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Volume 37 Issue 4

Fall/Automne 2017



New HSC hospital to transform women’s healthcare thanks in part to facility management team

2017 CHES Award Winners A Green Alternative to Composting Hospital Garden Yields Fresh Food

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Issue 4




Kevin Brown


Annette Carlucci


Elizabeth Nguyen




6 8

24 A Collaboration of Efforts  Facility management involvement in integrated design process key to success of new HSC Women’s Hospital

Editor’s Note President’s Message

10 Chapter Reports

28 Flush of Genius  Pulp macerators reduce risk of crosscontamination, offer cost savings



CHES Canadian Healthcare Engineering Society


Société canadienne d'ingénierie des services de santé


16 Forging a Green Future in Quebec Un avenir plus vert dans Québec


20 Power of Engineering Passion becomes profession for Ken Herbert

32 Seeing the Light LED retrofit brings big energy, cost savings to Mackenzie Health

22 Repeat Performance Ontario chapter’s high hopes become reality with second President’s Award win

34 Dream Team FMO, EES departments collaborate on Delta Hospital upgrade project to enhance operations, improve energy efficiency 36 A Growing Opportunity Hamilton Health Sciences gives back to community, patients with hospital garden 38 Power of Digestion Runnymede Healthcare Centre adopts alternative composting technology to ‘eat’ through waste


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


Newfoundland & Labrador: Colin Marsh Maritime: Helen Comeau Ontario: Jim McArthur Quebec: Michel Brisson Manitoba: Reynold J. Peters Saskatchewan: Jim Allen Alberta: Peter Jarvis British Columbia: Steve McEwan FOUNDING MEMBERS

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

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COLLABORATION OF EFFORTS IT HAS BEEN almost three years since I took over the editorial reins of Canadian Healthcare Facilities, and my view of the healthcare industry, particularly hospitals, has changed during this time. Today, thanks in part to the people who have contributed content to the publication, I see hospitals as more than just a place where doctors and nurses work, and the sick and injured are treated. They’re complex environments with many moving parts and a multitude of people who work behind the scenes to ensure safe and efficient operations. One such person is Ken Herbert, who dedicated more than three decades to the healthcare industry. The second class power engineer served in numerous key positions at three Alberta hospitals over the course of his 35-year career before retiring in 2015. Herbert’s continued contribution to healthcare engineering during this time was recently recognized at the 2017 CHES National Conference in Niagara Falls, Ont., where he was bestowed with the Hans Burgers Award. Also honoured at the esteemed event was the Centre hospitalier universitaire de Québec-Université Laval and CHES Ontario chapter, which received the Wayne McLellan and President’s awards, respectively. You can read all about the three award recipients and their achievements beginning on page. 16. From there we turn to the new Women’s Hospital at Health Sciences Centre (HSC) Winnipeg. The design and construction of the nearly 400,000-square-foot building has been a true collaboration between stakeholders. The facilities management team has been involved in the redevelopment since its earliest stages, which is key to better project outcomes. You can read all about the facility beginning on page 24. The new HSC Women’s Hospital isn’t the only story this issue that explores the role facilities management and associated departments have played in hospital projects. Others include Dream Team, which details the participation of Delta Hospital’s facilities maintenance and operations team in a hospital upgrade project, and A Growing Opportunity, which delves into how Hamilton General Hospital’s facilities management department contributed to the development of the hospital’s community garden. As always, I’m interested in obtaining your feedback and article proposals. After all, collaboration produces better outcomes. Clare Tattersall

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.

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WORDS OF APPRECIATION I HAVE OFFICIALLY completed my commitment as CHES National vice-president. The support I received from my colleagues and peers, as well as the current and past executive teams, made the past two years seem significantly shorter than they were. I have the utmost respect for Mitch Weimer (outgoing president) and Peter Whiteman (outgoing past president), and can’t praise them enough for their encouragement and direction. I also want to thank the other members of the executive committee — Roger Holliss (incoming vice-president), Craig Doerksen (treasurer), Sarah Thorn (outgoing secretary) and Kate Butler (incoming secretary) — for their hard work and passion for the organization, as well as the provincial chapter chairs for their involvement at the local level. Not to be forgotten is executive director Donna Dennison and conference coordinator Jenny Oh. Their tireless support over the last few years has been much appreciated. I look forward to working more directly with them moving forward. I have been fortunate to participate on the CHES National conference organizing committee, serving as the executive liaison. In 2016, Norbert Fischer and his team from B.C. hosted an outstanding conference in Vancouver. We just closed the doors on this year’s event, which took place in Niagara Falls, Ont. Barry Hunt and his group have exceeded their goals, surpassing the last time they hosted the conference in 2013. Congratulations! One of the many highlights of the CHES National conference is the awards night. This year, CHU de Québec-Université Laval (Wayne McLellan Award of Excellence in Healthcare Facilities Management) and Ken Herbert (Hans Burgers Award for Outstanding Contribution to Healthcare Engineering) received nods from the Society. For the second year in a row, the Ontario chapter nabbed the President’s Award for its commitment to education, administration and representation in the activities of the national board. I’d like to thank the sponsors that financially support these awards as well as the conference. It would be an insurmountable task to hold these events without them. The CHES National conference is just one of many educational opportunities offered to members. I’d like to extend my gratitude to the chair of the professional development committee, Robert Barss. He and his committee are continually improving our educational offerings, which include webinars, the Canadian Healthcare Construction Course (CanHCC) and the Canadian Certified Healthcare Facility Manager (CCHFM) program, among other course offerings. Last but not least, I’d like to thank my employer, Alberta Heath Services, for supporting me on this journey. I look forward to performing my duties as CHES National president and your backing is greatly appreciated as we work to maintain what has currently been established, as well as move the organization forward so that it remains of value in our respective healthcare fields. Preston Kostura President, CHES National

EARN CONTINUING EDUCATION CREDITS FROM CHES Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Fall 2017 issue of Canadian Healthcare Facilities and passing a quiz based on articles in the issue. Once you’ve read the issue from cover to cover, simply go online to to take the quiz. CHES members who pass the quiz will be able to claim one contact hour (0.1 CEU) on their CanHCC or CCHFM certificate renewals.




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It was an incredible summer in British Columbia. The province broke records for highest temperatures in more than 100 years, the longest drought and the worst fire season. The effect on the public, staff and our healthcare facilities was immense. B.C.’s health authorities were tasked with evacuating more than a dozen facilities while having to mitigate some of the poorest air quality on record province-wide. Provincial emergency management systems were thoroughly tested with many lessons learned. The importance of redundancy required by CSA standards was put to the test during the many power failures and environmental demands. The B.C. chapter has started planning next year’s conference. It will be held June 10-12, at the Delta Whistler, and be followed by the Canadian Healthcare Construction Course (CanHCC). Call for abstracts will be posted online by the end of October. The 2018 conference theme is still in the works; however, it will likely reflect the many lessons learned from this year’s record-breaking events in B.C. The chapter’s education committee posted an expression of interest online for volunteers to assist with conference planning and other education initiatives. This is a great opportunity to take advantage of all CHES has to offer.

The chapter’s spring professional development day was a resounding success. It saw approximately 80 attendees — the largest turnout ever. As well, for the third year in a row, the chapter had to turn away vendors who wanted to participate in the educational forum. A total of six vendors gave presentations. Topics included: contract management for design and construction contracts in healthcare facilities (Catalyst Consulting Engineers Inc.); water management plan (Chem-Aqua); increasing ROI on a facility’s IT investment by leveraging the integration of an IP-based nurse call system with its network (Genesis Integration Inc.); infection control during construction activities and reducing nosocomial infections in healthcare patients (All-Tech Environmental Services Ltd.); digital hospital patient-centred care (Honeywell Energy Solutions Group); and wireless technology and video surveillance (Babb Security Systems). Fall is now well underway and so, too, is planning for the 2018 CHES National Conference in St. John’s, Nfld. Venues have been booked, companion program events lined-up and entertainment finalized. The Newfoundland & Labrador chapter is sitting in a solid financial position so the executive committee decided to send an additional person to this year’s CHES National Conference in Niagara Falls, Ont., bringing the total number of members in attendance to four. This was strategic, providing the opportunity to fully appreciate what goes into a conference of this magnitude and understand what’s expected of the 2018 CHES National Conference. The chapter executive committee is complete once again. After saying goodbye to long-term members Bill Squires and Brian Kinden, we have welcomed Carlson Way and Doug Kennedy as the new vice-chair and treasurer, respectively. Randy Cull has moved into his new position as chapter secretary. It has been a rocky year for the province of Newfoundland and Labrador. Tough fiscal times has led to cutbacks of all types. Provincial strategies to improve the economic situation have resulted in job losses within the government sector. Many of our peers have lost their positions, some of which have been active CHES members for years. Presently, there are 42 active paid members. The chapter is pushing recruitment of vendors/suppliers, consultants and other healthcare dependents to improve membership enrollment.

