He received $1,000 to assist in his studies. Wrapping up, the chapter is on solid financial ground and a new executive was put in place at the annual meeting that will serve in their positions for a two-year term. The new executive consists of Robert Barss (chair), Denis Pellichero (immediate past chair), Helen Comeau (executive vice president), Angus Smith (secretary), Gordon Jackson (treasurer), Keith Fowler (NB vice chair), Darrel Gallant (NS vice chair), Lane Mingo (PEI vice chair), and Kerry Fraser (associate chair).

Robert Barss, Maritime Chapter Chair

this meeting will be posted on the web site. This year is an election year, so please give some thought to running for a position. We will be looking for a secretary, treasurer, and vice chair. Roger Hollis will assume the office as chapter chair and I will move to past chair. Thank you to Ron for standing in as the past chair for the last four years. Our scholarship program is almost complete. At the November meeting, we will put the finishing touches on the document and we should hopefully have some candidates in time

for our spring meeting. As always, I want to thank the executive for all their hard work. I would also like to thank Allen Lyte for his service over the years. Allen has resigned as the Ontario representative for communications. Jim Durocher will assume this role. Thanks, Jim, for your help. I would like to take this time on behalf of the executive to wish all the Members of CHES a very safe and joyous season. Allan Kelly, Ontario Chapter Chair

CALL FOR NOMINATIONS FOR AWARDS 2015 Hans Burgers Award For Outstanding Contribution to Healthcare Engineering

2015 Wayne McLellan Award of Excellence In Healthcare Facilities Management DEADLINE: April 30, 2015

DEADLINE: March 31, 2015 To nominate: • Please use the nomination form posted on the CHES website and refer to the Terms of Reference. Purpose • The award shall be presented to a resident of Canada as a mark of recognition of outstanding achievement in the field of healthcare engineering.

To nominate: • Please use the nomination form posted on the CHES website and refer to the Terms of Reference. Purpose • To recognize hospitals or long-term care facilities that have demonstrated outstanding success in completion of a major capital project, energy efficiency program, environmental stewardship program, or team building exercise. Award sponsored by

For Nomination Forms, Terms of Reference, criteria, and past winners www.ches.org / About CHES / Awards Send nominations to; CHES National Office ches@eventsmgt.com Fax: 613-531-0626 Fall/automne 2014 11

2014 CHES NATIONAL “Believe that you can make a difference” By Gordon D. Burrill and Barry Hunt

The crowd welcomes keynote speaker Hélène Campbell

The 2014 CHES National Conference in Saint John, NB may be over, but the work to improve the healthcare physical environment is just getting started. That is, while many of us had the pleasure of attending that fantastic event, we now also hold the responsibility to turn those lessons into actions. Attempting to summarize the whole of the conference here, or in the one-hour closing plenary, is nearly impossible. No doubt, ideas flowed freely and many of us left the conference with a long “to do” list. If you haven’t had the chance yet, visit the CHES website (www.ches.org) to view the closing plenary which was webcast across the country to catch up on the many ideas that came out of the conference for yourself. Clearly, there was an abundance of great ideas to improve patient experiences and outcomes; and these are all ideas that CHES members can apply to their respective facilities. Below are just some of our leaders top “to do’s” for facilities managers across the country. They are in no particular order, as their priority is for you to decide. However, it's important you take action on them today – your patients and their families are depending on it. They include: • Motivate your staff to perform at 100% on every task at every shift. • Find a method to engage patients, families, volunteers, and others in the development of maintenance methodologies. 12 Canadian Healthcare Facilities

Sharing insights and ideas at the Exhibition Hall

• Develop a “culture of no blame” to ensure continual improvement. • Invoke one of Stephen Covey’s seven habits to “sharpen the saw”. • Develop and implement a water system management plan. • Look at everything you do from the patient’s perspective. • When planning new spaces, consider the emotional and spiritual wellbeing of the patients in addition to their physical wellbeing. • Help O&M staff to recognize that they contribute a positive patient experience. • Ensure that all staff have access to the standards they need to do their jobs. Everything you do in your facility impacts on the patient experience and can have a significant impact on their wellbeing. The keynote speaker at this year’s conference, Miss Hélène Campbell, was inspirational in her perspective and energy. And while there were several great messages in her address, one that struck us as we all went our separate ways from Saint John was to, “Believe that you can make a difference”. Making that difference starts by taking action…so away you go!

CONFERENCE REVIEW

Performers “Before the Mast” take the stage at the CHES Gala Banquet

Delegates attend one of the conference's many education sessions

Fall/automne 2014 13

CHES LIFETIME MEMBERSHIP AWARD

Rick Anderson

Rick Anderson was among the honorees at the CHES 2014 Annual Conference in Saint John after receiving the association's Lifetime Membership designation. The award was given to Anderson in recognition for his vast contributions to Ontario's healthcare industry and his long-running tenure with the CHES Ontario Chapter. “Receiving the Lifetime Membership was certainly a surprise,” Anderson told CHF magazine from his home office in Tillsonburg, adding, “At the same time, this honour is very much appreciated, because it acknowledges CHES's recognition of the work that many of the members put in to volunteering for a variety of positions and responsibilities that support the organization.” Anderson joined the CHES Ontario Chapter in 1991 and played a crucial role in its growth and stability over the two decades that followed. In those years, he also participated as a member of several of the Ontario Chapter Annual Conference Committees, and as the long-standing chair of the Ontario CHES Educational Committee. It was through this latter role that he built upon former member Bill Sheppard's CHES Bursary Program, raising its value from $15,000 in the 1980s to the current endowments which exceed $300,000 in nine colleges. Reflecting back on his time with CHES, Anderson says he's most appreciate of the value CHES was able to provide its members and the industry, noting, “There's a big value to be had in organizational cohesiveness and having all the members gain from each other through that peer activity. When I eventually became the education committee chairperson for provincial chapter, to me it was just a logical extension, because I understood that education gave people more tools for their 14 Canadian Healthcare Facilities

CHES President Peter Whiteman awards Rick CHES' Lifetime Member at 2014 CHES National Annual Conference

jobs, which was one of CHES' goals.” Outside of CHES, Anderson served at Woodstock General Hospital as its director of environmental service under a contracted management status for the entirety of his 22-year career. “I fully enjoyed my career with Woodstock. There were a few of the Woodstock managers under that same contract status, but the management group treated us as one-of theteam. As contractors, we were all treated on an equal basis with our hospital counterparts, and that was quite refreshing.” Anderson may have capped his career with Woodstock in December 2013, but that's not to say he's retired from the industry altogether. In fact, he has been eager to join the Canadian Coalition of Green Health Care in participating in the launch of the Healthcare Energy Leaders of Ontario (HELO) program as one of its selected Energy Managers. “The HELO program is sponsored by the Ontario Power

Authority to give support without cost to organizations that want to reduce their energy consumption but don't necessarily have the wherewithal or expertise to do so,” he explains. “There are, however, many of us who, having been facility managers, have performed that responsibility in our facility careers. So, when the CCGH began looking for qualified staff with that background to apply, I became a willing candidate.” As for his newly bestowed CHES Lifetime Membership designation, Anderson says he's proud to receive the honour and to continue to be a part of the association that, in turn, is giving much to the industry itself. “CHES is an integral resource for people in the facility management field, because we can often get so caught up in the day-to-day regimen that we forget we're not the only ones dealing with our types of problems. That's where CHES can offer such valuable insights that come with peer-related interactions.”

Rick enjoys a retirement send-off with Woodstock General Hospital

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Fall/automne 2014 15

AWARD RECIPIENT

Hans Burgers Award for Outstanding Contribution to Healthcare Engineering

Per E. Paasche

By Matthew Bradford

This September, CHES honoured one of its healthcare industry's greats with the posthumous awarding of its Hans Burgers Award for Outstanding Contribution to Healthcare Engineering to Per E. Paasche. The award was given out during the 2014 CHES National Conference in Saint John, New Brunswick, in recognition of Paasche's far-reaching work within the NB healthcare industry and CHES itself. “Per was a strong believer in CHES and its objectives. He worked hard to ensure its growth and sustainability, not only as a believer but as an active and vocal supporter,” says Phil Langford with the CHES Maritime Chapter, adding, “There wasn’t anything he wouldn’t do when asked to improve the image of the organization.” A member of CHES since 1983, Paasche helped establish the Maritime CHES Chapter alongside George Seeley. Over the years that followed, he was instrumental in shaping its growth, serving as its national secretary from 2006 to 2010, chair of its communications committee, and an active player in the development of the association's website. “I met Per when I joined the CHES Maritime Chapter and was impressed by his involvement in the organization,” recalls Langford. “Our friendship continued to grow as we both served on the National Board of Directors and various CSA Health Care Technical committees. His concern over ensuring that the correct issues were being addressed regarding the facility management components of healthcare -- particularly the electrical component -- was unmatched.” 16 Canadian Healthcare Facilities

During his time with CHES, Paasche negotiated member access to CSA standards on healthcare. He also represented CHES and the New Brunswick Department of Health on numerous CSA committees, including as a member of the Strategic Steering Committee on Health Care Technologies, chair of the CSA's Technical Committee on Application of Electricity in Health Care, a member of the Health Care Facilities Sterilization Committee, and a member of the Infection Control During Construction and Renovation Committee, to name just a few. “Per has had a profound impact on CHES and healthcare overall,” says Ralph Mayfield with the CHES Maritime Chapter. “The chapter executive truly feels that Per Paasche deserves this award for his outstanding service to both CHES and the healthcare industry.” Per's legacy within the industry began in 1977 when he became a professional engineering after obtaining a bachelor of science degree from Dalhousie University and a master's degree in engineering from Nova Scotia Technical College. From there, he applied his expertise and wisdom to work within numerous New Brunswick hospitals under the province's Department of Health banner. His career has also paired him with the University of New Brunswick, the Institute of Biomedical Engineering, and with hospital commissioning initiatives across the province up until his retirement in 2008. “Per contributed by providing technical support and insight into virtually every hospital construction project in New Brunswick during his time at the University of New Brunswick and through his time representing the

Nancy Paasche accepts the Hans Burger Award on behalf of Per at 2014 CHES Awards Gala