—Steve McEwan, British Columbia chapter chair

ALBERTA CHAPTER I am happy to announce the Alberta chapter now has a full executive committee. Dan Ballantine has filled the role of vicechair. He is the facilities maintenance and engineering manager at the Peter Lougheed Centre in Calgary, and a CHES member for many years. Dan’s education as an electronics technician, extensive healthcare experience and high level of professionalism is a welcome addition to the executive team and a benefit to the chapter. In September, I travelled to Niagara Falls, Ont., for the CHES National Conference — my first as chapter chair. It was a wonderful opportunity to network with other chapter chairs, among others in the healthcare industry. We have begun planning the 2018 Clarence White Conference & Trade Show, which will be held April 16-17, at the Sheraton Hotel in Red Deer. We have already received sponsorship interest and been in contact with potential speakers. The Alberta chapter hosted the Canadian Healthcare Construction Course (CanHCC) Oct. 17-18, at the Renaissance Edmonton Airport Hotel. It provided participants the opportunity to learn about the unique challenges of healthcare planning, design and construction, and how to overcome them. I would like to congratulate Preston Kostura as he transitions to the position of CHES National president. Preston is a former Alberta chapter chair who has played a pivotal role in the chapter’s growth and development as well as the continued success of the Clarence White Conference & Trade Show. —Peter Jarvis, Alberta chapter chair 10 CANADIAN HEALTHCARE FACILITIES

—Colin Marsh, Newfoundland & Labrador chapter chair St. John's, Nfld.


ONTARIO CHAPTER The change in seasons, from summer to fall, brought with it changes on the Ontario chapter executive team. This is my last report as chapter chair as I move on to my new role as CHES National vicepresident. I’d like to thank all those that I’ve had the pleasure to work with and who have supported me during my tenure as chapter chair. Hopefully I’ve left the Ontario chapter well-positioned to continue advancing its mission. Also stepping away (though hopefully not too far) from the executive team is Allan Kelly, who has completed his six-year stint as past chair. I’d like to thank Allan for his years of service and, though his formal commitment to CHES Ontario has come to an end, I hope to see him continue his efforts within the chapter in some other capacity. With the changing of the guard comes a new face to the chapter executive, Beth Hall (secretary). She joins John Marshman (vice-chair), Ken Paradise (treasurer), Larry Erwin (communications and public relations) and Richard White (partnerships and advocacy), who are progressing through the CHES ranks, and well-experienced members Jim McArthur (chair), Rick Anderson (education and professional development), Ron Durocher (conference planning) and Jeff Weir (membership). An e-mail was sent to all Ontario chapter members in early August, with the results of the 2017 election. The e-blast also included photos and biographies of all committee members, including those who do not sit on the chapter executive, to acknowledge the time and effort volunteered by others beyond the executive team. Early numbers indicate the 2017 CHES National Conference was successful on many fronts. From the number of attendees (753) and trade show exhibitors (154) to the quality of the speakers and record-setting sponsorship dollars, the event reflected the significant effort put forth by the entire organizing committee over the past year. I’d like to thank all who contributed to bringing the conference to fruition as well as those who took the time to attend. Hopefully everyone took something away from it that will improve their facility. The latest edition of Z7396-12, Medical Gas Pipeline Systems-Part 1: Pipelines for Medical Gases, Medical Vacuum, Medical Support Gases and Anesthetic Gas Scavenging Systems, has been published. CHES and the CSA Group are now working together to develop a communications and awareness strategy for 2018, to educate healthcare managers on the revised standard, help them understand the changes and explain what they mean to them. There is talk of hosting a webinar in 2018, and perhaps incorporating the topic into the speaking session lineup of one of next year’s conferences. In early August, a contingency of our project team (17 hospitals and Class 1 Inc.) was asked to give a presentation in Toronto, to the Ontario Centres of Excellence (OCE) judging/selection panel as part of the second and final stage of the review/approval process. Our presentation was one of approximately 18 submissions still in the running for significant grant money in support of developing and installing new technologies to reduce the release of greenhouse gases into the atmosphere. In the end, we weren’t awarded the grant; however, we are actively seeking funding from other sources. —Roger Holliss, Ontario chapter chair 2017 CHES National Conference in Niagara Falls, Ont. FALL/AUTOMNE 2017 11





With the most successful CHES Maritime 2017 Spring Conference & Trade Show behind us, we are well on our way in planning this year’s fall education day, which will be held Nov. 21, at the Best Western Glengarry Hotel in Truro, N.S. We welcome all frontline maintenance workers in hospitals and long-term care facilities to register and join us for the day. Revenue generated from this year’s conference enabled the chapter to cover the travel expenses for two executive team members to the 2017 CHES National Conference in Niagara Falls, Ont., in September. It was an excellent learning and networking experience that provided leadership growth for the executive members. I have the privilege of working with some great individuals on the chapter executive committee. It is with great joy that I announce Robert Barss has accepted the role of vice-chair. Robert previously served as chair of the chapter. Among other responsibilities, the vice-chair is responsible for leading the planning of the chapter’s spring conference. Next year, it will be held in Moncton, N.B., which has been an excellent host city in the past. We look forward to another successful conference in 2018. The chapter is able to balance the books while offering several financial incentives to its members in the way of student bursaries, contribution to Canadian Certified Healthcare Facility Manager (CCHFM) exam fees, webinars, the fall education day and other rebates.

The Manitoba chapter once again sponsored a session at the BOMA Manitoba Building Expo, which took place Oct. 17, at the Victoria Inn Hotel and Convention Centre in Winnipeg. The focus of the session was the new Selkirk Regional Health Centre. The cost of attendance to the session, luncheon and trade show was covered by the chapter for all Manitoba CHES members. We are continuing to work on next year’s education day. If you would like to propose a topic or have any suggestions, please contact a member of the executive team. Keep in mind that 2018 is an election year. CHES members that are interested in joining the chapter executive should convey their interest as soon as possible. Tom Still will be taking over as chapter chair, leaving the position of vice-chair open. The roles of treasurer and secretary will also need to be filled. Both Tom and I attended this year’s CHES National Conference in Niagara Falls, Ont., Sept. 17-19, on behalf of the Manitoba chapter. I’d like to congratulate past chapter chair, Craig Doerksen, who will continue on as treasurer on the national board for the next two years. The chapter is currently pursuing educational opportunities and partnerships with other organizations throughout the province, including Construction Specifications Canada (CSC) Winnipeg, the Winnipeg Construction Association (WCA), the American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE) Manitoba and the Building Owners and Managers Association (BOMA) Manitoba, among others.

—Helen Comeau, Maritime chapter chair

—Reynold J. Peters, Manitoba chapter chair

CHES Canadian Healthcare Engineering Society


Société canadienne d'ingénierie des services de santé


CALL FOR NOMINATIONS FOR AWARDS 2016 2016 Hans Burgers Award

For Outstanding Contribution to 2018 Hans Burgers Award Healthcare Engineering

Wayne McLellan Award of Excellence In Healthcare Facilities Management

For Outstanding Contribution to Healthcare Engineering DEADLINE: April 2018 DEADLINE: April 30, 30, 2016

2018 Wayne McLellan Award of Excellence In Healthcare Facilities Management April 30, 2018 DEADLINE: DEADLINE: April 30, 2016

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

For Nomination Forms, Terms of Reference, criteria, and past winners / About CHES / Awards For Nomination Forms, TermsNational of Reference, and past winners Send nominations to: CHES Officecriteria, Fax: 613-531-0626 / About CHES / Awards


Send nominations to; CHES National Office

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Supporting Healthcare's Sustainability Leadership Q&A With Enbridge's Matt Cannon Canada's healthcare sector has long been a role model for energy-saving and carbon-reducing initiatives. Today, its leadership in sustainability continues to shine through in its approach to facility retrofits, expansions, and upgrades.

With more on how healthcare stakeholders are leading the charge in sustainable planning and how energy professionals are providing support, is Matthew Cannon, Enbridge Energy Solutions Consultant. How would you characterize the healthcare sector's approach to carbon reduction? Customers in the healthcare space are very calculated in their approach to managing the carbon output of their facilities. More and



more, they're focusing on long-term energy initiatives over short-term, low hanging, opportunities. It's a very positive shift across the sector and one that's becoming the norm. That is, there have always been a select few customers in this space that we've worked with on long-term energy-efficiency projects, but now we're seeing that same approach being taken by virtually everyone. That's a positive trend, because implementing those types of projects will provide facilities with savings for a period of 15-25 years.

Are there any common strategies among them? Each hospital is different; each has different processes, focuses, and infrastructures, so it is hard to identify one specific trend when it comes to their operational needs and the technologies they're pursuing. If I had to find one commonality, however, it's that while we're seeing healthcare clients make large investments in energy efficiency initiatives, we're also seeing them optimize existing systems. Take HVAC (heating, ventilation, and air conditioning) systems, for example. Healthcare clients traditionally focus on patient comfort or ease of operation and maintenance with their HVAC equipment. There was a “set it and forget it� attitude. Now, as mentioned, they're taking a more calculated approach as to what HVAC components perform best when it comes to reducing carbon emissions as well as ensuring patient comfort and ease of operations. How are healthcare clients balancing the need to reduce their carbon footprint with the need to protect their budget? When I get involved with a project, the goal is to optimize the money they're spending. That's the benefit of involving Enbridge from the get-go; we find ways to maximize the return on investment for big-ticket items by working with customers to understand their needs and then identify natural gas reducing opportunities in their facilities. When we do find ways of reducing their natural gas consumption, it lowers their operational costs and frees up funds for larger, more expensive projects. That makes those big investments more likely to succeed in being approved.