New Brunswick Department of Health,” says Gordon Burrill, former CHES president. “He helped connect the construction world with the changing technological and standards world, and was a tireless fighter for any technical subject he believed to be true. He fought to uphold the value of educated and respectful debate at the standards table, both nationally and at the provincial level.” Reflecting on his career on a whole, Langford notes: “Per's working career and his know ledge in his field of expertise and work ethic was exemplary. Many of those hospital projects have benefited from Per's involvement, and he

“[Per's] concern over ensuring that the correct issues were being addressed regarding the facility management components of healthcare -- particularly the electrical component -- was unmatched.” set the bar high by being involved in many organizations related to the field of healthcare.” Outside of the jobsite, Paasche dedicated his energy and passion to his family. He is survived by his wife Nancy, children Ingrid and John Anthony, and grandchildren Jake, Jesse, Jensen, and Halden. Those who worked with Paasche will attest to his affinity for camping, his volunteer work w ith prov incial swimming teams, and his ability for building strong, lasting relationships. “Per was the type of person who

would call you at any hour when he just wanted to know how you and your family were. He would also call if he felt a second opinion was needed for a particular policy or technical problem that he was working on,” says Langford. “He was a caring individual and dedicated to those he called his friend.” Speaking to Paasche's legacy, Peter Whitemen adds: “In the time I have known Per, I have come to appreciate his dedication and his drive to improve healthcare and electrical safety. His work and presence with CHES will be greatly missed.”

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Fall/automne 2014 17

Wayne McLellan Award of Excellence in Healthcare Facilities Management

Kingston General Hospital

By Matthew Bradford

Kingston General Hospital (KGH) launched a large-scale energy project in 2010 with the goal of upgrading its existing infrastructure and making the hospital one of the most energy-efficient healthcare facilities in Canada. In 2013, it kicked off the second phase of its energy saving project, and in 2014 its efforts were honoured with CHES's Wayne McLellan Award of Excellence in Healthcare Facility Management. “We're honoured to receive this very prestigious award as well as the national recognition that comes along with it,” says Allan McLuskie, director of facilities management with KGH, who attended the 2014 CHES National Conference in Saint John to accept the award on behalf of the hospital. McLuskie took lead on the energy project after joining KGH in 2012 and picking up on the project, which was first started by his predecessor, Chris Mackay, two years prior. That initial phase included a $10.5 million energy and infrastructure retrofit, while the second phase was comprised of an additional $819,000 energy saving initiative. The team was also aided by Chris Rousseau, who guided both projects as the project coordinator. “With these projects, we addressed the need to update some of our infrastructure as well as better control our energy and water usage,” he recalls. “We knew there was an opportunity to become more efficient, and at the same time upgrade some of our existing infrastructure which, on average, dated back to the 1960s.” 18 Canadian Healthcare Facilities

All combined, the project produced a 14 per cent reduction in the hospital’s energy footprint and a 25 per cent reduction in its water usage, saving KGH nearly $800,000 annually. “The people who most benefit from this project are the patients, because now we can direct the money we save back into patient care,” says McLuskie. KGH success is owed in part to its partnership with Honeywell, an Energy Services Company (ESCO) who collaborated with KGH's maintenance team to assess, review, and improve upon many of the facility's systems. “The maintenance team participated in the development of the scope of work, presented the project to senior management, reviewed designs and specifications, and worked closely with the ESCO during the implementation phase,” says McLuskie. Together the team implemented a number of waste and energy reduction programs. Their success resulted in the diversion of 25 per cent of its waste from the landfill and a 14 per cent reduction in energy use (the equivalent of 6,354,000 kg of CO2 per year-to-year); and the conservation of nearly 76,000 cubic metres of water annually (a 25.5 per cent reduction). Furthermore, KGH further increased its waste reduction through the introduction of a composting program to its Nutrition Services Department, biomedical and general audits, its partnership with the Canadian Coalition for Green Healthcare; as well as its environmentally aware procurement process.

Enhancements to KGH's building equipment and processes were a key focus of the energy project. These included upgrades and retrofits including, but not limited to: • Upgrades to lighting system with energy efficient alternatives; • an expansion of the building automation system; • upgrades to the chiller plant; • the installation of weather-sealing on all buildings; • the replacement of more than 250 windows in its historic, 175-year-old Watkins Wing; • upgrades to KGH's mechanical systems; • the replacement of air handling systems; • the installation of hot water condensing boilers; • the replacement of 10, oil-fired boilers with new high-efficiency gas-fired models; • thermal piping insulation; and • the installation of computer “sleep mode software” on 1250 computers.

From left to right: Peter Whiteman (CHES President), Allan McLuskie (Director of Facilities Management, KGH), Eleanor Rivoire (Executive VP & Chief Nurse Executive, KGH), and Luis Rodrigues, VP of Energy Solutions Canada, Honeywell).

Naturally, a project of this scope presented the KGH team with logistical challenges; the most pressing of which was balancing 24/7 hospital services with a wide-scale expansion and renovation. “The challenge in an acute care hospital is that you can't stop operating the facility. We needed to look after our patients, some of whom were on life support. They're lives depended on the systems we changed, so we had to maintain the operational side of the hospital while implementing improvements. That was one of the biggest challenges,” says McLuskie. Fortunately, McLuskie notes KGH and Honeywell's team were more than up to the task, recalling, “Our success came down to a really close relationship between Honeywell and our staff across the board, working out schedules and working together to make changes where necessary. It was a genuine team effort.”