What programs and incentives does Enbridge provide for healthcare clients? Most of the opportunities for healthcare clients fall under our Custom Program, which provides an opportunity for customers to go forth and conquer their facility upgrades, retrofits, and expansions that are relevant to their specific facilities, rather than try to fit them in a box. Whether it's a boiler retrofit or optimizing their heating system, the program helps assess what their needs are and applies a new outlook on how to capture energy savings for reduced natural gas consumption. Beyond this unbiased consultancy and advice, our program also provides customers with financial incentives for quantitative studies and for project implementation. What are the advantages of involving an Enbridge Energy Solutions Consultant in these projects? Holistically speaking, at the core of our

offering is that we understand thermal energy systems. As a utility, we deliver gas to customers, but we are also best placed to work with them, understand how they use gas and offer unbiased advice about how they can use it more efficiently. In a lot of cases, we bring forward ideas they haven't even considered. At the end of the day, the expertise I bring to the table gives customers confidence. The key to it all, however, is building good client relationships. The incentives that come to customers by way of reducing natural gas consumption are great, but what really drives energy savings is working with each customer and helping them optimize their facility. It also helps to create a culture shift that leads to long-term planning in regards to reducing their natural gas consumption and carrying through other carbon-reducing initiatives.

To learn more about Enbridge's energy-saving programs and incentives, visit commercial. To contact an Enbridge Energy Solutions Consultant (ESC), phone 1-866-844-9994 or email



FORGING A GREEN FUTURE IN QUEBEC Un avenir plus vert dans Québec


ustainability has been top of mind for quite some time at the Centre hospitalier universitaire de Québec-Université Laval, commonly referred to as the CHU. In 2010, the largest university hospital in the province embarked on a series of deep energy retrofits at Hôpital de l’Enfant-Jésus (HEJ), the first of four hospitals to undergo these improvements at a total cost of $46 million. As completion of the upgrades at the final healthcare facility nears, the mood at the CHU is almost euphoric. The healthcare network’s recent CHES award win for its energy efficiency program has served to heighten the excitement of all involved in the sustainability strategy. “We put a lot of effort into this organizational priority so it was a great achievement for us,” says the CHU’s director of technical services, Pierre-André Tremblay, about the 2017 Wayne McLellan Award of Excellence in Healthcare Facilities Management, which he accepted on behalf of the healthcare organization. Presented at this year’s CHES National Conference in Niagara Falls, Ont., the annual honour is bestowed upon a health authority or hospital that has demonstrated outstanding success in the completion of a major capital project, energy efficiency program, environmental stewardship initiative or other facility leadership program. The projects at the CHU’s three completed sites (HEJ, Hôpital du Saint-Sacrement or HSS, and Centre hospitalier de 16 CANADIAN HEALTHCARE FACILITIES


e Centre hospitalier universitaire de Québec-Université Laval, communément appelé le CHU, est depuis longtemps à l’avant-garde de la durabilité. En 2010, il a entrepris une série de rénovations énergétiques poussées à l’Hôpital de l’Enfant-Jésus (HEJ), le premier de ses quatre hôpitaux à subir ces améliorations, pour un coût total de $46 millions. À l’approche de l’achèvement des travaux, l’ambiance du CHU est presque euphorique. Le récent prix CHES remporté par l’établissement pour son programme d’efficacité énergétique a permis d’accroître l’enthousiasme de tous les participants. “Nous avons consacré beaucoup d’efforts à cette priorité organisationnelle,” a déclaré le directeur des services techniques du CHU, Pierre-André Tremblay, au sujet du Prix d’excellence Wayne McLellan. Remis au dernier congrès national du CHES, à Niagara Falls, ce prix annuel est décerné à une autorité sanitaire ou à un hôpital qui a démontré un succès remarquable dans la réalisation d’un grand projet d’immobilisation. Les projets des trois sites du CHU (HEJ, Hôpital du Saint-Sacrement ou HSS et Centre hospitalier de l’Université Laval ou CHUL) ont permis de réduire de 29%, soit près de $2.9 millions par année, les factures d’énergie. L’argent économisé a permis de financer les améliorations de l’efficacité énergétique. Les émissions de gaz à effet de

l’Université Laval or CHUL) have slashed energy bills by 29 per cent, helping to reduce the organization’s bottom line by nearly $2.9 million a year. The money saved helped finance the energy efficiency improvements, along with financial incentives provided by utilities and governmental programs. Greenhouse gas emissions have also been lowered by 56 per cent, which is equivalent to emissions of 12,914 tonnes of carbon dioxide (eqCO2). An additional $657,484 a year in savings and 3,735 tonnes of eqCO2 emissions reductions are expected when the fourth site (Hôpital Saint-François d’Assise or HSFA) is completed this fall. These results have been achieved through conversion of steambased heating systems to hot water; installation of heat pumps and geothermal heating systems; optimization of ventilation systems; installation of a solar wall for fresh air preheating; optimization of chilled water networks; lighting conversions; central control system upgrades; and modernization of major central plants, all of which required careful planning and coordination with various hospital departments to avoid any service disruption to patients. “It was a juggling act because we had to maintain services while allowing for the improvements, but we never lost sight of keeping patients safe,” says Tremblay. “It’s our highest priority.” MULTI-FACETED MEASURES TRANSFORM THE CHU

The heating systems on the first three sites (HEJ, HSS and CHUL) were optimized to completely remove the steam requirements for heating. Some existing piping was reused, depending on its condition, and new piping was installed to create new hot water heating networks. This required changing coils in some ventilation systems as well as changing radiators in other areas. At CHUL, 1,000 aging radiators were replaced with new hot water radiators. At all four sites, heat pumps were installed to maximize heat recovery through the chilled water loops as well as some ventilation exhausts and boiler chimney stacks. The idea was to take advantage of the heat pumps’ high efficiency and Quebec’s cheap and clean hydro-electricity to reduce the use of natural gas. Dedicated geothermal heat pumps were also installed and properly sized for the geothermal underground

serre ont également été réduites de 56%, ce qui équivaut à 12,914 tonnes de dioxyde de carbone (eqCO2). Des économies additionnelles de $657,484 par année et 3,735 tonnes d’eqCO2 sont attendues lorsque le quatrième site (Hôpital Saint-François d’Assise ou HSFA) sera terminé cet automne. Ces résultats ont été obtenus grâce à la conversion de systèmes de chauffage à vapeur en systèmes à eau chaude; à l’installation de pompes à chaleur et de systèmes géothermique; à l’optimisation des systèmes de ventilation; à l’installation d’un mur solaire; à l’optimisation des réseaux d’eau glacée; à la conversion de l’éclairage; à des mises à niveau du système de contrôle et à la modernisation des centrales. “C’était un numéro de jonglage parce que nous devions maintenir les services tout en apportant les améliorations, mais nous n’avons jamais perdu de vue la sécurité des patients,” dit Tremblay. “C’est notre plus haute priorité.” DES MESURES MULTIPLES TRANSFORMENT LE CHU

Les systèmes de chauffage des trois premiers sites (HEJ, HSS et CHUL) ont été optimisés pour éliminer complètement les besoins en vapeur. Certaines canalisations ont été réutilisées, selon leur état, et de nouvelles ont été installées pour créer de nouveaux réseaux de chauffage à eau chaude. Il a fallu pour cela remplacer les serpentins dans certains systèmes de ventilation ainsi que des radiateurs dans d’autres secteurs. Au CHUL, 1,000 radiateurs vieillissants ont été remplacés par de nouveaux radiateurs à eau chaude. À les quatre sites, des thermopompes ont été installées pour maximiser la récupération de chaleur à travers les boucles d’eau glacée ainsi que les échappements de ventilation et les cheminées de chaudière. L’idée était de profiter de l’efficacité des thermopompes et de l’hydroélectricité bon marché et propre du Québec pour réduire l’utilisation du gaz naturel. Des thermopompes géothermiques ont également été installées et dimensionnées pour l’échangeur géothermique des trois premiers sites. Ce réseau souterrain ajoute jusqu’à 50 kilomètres de tuyauterie. Des détecteurs de mouvement ont été installés sur chacune des 43 hottes afin d’assurer une bonne qualité de l’air dans le laboratoire FALL/AUTOMNE 2017 17