ONGOING STEWARDSHIP

Kingston General Hospital

Since its energy project's completion, KGH has kept energy conservation front and centre through both internal and external programs. The creation of its “Energy Matters” promotional campaign, for instance, helps raise awareness and interest for environmentally-friendly practices throughout all of its departments; while its participation in a Save On Energy video has helped Ontario Power Authority and Kingston Utilities extoll the virtues of similar projects to other healthcare stakeholders. What's more, KGH reps have shared their successes with numerous associations and forums. This includes the Toronto & Region Conservation Authority (Green Healthcare Group), who awarded KGH with the 5% Club designation in 2010 for its ability to lower its energy use by 5 per cent over a period beginning in 2006.

Overall, McLuskie is confident the project has delivered results across the board, for staff, patients, and community members alike. As for the award, he adds that too has a special significance: “I was a friend and colleague of Wayne McLellan. We worked together back in the 1990s at Saint Joseph's Health Care in London and he was a personal friend. Even back then he was a strong supporter of CHES. It was a tragedy when we lost him, but to win this award with his name on it was special for me.” Looking down the road, McLuskie says KGH will remain diligent in its pursuit of energy saving initiatives in all it does, insisting, “At KGH we believe it is incumbent upon health care providers to take a leadership role in reducing our carbon footprint and thereby contribute to the overall health of the planet and the health of our community, including current and future patients.” Fall/automne 2014 19

ENERGY

BENCHMARKING Tools for Ontario Healthcare Facilities Engineering By Robert Hutton !"#"$%"#&'()*%+#

In business -- and certainly in healthcare -- metrics, benchmarks, key performance indicators (KPIs), and surveys are all "tools of the trade". They provide a means to show progress, improvements, and comparators. In healthcare engineering, these tools are used to support funding requests, measure changes, or drive continuous improvements in our facilities. They are an assist when documenting cost avoidance or savings during projects and can demonstrate the ongoing value of a project. In Ontario, four of the most common processes are the annual energy submissions as part of the Green Energy Act, the Ontario Hospital Association Green Hospital Scorecard, the IFMA/ ASHE/CHES Healthcare Facility Management Report (Benchmarking 2.0), and the recently released NRCan Energy Star Scorecard for Canadian hospitals using Portfolio Manager. All four of these processes include energy as a major part of their metrics. The Green Hospital Scorecard and the IFMA/ ASHE/CHES Benchmark 2.0 report include environmental factors regarding waste/recycling; and the IFMA/ASHE/CHES report covers maintenance, operations, and risk management. 20 Canadian Healthcare Facilities

THE FOUR TOOLS

The IFMA/ASHE/CHES Healthcare Facility Management Report (Benchmarking 2.0) uses a voluntary survey to gather data for 2011 across North America. It is representative of seven !"#$%&'() *#+,- ./ categories of healthcare !"#$%&'(#)"'*#+,$,%-' .#/#0"1"/%'2"34)% facilities, with 50% to 60% of the data being from Canadian 5'(),%,+#$'6#13$,/0'47'84)%&'51"),+#/' !"#$%&'(#)"'*#+,$,%,"9 healthcare facilities (although this varies by sub category). The repor t displays data across multiple categories. These include facility, utilities, operations, environmental/ waste, and maintenance; describing both "volumes" and costs in each category. This report is accessible to members through CHES. The OHA's Green Hospital Scorecard survey was a voluntary submission of 2012 data in four categories of healthcare facilities. Submissions from the 71 healthcare facilities resulted in 24 hospitals receiving a silver ranking and 47 hospitals receiving a bronze. The scorecard given to each participating facility provides a graph of seven categories showing their ranking/score compared to the average submission and also to their peer group average. The Ontario Green Energy Act requires public funded facilities in Ontario to submit their energy information