CHES AWARDS exchange on the first three sites. This underground network adds up to 50 kilometres of piping. Motion sensors were installed on each of the 43 hoods that assure proper air quality in CHUL’s laboratory/research department, allowing dampers to reduce the exhaust air speed. A new air sampling system that draws air samplings from various areas to a central probe station was also installed. This system allows for efficient monitoring of large areas with limited amounts of probes and sensors, reducing maintenance costs and the recalibration required for such components. With this new system, along with the presence of sensors on each hood, evacuation rates under normal operation are reduced; however, if air contaminants are detected, fresh air and evacuation rates can increase rapidly. A 2,500-square-foot solar wall was also installed at CHUL to preheat the fresh air of some ventilation systems. In optimal wintertime conditions, the heat gain is as much as 12 C. During summer, dampers allow the fresh air intake to bypass the solar wall and enter the ventilation system without being preheated. Most of the chilled water networks were optimized to modulate according to each building’s cooling load. Using variable speed drives, the chilled water pumps now reduce their speed during low cooling demand periods. This prevents excessive heat from the pumps dissipating in the chilled water networks, which represents an additional cooling load for the chillers. At three sites (HEJ, HSS and CHUL), 35,000 T12 tubes were replaced by T8 tubes, which contain much lower levels of mercury. Magnetic ballasts, some of them containing hazardous material such as PCB (polychlorinated biphenyl), were also removed and replaced by electronic ballasts. For the fourth site (HSFA), new lighting takes advantage of LED technology, completely eliminating mercury. New controls and graphic displays were implemented where needed, along with all the new probes and sensors required to optimize and manage the new systems. On some sites, major recommissioning of the existing systems was also performed. On all four sites, some boilers, chillers and, in some cases, cooling towers were replaced. New adiabatic dry coolers were added at the fourth site (HSFA) to reduce water consumption, chemical use and the threat of legionella. ENGINEERING SUSTAINABILITY FROM THE GROUND UP

The CHU’s decision to embark on this ambitious project was fuelled, in part, by necessity. Much of the organization’s energy infrastructure and equipment was aging and nearing the end of — or even exceeding — its service life and therefore needed to be replaced. However, to do so over a short period of time was impossible if the CHU relied solely on the provincial government’s health budget. Instead, it decided to leverage the energy savings to pay for all the efficiency improvements. To achieve unconventional results, the CHU resolved to work with an external performance contracting design-build firm. Chosen through a public request for proposals (RFP), the winning bidder guaranteed the project cost, financial incentives and annual savings, completely removing the financial risk from the healthcare network. “This approach worked tremendously well in all four of our buildings, which together amount to more than 3.6-million square feet,” says Tremblay. “It required more involvement from the CHU administration during the RFP process and detailed study phase, but the impressive results far outweigh these efforts.” 18 CANADIAN HEALTHCARE FACILITIES

du CHUL. Un nouveau système d’échantillonnage de l’air a également été installé. Ce système surveille de grandes surfaces avec des quantités limitées de sondes et de capteurs, réduisant ainsi les coûts de maintenance et le recalibrage. Avec ce nouveau système, les taux d’évacuation sont réduits en temps normal, mais peuvent augmenter rapidement si l’on détecte des contaminants. Un mur solaire de 2,500 pieds carrés a également été installé au CHUL pour préchauffer l’air frais. Dans des conditions hivernales optimales, le gain de chaleur peut atteindre 12 C. En été, les registres permettent à l’entrée d’air frais de contourner le mur solaire. La plupart des réseaux d’eau glacée ont été optimisés. Les pompes à eau glacée réduisent maintenant leur régime pendant les périodes de faible demande. Cela empêche la chaleur excessive des pompes de se dissiper dans les réseaux d’eau glacée. Sur trois sites (HEJ, HSS et CHUL), 35,000 tubes T12 ont été remplacés par des tubes T8, qui contiennent beaucoup moins de mercure. Des ballasts magnétiques, dont certains contenaient des matières dangereuses telles que les PCB (polychlorobiphényle), ont également été retirés et remplacés par des ballasts électroniques. Pour le quatrième site (HSFA), un nouvel éclairage profite de la technologie DEL, éliminant complètement le mercure. De nouveaux contrôles et affichages graphiques ont été mis en place en cas de besoin, ainsi que les nouvelles sondes et capteurs nécessaires pour optimiser et gérer les nouveaux systèmes. Sur certains sites, la remise en service majeure des systèmes existants a également été effectuée. Sur les quatre sites, des chaudières, des refroidisseurs et, dans certains cas, des tours de refroidissement ont été remplacés. De nouveaux refroidisseurs secs adiabatiques ont été ajoutés au quatrième site (HSFA) pour réduire la consommation d’eau, l’utilisation de produits chimiques et la menace de légionelles. UNE CONCEPTION FONCIÈREMENT DURABLE

La décision du CHU de se lancer dans ce projet ambitieux a été alimentée, en partie, par la nécessité. Une grande partie de l’infrastructure et de l’équipement énergétiques de l’organisation vieillissait et approchait la fin de sa durée de vie ou la dépassait même. Cependant, le faire sur une courte période de temps était impossible si le CHU comptait uniquement sur le budget de santé du gouvernement provincial. Au lieu de cela, on a décidé de tirer parti des économies d’énergie pour payer toutes les améliorations de l’efficacité. Pour parvenir à des résultats non conventionnels, le CHU a décidé de travailler avec une entreprise externe de conceptionconstruction. Choisi dans le cadre d’une demande de propositions (DP) publique, le soumissionnaire retenu a garanti le coût du projet, les incitatifs financiers et les économies annuelles, éliminant complètement le risque financier du réseau de soins de santé. “Cette approche a énormément bien fonctionné dans nos quatre immeubles, qui totalisent ensemble plus de 3.6 millions de pieds carrés,” affirme Tremblay. “Il a fallu plus de participation de l’administration du CHU pendant le processus de demande de propositions et la phase d’étude détaillée, mais les résultats impressionnants dépassent de loin ces efforts.” Le service d’ingénierie et de maintenance de l’organisation a été très impliqué dès le début du projet, tout comme le service de contrôle des infections, qui a veillé à ce que les stratégies appropriées soient appliquées pendant la phase de construction pour assurer la sécurité des patients, des visiteurs et du personnel.

CHES AWARDS The organization’s engineering and maintenance department was deeply involved with the project from the get-go, as was the infection control department, which ensured the proper strategies were applied during the building phase to keep patients, visitors and staff safe. To begin, the engineering and maintenance team identified the various needs, such as energy efficiency targets, asset renewal requirements, energy redundancy and other sustainability goals, and selected the most appropriate business model to achieve them, which ended up being the performance contracting approach. Then, working with a third-party consulting firm, the team developed a detailed RFP. This involved gathering all the information necessary to build a reference year for each hospital and setting fixed energy rates for all bidders. Throughout the entire proposal and detailed study phase, the engineering and maintenance team made sure the suggested energy conservation measures would not hinder proper operation or daily maintenance tasks. The team also informed the designbuild firm of the various building needs and current system flaws. During the construction process, weekly meetings were held with the design-build firm and all stakeholders to make sure the work plans addressed the most important issues along with proper emergency situation solutions. In the performance follow-up period, the engineering team made sure proper preventive maintenance tasks were performed on the equipment. Every year, the team reviews and validates the performance reports issued by the design-build firm. “It’s been a tremendous effort,” says Tremblay. One that has clearly paid off.

Pour commencer, l’équipe d’ingénierie et de maintenance a recensé les besoins, tels que les objectifs d’efficacité énergétique, les exigences de renouvellement des actifs, la redondance énergétique et d’autres objectifs de développement durable. Puis, en collaboration avec un cabinet de consultants tiers, l’équipe a élaboré une demande de propositions détaillée. Cela impliquait de rassembler toutes les informations nécessaires pour constituer une année de référence pour chaque hôpital et fixer des tarifs d’énergie fixes pour tous les soumissionnaires. Pendant toute la durée de la proposition et de la phase d’étude détaillée, l’équipe d’ingénierie et de maintenance a veillé à ce que les mesures d’économie d’énergie suggérées n’entravent pas le bon fonctionnement ou les tâches d’entretien quotidien. L’équipe a également informé l’entreprise de conception-construction des différents besoins de construction et des défauts actuels du système. Au cours du processus de construction, des réunions hebdomadaires ont été tenues avec l’entreprise de conceptionconstruction et tous les intervenants pour s’assurer que les plans de travail abordaient les questions les plus importantes ainsi que les solutions de situation d’urgence appropriées. Pendant la période de suivi de la performance, l’équipe d’ingénierie s’est assurée que les tâches de maintenance préventive appropriées étaient effectuées sur l’équipement. Chaque année, l’équipe examine et valide les rapports de performance émis par l’entreprise de conception-construction. “Ce fut un énorme effort,” dit Tremblay. Ça en valait clairement la peine.


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POWER OF ENGINEERING Passion becomes profession for Ken Herbert


ew people know what they want to be when they grow up. This was not the case for Ken Herbert, who, at the age of 14, decided he wanted to be a power engineer after touring the Southern Alberta Institute of Technology (SAIT) with his Grade 9 class. “As soon as I entered the power engineering lab at SAIT with the boilers, turbines and associated equipment in full operation, I knew this was going to be my career,” he says. From there, Herbert followed the technical route through high school to prepare him for his post-secondary education at SAIT. After graduating in 1973, he quickly landed a job as a recovery boiler operator at the Procter & Gamble pulp mill in Grand Prairie, Alta., where he remained for two years. Herbert then moved back to Edmonton and worked at several different power generation plants. It was here that he learned 20 CANADIAN HEALTHCARE FACILITIES

about the field of facilities maintenance and engineering. Intrigued, he took a position with Public Works Canada (PWC) in 1977, as a mechanical/ technical inspector, which involved travelling to various sized federallyowned facilities in the Prairie provinces to perform mechanical inspections and m i n o r r e n ov a t i o n s , a s w e l l a s troubleshoot projects. Unfortunately, three years into his role with PWC, Herbert’s department was abolished and absorbed into another. However, as one door closed, another opened. Herbert’s then-director, Jim Porter Sr., suggested he’d be an asset in a healthcare facility and recommended him for the position of chief engineer at Edmonton General Hospital. And so began Herbert’s 35-year storied career in the healthcare industry, which involved numerous key positions in three facilities: Edmonton General Hospital

(1980-1986), Grey Nuns Community Hospital (1986-2002) and Royal Alexandra Hospital (2002-2015). “I was 27 years old and had no supervisory experience when I joined Edmonton General Hospital, but Jim must’ve seen something in me,” reflects Herbert, who believes it was his strong work ethic, passion for facilities maintenance and engineering, and ability to effectively interact with others that was behind Porter's backing. These traits continued to serve Herbert well throughout his career. From 1986-1988, he was part of the Alberta Urban Hospitals project management team, and played a key role in the construction, inspection, commissioning and turnover of Grey Nuns Community Hospital in Edmonton. In 2002, he accepted the position of project coordinator and manager for the Royal Alexandra Hospital’s $100-million ambulatory care redevelopment project.

“One of my objectives was to bridge the gap between the project management department and the facilities maintenance team,” explains Herbert. “When I first came on-board everything was done through meetings, which hampered the process, so I took it upon myself to meet face-to-face with the construction superintendent every day to find out what was needed.” Herbert’s ability to establish and maintain solid working relationships on this project garnered him the Capital Health REACH Award for Excellence in Customer Service in 2004. This is one of many accolades Herbert has received, others being the Alberta Health Services Initiative of the Year Award, which he co-won with Ted Haggart in 2012, for the development and start-up of a project coordinator boot camp, and, most recently, the 2017 Hans Burger s Award for Outstanding Contribution to Healthcare Engineering. Presented at this year’s CHES National conference, Herbert says the award is by far his greatest achievement to date. “I was extremely honoured and proud but also shocked because I had put my healthcare career behind me,” says Herbert, who retired in June 2015 after bouncing back from a serious health scare. Approximately one year prior, Herbert was diagnosed with an operable brain tumour. Within weeks it was removed and he soon received the good news that it was benign. Still, the experience was life-changing. “I was sitting in the backyard while on my three-month medical leave and I turned to my wife and said, ‘I could do this every year, have the summer off.’ She replied, ‘Why don’t you?’ And that was that.” After returning to his position as senior project manager at Royal Alexandra Hospital in September 2014, Herbert busied putting a succession plan in place. Fortunately, his role as past chapter chair of CHES Alberta was coming to an end that fall, so a second succession plan was not needed. “CHES Alberta was already in good hands,” says Herbert about then-chapter chair Preston Kostura and incoming chair Tom Howard, both of which he encouraged to get involved in the Society. “It’s such a great organization and it embraces so many in the healthcare industry

— consultants, contractors, vendors, frontline staff and, of course, engineers.” This inclusivity drew Herbert to CHES 25 years ago. At the time, he was a member of the Hospital Engineers Association of Alberta (HEAA). He joined the organization in 1980, and served in the roles of secretary, vice-president and president before ceasing his membership in 2002, when he moved from facilities maintenance engineering to project management No longer a member of HEAA, Herbert had more time to volunteer for CHES. Beginning in 2004, he dedicated a decade of service to the Alberta chapter, serving as treasurer, vice-chair, chair and finally past chair. During this time, he was involved in numerous provincial conferences and trade shows, participated in a variety of committees and played a pivotal role in the 2012 merger of HEAA and CHES Alberta, which created one body and voice for those in the province’s healthcare industry. With his retirement, Herbert’s role in CHES has diminished; however, he’s still a strong proponent of the organization. The same can be said for the field of power engineering. Since taking early retirement in 2015, Herbert has taught future power engineers at the Northern Alberta Institute of Technology (NAIT) in a power lab very similar to the one he visited nearly 50 years ago. “I have a great passion for the profession,” says the now part-time instructor. “It was my first love.” The second (though of no less importance) is his wife Charmaine, whom he affectionately calls Charlie. The two met at Edmonton General Hospital in 1984, when Herbert was a project/systems supervisor and his now-wife was a nursing administration secretary. They have been married for 33 years, are parents to four sons, three dogs and two cats, and are now grandparents. Their first grandchild was born this past spring — a welcome addition at the many dinners they host. “Family is very important,” says Herbert, who recently turned 65. So, too, is two sports teams from Cowtown. Their colours — red, white and black — have donned Herbert’s offices throughout the years and it’s rare to find him not wearing a jersey on game day.

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Why brands need to stop the slang By Steven Chester Fam, this this column is going to be so on fleek. Did the line above make you roll your eyes, if you understood even a word? According to recent research from Sprout Social, you’re more than likely one of the 69 per cent of respondents to their survey who found brands who use slang annoying, versus the 31 per cent who found it cool. Authenticity and personality As in all company-run social channels, authenticity and brand personality is a great thing, and so is being current and inclusive. Turning your logo to a rainbow theme during Pride Week or showcasing staff poses in Santa Claus hats at Christmas is fun and creates goodwill – but don’t use those holidays to sell more, unless you’re in the greeting card business. The survey also found that consumers believe there’s value in brands who are honest (86 per cent), helpful (78 per cent) and friendly (83 per cent). Here’s where the grey areas start to creep in: funny and trendy rank at 72 per cent and 43 per cent respectively, and snarky at 33 per cent. Keep in mind that in the B2B world, we’re a bit more conservative, as marketers are often reaching out to an audience who is at their workplace, and the demographic is likely older than the typical demographic on the social network they’re using. #SquadGoals While the colloquialisms of the day change frequently, the secret sauce to a great social media presence does not. If you’re consistently producing compelling, informative, or entertaining content that your audience wants to engage with, your brand is most of the way there.

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REPEAT PERFORMANCE Ontario chapter’s high hopes become reality with second President’s Award win


inning the President’s Award is no small feat. Since its creation in 2014, CHES chapters have competed yearly to capture the coveted prize, which includes a trophy engraved with the victorious team’s names, as well as two CHES National conference re g i s t r at i o n s a n d ex p e n s e s t o a maximum of $2,500 each. This year the Ontario chapter was triumphant, making it the first two-time and backto-back winner. What’s more, the chapter was bestowed the honour on its home turf. “Even though we improved our score over last year’s, we knew it was going to be tougher to win,” says Roger Holliss, who accepted the award on behalf of the chapter at the 2017 CHES National Conference in Niagara Falls, Ont. “Every chapter is ramping up their game to improve services to their membership.” The President’s Award is presented annually to the CHES chapter that demonstrates its commitment to education, administration and representation in the activities of the chapter and national board. Each chapter is scored on accounting practices, conference/education day, membership, chapter executive practices, committee work and additional offerings (from submitting articles to Canadian Healthcare Facilities to providing extra member benefits). Specifically, points are given for activities that benefit members and the work of CHES, such as number of meetings attended in the course of committee work and special education sessions. After the crowning of last year’s award, the chapter executive doubled down on its commitment to participate in committee work. The chapter has a representative on all six CHES National committees and subcommittees, of which Ontario members Richard


Trane’s Guy Bourbonniere with now past Ontario chapter chair, Roger Holliss.

White and Larry Erwin are chair of the partnerships and advocacy committee and vice-chair of the communications committee, respectively. “We’re trying to increase our voice and be part of a bigger process that goes beyond Ontario,” says Holliss, who acknowledges this is a difficult feat for chapters like Newfoundland & Labrador that have far fewer members. “If you’re a bigger chapter, you not only have the numbers to draw upon to get involved but you should be playing a larger role.” On the education front, the chapter spent the past year gearing up for the 2017 CHES National Conference. Held Sept. 17-19, at the Scotiabank Convention Centre, the event was by all accounts a huge success. It attracted more than 750 attendees and boasted a sold-out trade show floor with 154 exhibitors. The educational program

covered a variety of topics and included a wide range of high-end speakers, two of which travelled from abroad to take part in the esteemed event. “It didn’t hurt to have the Falls in our backyard, too,” adds Holliss. “It made for a nice backdrop.” Over the course of the last year, the Ontario chapter has continued to exten d fin an c ial s upport to th e Canadian Coalition for Green Health Care. The organization has received $30,000 in the past three years to assist with programs that will help healthcare facilities across the province participate in energy-saving initiatives. The chapter is also part of a coalition of 17 hospitals that applied for funding from the provincial Ministry of the Environment and Climate Change/ Ontario Centres of Excellence to assist with reducing/eliminating greenhouse gas emissions linked to anesthetic gas


waste. Despite the team’s valiant efforts — it was one of more than a dozen selected to give a presentation to the judging panel as part of the final stage of the review/approval process — the coalition didn’t receive the grant. Be that as it may, the chapter will continue to support this greenhouse gas emission reduction measure and is actively seeking funding from other sources. “Healthcare facilities are a significant contributor to g reenhouse g ases through anesthetic gas emissions so we need to do something,” says now past chapter chair Holliss, who recently assumed the position of vice-chair on the CHES National board. Having “graduated on” from the

“EVEN THOUGH WE IMPROVED OUR SCORE OVER LAST YEAR’S, WE KNEW IT WAS GOING TO BE TOUGHER TO WIN (SINCE) EVERY CHAPTER IS RAMPING UP THEIR GAME TO IMPROVE SERVICES TO THEIR MEMBERSHIP.” chapter executive, Holliss will not be directly involved in this cause as part of the Ontario chapter (although he will still be part of the coalition as an Ontario hospital member). However, he is confident the team that’s currently in place will work hard on behalf of the membership to advance the chapter’s agenda.