THE PATIENT PERSPECTIVE

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K A C8,#$ '(#N annually, !"#$%& '(# starting with 2011 data in July C8(,# F#"#$8,/+" 2013. This year, EACH PROCESS IS UNIQUE OKFFF PF@F JFKFFF BJ@J All of the aforementioned TK""F the 2012 data will be submitted in July along with their tools use a category for the IJKFF" TKFFF RKIOT JT@O IBKFFF BF@F IFKPF" Conservation and Demand Management Plan (CDM). The facility type. Unfortunately, they are not consistent and do PKPBT JJ@? RKFFF "RKBJ" IFKFFF BKOO" IO@P data is"JKRTR then captured by the province'sIB@R Ministry of Energy not healthcare facilities. For example, in the case of PKFFF JF@F cover all BKIOI "BKFFF ""KIFO and healthcare facilities post their data on their respective the Green Energy Act, only public hospital data is captured. BKFFF IF@F "FKFFF websites. In the healthcare group, there are three categories In the IFMA/ASHE/CHES report JKFFF and the NRCan Energy ?BKFFF IKFFFof categories allowing "F@F system, there is a greater number for “public hospital”: acute/chronic, acute, and chronic. Star ?FKFFF "KFFF Lastly, the NRCan Energy Star Scorecard for Canadian for ?F@F more precise benchmarking among peers. BKFFF ?KFFF facilities is a voluntary tool (Portfolio Manager) through Additionally, the OHA Green Hospital Scorecard covers which healthcare provide utility data"F?F under academic, and small facilities. Only "FFT "FFO "F?F non-acute, "F?? "F?" "FFT "FFO "F?? six "F?" community, "FFT "FFO "F?F "F??facilities "F?" facility type categories. Data can be submitted for multiple J Energy Star allows for benchmarking of long-term care H E !"#$%& D",#"(/,& C8,#$ D",#"(/,& years and results in a ranking against one'sC8(,# D",#"(/,& facility over a facilities. Other variances include the fact the IFMA/ASHE/ "@BF I@FF R@FF period of time. Those P@PB that fall within the "Hospital" CHES report, Energy Star, and OHA's Green Hospital P@FF B@OO "@BF category can receive a ranking in the Energy Star program. Scorecard include water, while "@FF the Green Energy Act B@IO B@FF J@TB "@FF ?@P? J@IR Results may also be shared J@FF with other facilities to further submission does not. ?@BF ?@JB ?@IF ?@BF ?@JR ?@?R ?@I" help benchmark one's facility Also of note?@FP is the fact that three ?@FF of the four processes are I@FF within a peer group.?@?O ?@FF F@OP ?@FR "@FF voluntary, which may be a pro or con depending on one's needs. F@BF

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Fall/automne 2014 21

In terms of coverage duration, the IFMA/ASHE/CHES report captures data every two years, while OHA's Green Hospital Scorecard and the Green Energy Act submissions occur annually. Meanwhile, Energy Star's Portfolio Manager provides a means for submissions with monthly data, which allows for monthly reports and the use of current data. Also, the year of the captured data varies among the four tools. Users will need

to be clear on their comparisons between the tools when reporting. Reports from the four tools also vary. The IFMA/ASHE/CHES report is a hard copy report available every two years. The Green Energy Act submission is available online as a spread sheet format annually using the submission template, while the Green Energy Scorecard is emailed to the representative hospital annually in the fall. Finally, the Energy Star is

an online program that anyone can sign up for (data is password protected) and allows for various "canned" reports and custom reports of you data. The coverage of each tool also differs. IFMA/ASHE/CHES compare only Healthcare facilities but covers North America. OHA's Green Hospital Scorecard and the Green Energy Act cover only Health Care facilities in Ontario. Energy Star covers all types of facilities and also is worldwide. Lastly, access to submit information or results varies. IFMA/ASHE/CHES report is available v ia CHES members in Canada, the Green Hospital Scorecard submission and results are via the representative hospital in Ontario, and the Green Energy Act submission is via the representative public funded facilities in Ontario; however, the results are available to the public. The Energy Star (portfolio Manager) results are available to anyone who signs up and downloads their own reports, while data may be shared by the facility with others. ADDITIONAL TOOLS

Should one wish to broaden their review, there are other additional resources such as the BOMA BESt 2011 Energy and Environmental Report and the NRCan Benchmarks and Best Practices for Acute and Extended Health Care Facilities guide to add to your tool kit. HWS1420P-00 shown

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MOVING FORWARD

Although each tool has both pros and cons, the old adage remains true: You can't manage what you don't measure. It's advisable to start with one or more of these tools and analyze where one's organization stands. A review of the results will then help determine what the organization is doing well and where the opportunities for improvement exist. Finally, those in Ontario's public sector may want to use benchmarking as part of their Conservation and Demand Ma n a g e m e n t P l a n t h a t t h e y h ave submitted for 2014 as part of the Green Energy Act requirements.

Robert Hutton is owner of MD ENERGY LABS. He can be contacted at MDENERGYLABS@Yahoo.ca. 22 Canadian Healthcare Facilities CHF_FKC_1_2PAGE_Vertical.indd 1

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CLIMATE DISR AND HEALTHCARE On the frontlines

By Tom Rand

I’m one of those people who stays up late at night worrying about climate change, and thinking about how desperately we need to focus on developing and implementing more clean technology worldwide.

24 Canadian Healthcare Facilities

RUPTION But in my defense, I have good reason to be worried. According to the World Health Organization—and pretty much every other reputable scientific source—the continued warming of the earth has the potential to adversely affect human health in a number of pretty terrifying ways. Global warming can change the range and seasonality of infectious diseases, disturb food-producing ecosystems, and increase the frequency of extreme weather events like hurricanes and deadly heat waves. It’s not beyond the realm of possibility that we could see malaria spread into Ontario if we don’t start taking significant action today. The sobering fact is we are headed towards six degrees of global warming in this century, which is well beyond the internationally agreed upon limit of two degrees. The momentum is massive and disastrous. Carbon accumulates in the atmosphere, so even if we stopped all carbon emissions tomorrow—which is, of course, an impossibility— that existing carbon we’ve already spewed into the sky would continue to linger in the atmosphere for hundreds of years. The damage is done. All we can do now is stop it from progressing. Climate change dwarfs all other problems the world is facing right now—and that’s saying a lot given the unrest, violence, and turmoil we’ve seen in the last several months around the globe. I’m desperately trying to do my part. As a Managing Partner of the privately backed $30 million ArcTern Ventures, my focus is on supporting the development of promising cleantech companies. In essence, I help build companies that can actually solve the problem. And the thing is, after helping to build Planet Traveler—the lowest carbon hotel in the world—I know it can be done. We took a century-old building in the heart of Toronto, and completely renovated and retrofitted it using cutting-edge techniques to reduce carbon production, energy use, and our overall impact on the planet. It was like a test lab for me. I wanted to see if it was actually possible to build a “green” building and make a profit doing so. We did. We cut carbon by 75% using technologies that help us produce our own electricity, recapture waste heat, and significantly reduce our

“Hospitals will be on the frontline as the climate change crisis worsens.” overall power consumption. So we continue to reap the cost and environment-saving rewards of choosing to invest in green technology, making the hotel more profitable, not less. Canada could blow past its Kyoto target if more companies and businesses used this model. The Planet Traveler experiment proves, beyond a shadow of a doubt, that it is possible to lower carbon emissions by three-quarters and still make money. So why isn’t this happening? Why aren’t more facilities utilizing existing green technology and making more of an effort to take their environmental responsibilities seriously? First and foremost, you have to be motivated to do it, and most business simply aren’t. Their core mandates are to be profitable, not green, so being low carbon just isn’t on the agenda. But it could be. In fact it should be. Energy prices are only going to continue to rise, so putting it on the agenda actually makes sound economic sense. HEALTHCARE: THE IDEAL MODEL?

Hospitals could be the perfect model for this kind of mindset change. As publicly funded, non-profit organizations, it’s potentially much easier for them to have the kind of long-term view you need to adopt and utilize green technology. They could comfortably invest in technologies that will lower energy consumption and carbon emissions, knowing there’s a payback in the long run. Hospitals also use two-to-three times more energy than other buildings, so this kind of outlook makes both fiscal and environmental sense. Fall/automne 2014 25

“As publicly funded, non-profit organizations, it’s potentially much easier for [hospitals] to have the kind of long-term view you need to adopt and utilize green technology.” And it can all start with a simple conversation. The people who run hospitals know its energy use patterns. Unlike office towers, hospitals are “on” 24 hours a day—but there are still peak and off-peak usage times. So if those folks talked to the engineers building the hospitals, together they could determine how to lower the cost of new energy systems based solely on the energy profile of the building itself. Hospitals will be on the frontline as the climate change crisis worsens. With an increase in infectious diseases, famine due to drought and crop failure, floods and other extreme weather events, it will become more important than Class1_CHF_Fall_2014_FINAL.pdf 1 14-10-29 3:45 PM

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ever for this critical piece of infrastructure to be up and running. Hospitals can’t afford to be susceptible to power outages—they can’t afford to rely solely on the grid anymore. They need to be part of the solution, not the problem. But like any concept that runs counter to deeply held beliefs, it’s still difficult for some people to fathom that any of this is actually true—that we really are quietly destroying our very own planet. We want to cling to the long-held belief that “things will look better in the morning”. In so doing, the cognitive guard dog blocking all contrary ideas, no matter how factually sound, from entering our brains helps us reject this new, frightening information that tells us we should be changing our behaviors—and that we need to do it right now. It’s not easy to jettison deeply held beliefs and accept something new, and disinformation campaigns that are funded to discredit scientists and put doubt in the minds of the general public don’t help matters. Creating a low-carbon economy is the hardest thing we, as humans, will ever try to do. We have become comfortable with the status quo and don’t like the idea of having to change or be inconvenienced in any way. I believe the solution is to put a price on carbon. It’s the most powerful tool in our arsenal. In fact, it may well be the only one. We clearly need to change how we’re doing things, since simply imploring people to conserve isn’t making a big enough impact on the problem. Shifting the burden for all the damage being done back to those who are responsible for it may be the only way to convince the biggest offenders to embrace the kind of new, clean technology that can save our precious environment and non-renewable resources. In the end, it may be the only way to save ourselves.

Tom Rand, Environmental Sustainability Expert and Venture Capitalist, will be speaking about the key roles hospitals can play in our quest for a low-carbon economy on November 3 at HealthAchieve. Learn more at www.healthachieve.com

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LIGHTENING THE FINANCIAL

BURDEN ON SENIOR LIVING FACILITIES A US solar powered case study

By Ted O’Shea There is a growing senior resident population at assisted living communities, and that means increasing energy costs as well. It’s a booming industry, but that doesn’t mean it’s a slam dunk for operators. The margins are surprisingly low and the industry as a whole is still trying to recover from the worldwide economic downturn. As a result, senior living facilities are always looking for creative strategies to cut costs and foster long-term financial sustainability. Many facility managers and CFOs are finding that one effective answer to their budget crises lies just overhead—the sun. By retrofitting their facilities with solar array installations, facilities are saving big money and, at the same time, saving jobs. It’s a winwin, not just for the operators, but for the communities as well. In addition to the positive financial and environmental impact, research shows that solar installations also greatly improve both 28 Canadian Healthcare Facilities

community and resident satisfaction. In addition, new financing models known as Power Purchase Agreements (PPAs), enable sustainability programs without redirecting capital from core business objectives. In other words, they allow senior living facilities to simply contract to buy the electricity and have the energy company to take on responsibility for installing, owning and operating the solar array. As such, facility owners incur little or no upfront costs or balance sheet liability in order to reap the benefits of the solar array. Implementation of any renewable solar solution has obvious and immediate benefits. Savings on utility bills increase Net Operating Incomes, without an increase in resident costs. PPA’s are typically fixed price over a 20 year period thus acting as a hedge against volatile electricity costs. Plus, as a more environmentconscious public demands sustainable energy practices where