“We had a succession plan in place to ensure the executive team was well-positioned to continue growing and performing as I transitioned to CHES National,” explains Holliss. “Now that I am changing roles, I’m going to miss everyone but I’m proud of what we have accomplished as a chapter.”

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A COLLABORATION OF EFFORTS Facility management involvement in integrated design process key to success of new HSC Women’s Hospital By Bill Algeo


esigned with patients and families in mind, the new Women’s Hospital at Health Sciences Centre (HSC) Winnipeg will be the city’s most comprehensive facility for women’s healthcare when it opens. The nearly 400,000-square-foot building will include 173 beds and feature a family birthing place that includes a state-of-the-art labour and delivery unit, as well as a neonatal intensive care unit. It will also have private space for oncology and palliative care patients. 24 CANADIAN HEALTHCARE FACILITIES

HSC’s facility management (FM) department has been involved in the Women’s Hospital redevelopment project from the earliest stages of design. This integrated approach is now common practice for new builds at HSC. The benefit is all stakeholders are allowed to provide realworld responses so that changes can be made early on, reducing the risk of costly amendments at the later design and construction stages. For instance, FM provided feedback from users in existing

HSC buildings so design shortcomings could be avoided, such as the use of a single thermostat to control two or more spaces with different occupancies. FM staff had the opportunity to review and comment at each drawing and specification stage. The department provided input on the inclusion of electricity and water meters to observe consumption, and the number and location of direct digital control (DDC) points to monitor, control, alarm and diagnose building systems remotely.


Products, equipment and methods — proven over years of real-life experience and included in in-house master design standards — were also shared with the design team. This allowed for competitive pricing without compromising quality. Product selection is based on low maintenance, high reliability, accessible technical support and an appealing life cycle. Once the project was wellunderway, a shop drawing review was carried out by FM staff to ensure the specified products were provided and no unapproved substitutions were made. By being involved at the earliest stage of design, project specifications reflected FM’s need for integrated commissioning from the very start of construction, and necessary spare parts, training, and installation-specific operations and maintenance documentation, not the typical sales literature ‘filler’ material. As well, equipment numbers and addresses were assigned as part of the centre-wide preventive maintenance program. This is critical for maintaining systems that support 31 buildings spread across 4.5 million square feet, tied together with two central energy plants and a network of passenger tunnels. INTERNAL GUIDANCE

FM requested, as an extra budget line in the project, a building system design intent manual (BSDIM) for the electrical and mechanical systems. This document is produced by the design engineers and provides a narrative of how the systems should work, assumptions made and modifications that can be applied at a future date. This information is not only invaluable for system setup and operation (as control sequences are rather vague), but it also provides designers tasked with making future modifications with a clear picture of the existing systems’ capabilities and limitations. FM staff used the building system design intent manual and control sequences to create equipment and building system test sheets. These test sheets, coupled with the DDC system contractor’s in-out results and graphic shop drawings, are used to develop a commissioning procedure and

throughout the entire commissioning process; sampling is not an option in a tertiary care medical facility. Equipment data is collected from these test sheets and initial project management schedules established. These schedules are altered as experience with the building systems is developed. Proper operation of a complex building requires well-trained staff armed with specific information, not a sales presentation. To this end, FM included a comprehensive specification section in the building system design intent manual that details the scope of training required for each system, number of hours required for each session, and whether classroom training and/or recording is necessary. HSC has a technical training officer to coordinate this important step. DRESS REHEARSAL

During the commissioning stage, it is not unusual for the consulting engineers to revisit their design and implement changes. These changes are captured in the building system design intent manual.

Once the contractor and HSC’s commissioning team are confident all systems are working properly, the life safety systems are tested. “We throw the switches for complete loss of power,” says Craig Doerksen, divisional director of facility management at HSC, and member of the Women’s Hospital redevelopment project steering committee executive. “We need to know with absolute certainty that the building and ultimately the people inside it will be safe under extraordinary circumstances. We look at the redundancies that are built in to ensure backup systems come on and function as they are supposed to.” From there, the team pulls together all the players for the consultants’ life safety test rehearsal. Each consultant — mechanical, electrical, structural and/or architectural — must witness the functionality and provide letters of certification to confirm their respective designs are reflected in the actual building and they work for their intended purpose. Rehearsals continue until the team is satisfied the systems will successfully meet FALL/AUTOMNE 2017 25

MAINTENANCE & OPERATIONS City of Winnipeg building inspectors’ approval. Consultants prepare verification letters to accompany the application for an interim occupancy permit, while city inspectors set a date and time for the test. Once the new Women’s Hospital successfully passes the life safety systems test and the building design team warrants the project is substantially complete, the City of Winnipeg will grant the occupancy permit. At this point, HSC will take full responsibility for the building and move into the next phase of readiness preparation for opening within a year of substantial completion. HSC needs the 12 months following substantial completion to install, test and prepare staff, equipment, work processes and clinical systems. Staff will run through simulations of the move as opening day nears. Once the team is confident that care can be provided safely, the new Women’s Hospital will welcome its first patients. A NEW STANDARD

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Years ago, FM staff had to dig through outdated owner and operator manuals and multiples versions of shop drawing submittals in an effort to maintain the equipment as built drawings were lost or outdated. With feedback from the shop floor, the entire process of capital project design, commissioning and building information capture has been reinvented. Now, once the new Women’s Hospital is populated, a benchmark will be established. Screenshots of DDC points of all equipment and systems will be noted, as will set points and operating conditions based on outdoor conditions of the benchmark date. This reference information will be used from time to time to compare current operating conditions to the benchmark and review the amount of variance. Power consumption and power factor correction will also be noted, as well as water consumption, and steam and chilled water loads. Reasons for change could be environmental, seasonal, fluctuating occupancy demands and operational hours. Technical problems will be flushed out from these reviews and unexplained abnormalities examined. HSC’s energy engineer will be available as an additional resource when tackling these technical issues. However, regardless of all the DDC alarms that have been set up, the user’s phone call to maintenance dispatch provides the best feedback on the building’s performance. Upon receiving a work order, FM technicians will review the EBI (enterprise buildings integrator) graphic display of the area to determine any systems problems before meeting with the user. Operating conditions will be compared with set points. Often the problem can be solved at this stage. Beyond this, the technician will visit the user for additional information and a site/equipment survey. Working together with the interrelated systems shop technicians, solutions will then be developed (unless it is something beyond FM’s control, like the seasonal changeover and draining of cooling units). Feedback from these visits can lead to changes in DDC programming and set points. Bill Algeo is a building technologist at Health Sciences Centre (HSC) Winnipeg. He’s also the facilities management representative for all major projects at HSC, and the commissioning authority for the Women’s Hospital redevelopment project.



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FLUSH OF GENIUS Pulp macerators reduce risk of cross-contamination, offer cost savings By Adam Roach


tudies have shown minimizing the risk of healthcare-associated infections (HAIs), such as methicillinresistant Staphylococcus aureus (MRSA), Clostridium difficile (C. difficile), norovirus, extended spectrum beta-lactamase (ESBL) and legionella, has an impact on hospital costs. HAIs extend patient treatment times and hospital stays, resulting in increased nursing levels and use of antibiotics. In some circumstances, total ward shutdown is necessary to break an infection cycle. Disposing of all human waste in a single area is an easy way to contain and isolate an infection before it can spread. Within a soiled utility room, effective decontamination is key to maintaining good hygiene and sound infection control. 28 CANADIAN HEALTHCARE FACILITIES


Pulp macerators and single-use pulp items are growing in popularity, driven by the need for higher standards in infection control in healthcare facilities. Due to the increasing number of outbreaks of infection caused by high-risk microorganisms, such as C. difficile, and the inability of washerdisinfectors to completely eliminate the risk of cross-infection, many healthcare facilities are moving away from the use of reusable human waste containers toward single-use pulp containers, followed by pulp maceration and disposal. Pulp macerators are an extremely reliable means of infection control. They completely destroy disposable pulp bedpan/urine bottle containers

and their contents, including maceratorfriendly wipes and bags, by pulverizing items into small particles using carefully designed blade technology. These particles are then released into an existing sewer system. At the end of e a c h c yc l e, a d i s i n f e c t i n g a n d deodourizing fluid is automatically injected into the machine. T his measured dose cleans the internal surfaces of the machine and leaves a fresh odour for when the lid next opens. In addition to completely eliminating the contamination risk arising from reusable products, pulp macerators enable much faster cycle times, which enhances work efficiencies and reduces valuable staff time spent in the soiled utility room.


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

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The efficient operation of pulp macerators results in staff, water and energy savings. Macerators are not complicated machines, and do not require as much maintenance and performance monitoring as traditionally used washer-disinfectors. As well, because it’s not necessary to empty machines before or after use, staff do not need to waste valuable nursing time in the soiled utility room. Water and energy usage is significantly lower than washerdisinfectors, which use heat to sterilize reusable items and therefore require more water and electricity. The exact amount of water and energy used is dependent on the capacity of the macerator. TRENDS WITH BENEFITS

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One of the key advantages of using single-use pulp items and pulp macerators is all human waste as well as the receptacle are disposed of directly into the machine, so there is no further interaction with the bedpan, urinal or other pulp containers. This removes the risk of utensils not being correctly sanitized, eliminating the danger of re-infection in wards. Some macerators also have the benefit of hands-free operation. This eliminates the possibility of contact and therefore crosscontamination, while antimicrobial surfaces and post-use disinfection chemicals reinforce the machines’ infection control credentials.

The growing use of maceration to dispose of human waste has heralded huge advancements in both the technology itself, and manufacturers’ understanding of the importance of everchanging healthcare sector requirements. Recent designs include features that are considered to be highly desirable for increased contamination control and ease of use. For example, hands-free operation and the incorporation of antibacterial materials in contact areas help reduce crosscontamination. Today, there is a wide variety of machines to choose from to fit any healthcare facility’s needs — large capacity machines that are able to cope with four to six pulp items and are suitable for busy soiled utility rooms, and smaller compact machines designed for low-demand areas or single-bed wards and en-suite facilities. There are even wall-recessed pulp macerators that are specifically designed to be incorporated into architects’ plans during the build and design stages of a project. Because they are built into the walls, the machines’ mechanics and plumbing are fully concealed, improving the look of the room. This new generation of built-in macerator has the added benefits of antimicrobial nanotechnology, crevice-free surface for easy cleaning and reduced noise levels, making it suitable for isolation and individual patient rooms. As well, operation is hands-free, with an audio prompt system that can be programmed into any language. Adam Roach is the engineering director at DDC Dolphin Ltd., which has been dedicated to excellence and innovation in soiled utility room products, service and maintenance in Canada and around the world for more than 25 years.

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SEEING THE LIGHT LED retrofit brings big energy, cost savings to Mackenzie Health By Stefanie Kreibe


usinesses around the globe, particularly publically funded organizations, are continually looking for ways to maximize return on investment and reduce costs while doing their part to become more environmentally friendly. Along with running critical medical equipment and chillers, lighting is one of the most energy intense and often wasteful expenses in the operation of a hospital, accounting for approximately 10 per cent of electricity used. This expense is controllable to a degree and reducing energy consumption can result in a significant decrease in corresponding operating costs. In 2015, Mackenzie Health, a healthcare provider in Ontario’s York Region, committed to pursuing a more efficient lighting solution that would be cost-effective, sustainable and provide enhanced lighting across its 700,000-square-foot Mackenzie Richmond Hill Hospital. At the time, the hospital had a combination of fluorescent and high intensity discharge (HID) lighting. As part of a comprehensive five-year green plan to reduce energy consumption, greenhouse gas emissions, costs and the hospital’s carbon footprint, all interior and exterior lighting fixtures and bulbs across the healthcare facility, as well as all lit signage, were systematically changed to more energy-efficient light-emitting diodes, or LEDs. This technology is more cost-efficient to operate, requires less maintenance and replacement, and will accommodate and mitigate the increase in 32 CANADIAN HEALTHCARE FACILITIES

demand for electricity anticipated by devices in the future. Over a period of 10 months, the hospital replaced more than 20,000 fixtures and 30,000 bulbs, and installed more than 10,000 ballasts to achieve the 100 per cent LED objective. This $1.75 million investment meets Illuminating Engineering Society (IES) recommendations, significantly reduces associated operating costs over the lifetime of the equipment and is expected to be paid for within six years, with a return on investment of 16 per cent. Moreover, the organization expects to realize more than $1.1 million in cost savings over the lifetime of the investment. Since the completion of the LED replacement project in February 2016, Mackenzie Health has achieved a significant reduction in annual utility spending and enhanced lighting levels inside and outside the hospital. In the first year following the retrofit, the organization achieved electricity savings of 1,536,744 kilowatt hours (kWh), which is approximately 10 per cent of the total electricity used across the facility annually. This further translates into cost savings of approximately $210,000, and is the equivalent of taking 180 homes off the grid for an entire year. This past March, Mackenzie Health was presented with a one-time rebate cheque for $127,314, which can be used for patient care as opposed to lighting the building and devices.

The switch to LEDs has also resulted in lower cooling costs over the summer months because the technology produces significantly less heat than traditional bulbs. The change has also reduced maintenance costs by 50 to 70 per cent, due to the longevity of the LED bulbs. Beyond cost savings, patients and staff have reported a greater sense of security, especially in the parking facilities overnight, because of the increased brightness of LEDs. The lights are also safer to remove and dispose of since, unlike fluorescent tubes, they do not contain hazardous chemicals such as mercury. This not only protects maintenance staff from contamination but the environment, too. Ensuring patients experienced as little disruption as possible was important to the success of the retrofit. Mackenzie Health collaborated with internal stakeholders and external vendors to coordinate work schedules. Much of the retrofit was completed during evenings and weekends when clinics were closed. To maintain patient comfort and safety, work in patient care areas was completed during the day when the majority of patients were awake or out of their room for a test or procedure. Stefanie Kreibe is a communications and public affairs consultant at Mackenzie Health, a regional healthcare provider serving more than 500,000 people across Ontario’s York Region and beyond.


From reception to maintenance, in the emergency room or at an off-site location, Motorola is helping healthcare providers work more safely and efficiently in the most demanding environments and challenging situations. SPECIAL CALL FEATURES TAILORED TO MEET THE NEEDS OF HEALTHCARE Healthcare centers constantly face the challenge of quickly reacting to unpredictable situations and still providing patients with seamless and discrete operations. Trying to look for medical staff using PA speakers, using cell phones with poor signal coverage, calling department extensions that are occupied, or physically having to look for someone to help, can be frustrating and disrupting for both medical staff and patients.


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DREAM TEAM FMO, EES departments collaborate on Delta Hospital upgrade project to enhance operations, improve energy efficiency By Kori Jones


ocated in the Lower Mainland of British Columbia, Delta Hospital is a 150-bed, community-based healthcare facility owned and operated by the Fraser Health Authority. It provides acute and extended care unit services to a catchment area of more than 100,000 residents. In spring 2014, the hospital’s facilities maintenance and operations (FMO) team began planning the upgrade of the existing inefficient heating plant. But what started as a necessary improvement resulted in a collaborative design-build project management opportunity, as the health authority’s energy and environmental sustainability (EES) team was in the process of identifying emission reduction opportunities with a strong business case to apply for carbon neutral capital project (CNCP) provincial funding.


“Building relationships with FMO teams across Fraser Health is inherent to the success of many of our projects,” says the health authority’s acting director of energy management, Robert Bradley. “On sites with established strong relationships and open communication, we have been rewarded with a better understanding of facility needs, and greater opportunity to identify and implement projects that enhance operations and improve healthcare facilities.” The FMO and EES teams allocated resources and coordinated responsibilities in a team-focused project implementation plan. This approach included a dedicated FMO project leader that managed the site d e s i g n - bu i l d c o o r d i n a t i o n a n d implementation with the direct support of Delta Hospital’s FMO team. The EES

team managed the project finances, as well as provided technical support, and successfully secured a significant CNCP grant. Additional financial incentives were obtained from the regional electricity and natural gas utilities to support the energy reductions of this project. The project team, with guidance from the mechanical engineering consultant, worked closely to develop a final high-efficiency condensing boiler plant designed with a consolidated hot water storage system. The final design celebrated solutions for several site-specific challenges, including retrofitting a new plant into an existing facility, which required proper system engineering, and re-piping to the boiler dual return water function, resulting in a return water temperature of less than 55 C most of the time. This low return temperature, which allows


the boilers to condense and operate at an optimal efficiency, is possible through the integration of double coil heat recovery hot water tanks, variable speed re-circulation pumps, heating coil energy valves and variable frequency drives on the hot water supply pumps. Project success was measured using more than a year’s worth of trend data from the hospital’s energy management information system, which reported six and 11 per cent in electrical gas savings, respectively (compared against the weather-adjusted preproject energy consumption baseline). The estimated annual savings from this project are $25,000 in energy and maintenance costs, and more than 80 tonnes of carbon dioxide equivalent greenhouse gas emissions. These achievements are due to the active participation of the FMO team, and the clear collaboration and communication throughout this project — the team