“Quite frankly, if we had started the green programs we have initiated in the past few years much sooner, I believe the cost savings would have helped us to get through a period of lower revenue without letting people go.” they live, solar energy is an efficient and cost-effective way to meet this demand. Lastly, renewable energy decreases communities’ greenhouse gas emissions and reduces their dependence on fossil fuels. CASE STUDY: GLEN MEADOWS RETIREMENT COMMUNITY

While there are an increasing number of examples of successful solar installations, Glen Meadow Retirement Community in Baltimore, Maryland, USA, is a model example. The community, which is a subsidiary of Presbyterian Senior Living (PSL) recently brought in ABM, a leader in the facility solutions industry, to install a 1.2-megawatt solar array which consists of 4,150 panels. It will generate 1.5 million kilowatt hours of energy annually—making it one of the largest such projects in the Baltimore metro area to date. The installation is projected to provide $700,000 in energy cost savings over the course of the 20-year power purchase agreement at a fixed, low-cost rate while reducing the demand for electricity created by coal and natural gas by 1.5 million kilowatt hours per year. ABM provided the proper engineering and design of the solar array to bring costs down and increase power production, along with giving guidance on the financial solution that ultimately made the project feasible. “Residents love the idea of green,” says PSL Chief Financial Officer Jeff Davis.“They think it’s phenomenal. Once we shared the idea, the residents were almost pushing us to get it done.” PSL only wishes they had implemented the project earlier. At the height of the recent economic downturn, Glen Meadows experienced a 30 per cent reduction in ‘move-in’ clients, which led Davis to look for cost-cutting measures anywhere possible. After being forced to lay off 130 of the senior living provider’s nearly 3,000 employees nationwide, Davis knew he needed to find a creative alternative to cutting additional labor. One day, while channel surfing at home, Davis happened upon a television documentary discussing the world’s future energy challenges. Among other eye-opening facts, he learned that energy consumption in the U.S. is three to ten times higher than in other countries. It was the ‘a-ha moment’ Davis had been waiting for and spawned the idea to create a ‘green’ committee at PSL. He quickly received approval from PSL CEO Steve Proctor. The group included himself, the corporate director of plant operations and construction, an energy consultant and a building systems engineer. One of the initial ideas of the committee was to utilize solar energy at certain sites—beginning with Glen Meadows. All involved agree the project has been a tremendous win. However, the success of the Glen Meadows solar array remains

somewhat bittersweet for Davis. “Quite frankly, if we had started the green programs we have initiated in the past few years much sooner,” Davis says. “I believe the cost savings would have helped us to get through a period of lower revenue without letting people go.” Of course, hindsight is always 20/20. The more important fact is that since the PSL committee started its work three years ago it has netted annual savings on several projects, including the Glen Meadows solar array, of nearly $1 million dollars and they helped fund the additional projects with stimulus money, low interest energy loans and cash flow—rather than PSL’s own capital budget. Energy retrofitting is such a good investment, Davis says, that he has recommended to his CEO and board that PSL set aside 20 percent of its annual $13 million capital budget and part of its $80 million endowment just for this purpose. “We’re picking up the easy dollars from deploying sustainable energy in new construction,” says Davis. “Now we need to go after the more difficult and expensive retrofitting.” Yet the retrofitting model is unquestionably beneficial to non-profit senior living providers like PSL because of their business model. “We have done business in some locations for 100 years,” Davis says. “The concept of long-term sustainability is ever more important and a huge value-add in terms of community and resident satisfaction.” Projects like the Glen Meadows solar array are also good for the state. Solar power accounts for only a small percentage of Maryland electricity generation, but the number of arrays in the state are expanding quickly. Commercial-scale projects such as the Glen Meadows array have grown from less than 1.5 megawatts in total five years ago to more than 60 megawatts now, according to the Maryland Energy Administration. What’s more, due to Maryland’s green energy mandates, the project helps reach statewide alternative energy targets that are commonly supported through tax credits and depreciation. As a result, thanks to sustainable solutions such as solar arrays, the future is looking a lot brighter for not just an industry, but an aging country as a whole. Ted O’Shea is a Vice-President of Energy at ABM Government Services and has executive management responsibility for ABM’s renewable power generation service offering and the Federal energy market vertical. ABM and its joint venture partners have completed over $1B in energy services projects that support clients’ goals of reducing energy consumption, increasing renewable energy production and increasing bottom line profits. ABM provides finance solutions for its energy projects that minimize investment and risk for its clients. Fall/automne 2014 29

HIRF 2014-15 IS COMING:

WILL YOU BE READY? By Robert Hutton

The Healthcare Infrastructure Renewal Fund (HIRF) is a Ministry of Health (MoH) capital grant program administered by the LHINs. As for what to expect, the following excerpt from last year's HIRF guideline helps to clarify the MoH's intention: "Hospitals are responsible for planning infrastructure renewal activities to ensure that their facilities are in a good state of repair. Recognizing the need for the renewal of health care infrastructure, the ministry created the HIRF program. This program supplements a hospital’s existing renewal program and helps to address renewal needs on a priority basis." "The Ministry of Health and Long-Term Care (“the ministry”) is now fully aligning HIRF with the results of the Facility Condition Assessment Program (“FCAP”). This means that there will no longer be a minimum HIRF amount for each Local Health Integration Network (“LHIN”). However, LHINs will be able to endorse urgent hospital infrastructure needs as exceptional circumstances." Hospital potential HIRF funding is determined using a hospital's Facility Condition Index (FCI) and its relationship to the rest of the province's Hospitals FCI. Therefore, it is critical that the audit is updated and correct. The guideline is intended to provide team with two options for submission. The primary format will be a project that improves your Facility Condition Index (FCI), where your current FCI is 0.3 or greater, less than $1M, and meeting FCAP priorities 1, 2, or 3. This process will be the easiest for the LHIN to review and approve. The second option is to provide a business case for "exceptional circumstances" where the hospital's immediate need can be demonstrated. This will be harder for the LHIN to review, but is still an option. PREPARATIONS

The first step is to review your current FCAP audit and be sure that it is up to date. The MoHLTC, thru their supplier, VFA, completes on-site updates every three years. Hospitals are expected to update the audit as changes occur during the interval between formal audits. Your audit will only be as good as the information provided to the VFA audit team. Ask yourself: Have you reviewed your audit to be sure there are no missing items? Do you have equipment that is breaking down more frequently than normal that is not appropriately captured in the audit? Have you changed the function or hours of operation directly impacting a piece of equipment's service life? Have you updated the audit indicating new or renovated space? Lastly, have you updated the audit with any new equipment? All of these factors have the potential to change your FCI and thus your share of the HIRF fund. You will want to be sure that you have completed this prior to the MoH calculating HIRF allocations this fall. SUBMISSION

Start by reviewing last year's HIRF guidelines and your last two HIRF 30 Canadian Healthcare Facilities

allocations. This will provide the submission requirements and the potential funding level. Using your online FCAP audit (VFA), complete a report showing all asset requirements with an FCI greater that 0.3 and meeting the FCAP priorities 1, 2, and 3. Once you have this list, prioritize those projects that meet your financial capital capabilities for this upcoming budget year and are similar to the previous allocations. Build a plan with several options both above and below the previous allocation dollars. Experience has shown it is best to limit the number of projects needed to meet the allocation dollar total. It's also important to confirm project budget/ costing, as this may be different than the VFA numbers or the intended replacement may be more costly due to capacity, technology, or code requirements. Also, obtain preliminary approval for the plan while you wait for the LHIN to provide this year's allocation. During your review of your audit, you may find you do not meet the 0.3 FCI requirement. You still have the alternative of submitting a business case for “exception circumstances”; however, this will require more effort as you are now having to "prove" your need to the LHIN. Once the LHIN has provided the allocation amount for your hospital, match it to your draft plan and finalize your submission. Be sure to submit your HIRF documents to the LHIN on time with all signatures so there are no delays. POST SUBMISSION

While you wait for approval from the LHIN, it is a good time to start planning for next year. Do you still have requirements from your list that qualify? If not, start drafting your business case as an exception. Will you have other capital projects this year that will impact your current FCI? The end of this process should be to develop both a short (1- to 3-year) and a long (3-to 10-year) infrastructure renewal plan. An ongoing plan provides you the means to react quickly to other grants and programs as they are announced while providing the details needed for next year's HIRF submission. Your project will need to meet procurement guidelines, so now is the time to start this process. You may be able to split the project into a design phase and the actual implementation phase, and obtain approval internally to proceed with design. This will help move the project ahead while awaiting your final approval from the LHIN. Remember that your project must be completed by March 31, 2016. PROJECT APPROVED!

Complete your procurement phase and award the contract. The last phase of your HIRF program will be to finalize costing and submit your summary financial report. Overall, good luck! Robert Hutton is owner of MD Energy Labs and the recently retired coordinator of energy and infrastructure for St. Joseph's Healthcare London.

Once he reduced his energy costs by 55% after installing a VFD, savings in other parts of his business went into overdrive. Once you start seeing the benefits from our incentives for installing premium efficiency motors and VFDs, you’ll want to look into making other areas of your facility like lighting, HVAC and building automation more efficient too. When you do, you’ll be joining institutions like Kingston General Hospital, St. Thomas-Elgin Hospital and Hotel Dieu Hospital who are already enjoying the energy savings that our incentives deliver. Take a look at their stories and our incentives at

saveonenergy.ca/canadian-healthcare

Subject to additional terms and conditions found at saveonenergy.ca. Subject to change without notice. OM Official Mark of the Ontario Power Authority.

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