operating the new plant was involved at every stage. This holistic view was built into the project goals, which included: providing Delta Hospital with a reliable and highly efficient modern heating plant upgrade that is delivered on schedule and budget; integrating the FMO team in the project design and implementation to develop system knowledge and provide a comprehensive project handover; and improving patient comfort while reducing energy consumption, the site’s environmental impact and heating plant maintenance requirements. “Involving the FMO team early in the system design and throughout the project delivery allowed direct input from the people who would be operating this system after the project was considered complete,” says regional supervisor of facilities maintenance operations, Dave Simmons, who was also the FMO design-

build project leader. “This approach also streamlined the decision-making process and identified design risks early on, which saved time and reduced project costs by approximately 30 per cent as compared to other projects using traditional design-bid-build project methodology.” An ongoing benefit of this teamorientated approach has been the identification of additional energy-saving opportunities. Continued communication between the FMO and EES teams about the performance of this system has resulted in an expanded building automation system that has improved control and tracking capabilities, and resulted in the successful pilot of an automatic fault detection and diagnosis (AFDD) system. Kori Jones is the energy manager at Vancouver Coastal Health.

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A GROWING OPPORTUNITY Hamilton Health Sciences gives back to community, patients with hospital garden By George Pankiw & Ann Higgins


eeds of hope were planted this past spring in a newly constructed vegetable garden on the campus of a large teaching hospital in downtown Hamilton, Ont.


Comprised of 11 beds, the garden was created through a partnership between Hamilton General Hospital, the Population Health Research Institute and Hamilton Victory Gardens to give back to the community and help patients with recovery.



Evidence has shown the Hamilton downtown core is particularly vulnerable relative to other areas of the city. The average life expectancy of someone living in the region is 21 years less than someone living in surrounding neighbourhoods. Many social determinants of health are factors in this discrepancy, food insecurity being one. In fact, 45 per cent of patients admitted to Hamilton General Hospital are malnourished, stay an average of three days longer than the expected length of stay and are eight times more likely to die. By transforming an empty plot of grass on the site, Hamilton General Hospital hopes to positively impact the socioeconomic needs of the hospital’s community and the residents it serves. The notion is that improving the overall health of the local population will reduce the need to access acute care in the hospital. HORTICULTURAL THERAPY

Hamilton General Hospital’s community garden not only provides a food source for those in need but it is part of an innovative therapeutic program for patients in the Hamilton Health Sciences Regional Rehabilitation Centre. The centre provides adult inpatient and outpatient rehabilitation to persons following stroke, spinal cord injury, acquired brain injury, neurological impairments and amputation. These patients have had a significant, life-changing experience through disease or injury. The path back to some level of independence can take a long time and be extremely challenging. While the therapy program varies depending on the presenting problem and individual, there are some overarching goals for patients in the rehabilitation process: achieving the ability to walk or be mobile independently or with the aid of a prosthesis, wheelchair or walker; retraining and practicing functional activities of daily living (for example, transfers, selfcare, reaching and carrying); and learning management of life in their ‘new’ self, which includes coping, knowledge of their limitations and abilities, nutrition and good health practices.

The Regional Rehabilitation Centre was already equipped with an outside exercise and practice facility but research has shown that when patients have a task or purpose to engage in that is meaningful, it goes a long way to bolster confidence and assist in their recovery. Further, since gardening is a functional activity, it can encourage a patient in a wheelchair to stand or a patient with a prosthetic leg to practice their balance. As a result, the garden was created and purposefully designed to allow for accessibility and functionality so that the therapeutic team could incorporate it into patients’ ongoing recovery regime. A UNIQUE CREATION

Hamilton Victory Gardens assisted with the building of the garden beds and provided a planting plan, but Hamilton General Hosptial’s facilities management (FM) team was instrumental in facilitating and managing the construction process. The standard installation design employed by Hamilton Victory Gardens in its other community gardens is to lay the concrete block garden beds directly on the existing soil with little or no preparation of the site. However, in order to ensure accessibility and safety, the original garden plans were modified with the installation of a 70-foot by 40-foot patio stone base, which supports 11 raised garden beds of varying heights to accommodate working from a wheelchair as well as standing. In addition, a concrete walkway was built from the Regional Rehabilitation Centre to the gardens. FM also designed a sprinkler system to provide water for the raised garden beds. The team engaged the grounds contractor to build the base, install the sprinkler and provide landscaping around the garden so that it blended into the existing hospital landscape. As a final touch, FM erected a small garden shed for storage. George Pankiw, P.Eng, is manager of facilities management at Hamilton General Hospital. Ann Higgins, PhD, is senior consultant of improvement, innovation and alignment in the adult regional care program at Hamilton Health Sciences.

GARDEN PARTNERS Hamilton General Hospital is one of seven sites within the Hamilton Health Sciences family of hospitals. It’s recognized as a regional centre of excellence in cardiovascular care, neurosciences, trauma and burn treatment, delivering care to patients across the Hamilton Niagara Haldimand Brant LHIN and beyond. Equally important, it serves as the community hospital in the downtown core of Hamilton, Ont. The Population Health Research Institute is a world leader in large clinical trials and population studies aimed at improving the health of at-risk groups with common and neglected conditions affecting Canadians and populations around the world. The institute wanted to extend its research work to something that would be a visible, concrete and meaningful contribution to the local community. Hamilton Victory Gardens is a non-profit organization that runs 18 community gardens in Hamilton. These gardens are tended by volunteers and produce thousands of pounds of fresh produce that is donated to local food banks and community kitchens across the city. The project was also supported by clinical and non-clinical teams at Hamilton General Hospital, the Regional Rehabilitation Centre and the community, which ensured its success and the ability to positively impact patients and community residents alike.

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POWER OF DIGESTION Runnymede Healthcare Centre adopts alternative composting technology to ‘eat’ through waste By Roxanne Hathway-Baxter


here is a long-standing commitment at Runnymede Healthcare Centre to improving sustainability. Proof of this is in the hospital’s ambitious, fiveyear strategic plan, laid out in 2015. As Runnymede celebrated its 70th anniversary, it pledged to continue to implement strategies and technologies that will lessen the hospital’s environmental impact, cut operating costs and improve the health of the community as a whole. Runnymede soon made good on its promise when it invested in a green technology to more efficiently manage its organic waste production. Last year, while using tools like the Ontario Hospital Association’s green hospital scorecard, which tracks a hospital’s environmental efficiencies and results from its annual waste audit, Runnymede discovered there were some gaps in its waste management process. Large amounts of organic waste were being sent to landfills because there was no viable green bin strategy in place to recycle these materials. The hospital looked at several potential solutions to the food waste problem. After careful research and consideration, it settled on bio-digestion as the best option. A bio-digester is a fully enclosed machine that can be used as an alternative to 38 CANADIAN HEALTHCARE FACILITIES

traditional composting. The device takes hundreds of pounds of solid food waste, including both raw and cooked leftover foods, from patients’ plates each day and converts it into filtered wastewater in a totally chemical-free process. The bio-digester essentially works like a large mechanical stomach, combining leftover food with water, plastic bio-chips and enzymes to break the waste down. The filtered waste water that is produced can then be safely sent down the drain. The whole process, from collection of waste to environmentally-friendly output, takes approximately 24 hours, and is constantly monitored by the bio-digester. Statistics on the usage and amount of food being digested are recorded, allowing the hospital to see exactly how much waste is being recycled. The environmental benefits provided by the bio-digester are huge and the impact can be seen as soon as six months after installation. Using this device for a year will divert nearly 50 metric tonnes of solid waste from landfills. Further, its operation only requires around the same amount of electricity needed to illuminate seven compact fluorescent light bulbs. Cost benefits are evident, as well. Prior to its use, Runnymede was spending more than $1,000 each year to send solid food

waste to landfills. Since its implementation in October 2016, this expense has been reduced by roughly half, with more cost savings expected to come. The money that is saved can be reinvested to better serve patients at the hospital and the community in general. Additionally, because solid waste can be transferred directly from patients’ plates into the bio-digester, less garbage disposal units are needed, which will bring down costs over time. Moreover, kitchen staff can focus their attention on other facets of their jobs, rather than having to devote time to taking food waste to outdoor containers. The many benefits of the bio-digester are apparent, making it a perfect addition to the hospital. New technologies like this are enabling hospitals like Runnymede to improve their sustainability, which in turn is beneficial for the environment, as well as more cost-effective for the institutions themselves. Roxanne Hathway-Baxter is a communications specialist at Runnymede Healthcare Centre, an innovative 206-bed rehabilitation hospital in Toronto that provides the highest level of patient-centred care to those whose treatment needs cannot be met at home or in an acute care facility.

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Canadian Healthcare Facilities | Fall 2017  

Canadian Healthcare Facilities | Fall 2017