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Canadian

HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY

Volume 40 Issue 4

Fall/ Automne 2020

A BETTER EXPERIENCE Rural Manitoba hospital provides enhanced service, puts patients at ease

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Inside Surrey's SafePoint Maritime chapter repeats victory Controlling high humidity at CKHA


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


CONTENTS

CANADIAN HEALTHCARE FACILITIES Volume 40

Issue 4

Clare Tattersall claret@mediaedge.ca EDITOR/RÉDACTRICE

14

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

Kevin Brown kevinb@mediaedge.ca

SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR

Annette Carlucci annettec@mediaedge.ca

PRODUCTION MANAGER/ Rachel Selbie DIRECTEUR DE rachels@mediaedge.ca PRODUCTION CIRCULATION MANAGER/ Rob Osiecki DIRECTEUR DE LA circulation@mediaedge.ca DIFFUSION

DEPARTMENTS

OPERATIONS & MAINTENANCE

4 6

Editor’s Note

8

Chapter Reports

24 Let’s ‘Dew’ It Desiccant dehumidification technology allows critical spaces to operate at lower temperatures ideal for patient health

President’s Message

CHES AWARDS

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

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

PRESIDENT

26 The Heart of Hospital Comfort Improving HVAC system resilience by understanding flow

VICE-PRESIDENT PAST PRESIDENT TREASURER SECRETARY EXECUTIVE DIRECTOR

14 A Hospital of Firsts Un hôpital innovant

HEALTH & SAFETY

18 A Happening of Monumental Proportions Unanticipated career shift paved way for Ron Durocher’s contribution to healthcare engineering

29 Investing in Community Health Safety considerations for designing, operating supervised injection sites

20 Rising to the Challenge Maritime chapter overcomes obstacles to secure second straight award win

Roger Holliss Craig Doerksen Preston Kostura Kate Butler Reynold Peters Donna Dennison

CHAPTER CHAIRS

Newfoundland & Labrador: Colin Marsh Maritime: Helen Comeau Ontario: Jim McArthur Quebec: Mohamed Merheb Manitoba: Reynold J. Peters Saskatchewan: Jim Allen Alberta: Dan Ballantine British Columbia: Norbert Fischer FOUNDING MEMBERS

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

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

Chinook Regional Hospital Redevelopment and Expansion | Lethbridge

Committed to better performing buildings. Structural Engineering Structural Restoration Building Science Parking Facility Design Structural Glass Engineering Building Energy Modelling

rjc.ca


EDITOR'S NOTE

THE ‘SHOW’ MUST GO ON WE ALL ANTICIPATED IT was coming but that doesn’t make it any less hard. That ‘it’ is Canada’s second wave of COVID-19, which is looking a lot different than the first. Testing capacity has drastically improved and our stocks of personal protective equipment have grown. More young people are being infected, who usually have milder or no symptoms, and hospitalizations and deaths are lower so far. We also know a lot more about the virus and how to treat it; however, the number of contacts per case is much higher than in the first wave, which is a troubling sign. Then there’s the unpredictable nature of COVID-19 and warnings that winter weather could increase its spread. Now more than seven months in, the pandemic continues to disrupt our lives and work in ways that were once unimaginable. Few, if any, would have ever contemplated that CHES’s annual national conference could be derailed; however, the executive committee had no choice but to defer the esteemed event until 2021, just as the individual chapters did with their local conferences. This did not postpone presentation of the CHES Awards of Excellence, though it looked different than in years past to adjust to the realities of our ‘new’ world. In a series of ceremonies held on different days, each with a virtual component, the recipients were honoured. The Interlake-Eastern Region Health Authority was bestowed the Wayne McLellan Award of Excellence in Healthcare Facilities Management for Selkirk Regional Health Centre, which has changed the way healthcare is delivered in rural Manitoba. Long-time CHES member Ron Durocher was recognized with the Hans Burgers Award for Outstanding Contribution to Healthcare Engineering. He has served on every Ontario chapter conference planning committee for the past 12 years, with the exception of one, as well as in countless roles at both the local and national level. The President’s Award went to CHES Maritime for the second consecutive year. This is the third time the chapter has received the accolade, nudging out the others in the friendly competition. These awards are the main focus of this issue in which we pay tribute to the recipients and all they’ve achieved. While the pandemic has uprooted so much, it has also shone a light on how important it is to continue to recognize those that so rightly deserve it.

Clare Tattersall claret@mediaedge.ca

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

4 CANADIAN HEALTHCARE FACILITIES

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


HEALTHCARE HEALTHCARE VENTILATION SYSTEMS VENTILATION SYSTEMS What’s really in yours ? What’s really in yours ?

We are pleased to announce that Ventcare now monitors hospitals the We are pleased50toplus announce thatinVentcare Ontario region. now monitors 100 plus hospitals in the

The location and inspection of the hospital

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.

The location and inspection the Some hospital your building audit thisofyear. of ventilation fire dampers may be part of you have already taken advantage yourofbuilding auditsoftware this year. program Some of our new youwhich have already taken advantage in conjunction with our of patented our newrobotics, softwareallows program us which in conjunction with our to minimize ceiling access patented robotics, allows us requirements. to minimize ceiling access requirements. To date, of the thousands of fire doors inspected To date, of the thousands approximately 30% are of fire dampersaccessible inspected not humanly approximately are from traditional30% ceiling not humanly accessible access points. Our from traditional ceiling patented robot overcomes points.allowing Our thisaccess obstacle, patented robot overcomes complete documentation of all obstacle, allowing fire this doors within the ventilation documentation all complete system. Further, of the total,of7% fire dampers within the ventilation have been found defective, blocked system. Further, of simply the total,closed 15% with wood, wired up, or have been found defective, blocked shutting off airflow. with wood, wired up, or simply closed shutting off airflow.

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PRESIDENT'S MESSAGE

OPPORTUNITY FOR RE-EVALUATION WHAT AN ABSOLUTELY bizarre year! I’m so glad I am a member of CHES to help get us through this pandemic ‘adventure.’ Being able to reach out to other CHES members as we try to navigate through this new healthcare world is proving to be invaluable. And despite the virus’ impact, CHES has managed to make progress on many non-COVID initiatives and has plans for more in the future. We are close to renewing a number of contracts with various partners to solidify our ability to both run the business of our society and continue to develop offerings and tools for our members, including the newly released set of medical gas training initiatives and the CSA standards online subscription service. CHES’s financial position is solid. The fiscal foresight our predecessors exercised in previous years is paying off. While other non-profit associations are faltering (or worse), we know CHES will ‘weather the storm’ and be able to meet our member obligations. What does CHES look like going forward? Certainly, COVID-19 has forced everyone to rethink how they conduct themselves, what to do and how to do it, CHES included. As an association, we are considering using our current environment to revisit how CHES should evolve not only to manage the next few months but perhaps permanently. For instance, should we re-think how to best manage future chapter and national conferences and our various training offerings? In some respects, this could be a blessing as it forces us to examine who we are, what we do and how we do it, so we can ensure our ability to support our members in the future. With that, I’d like to again thank everyone for their efforts these last few months. Supporting healthcare as we have done historically is challenging at the best of times. To maintain this level of performance and, in many cases, exceed your institutions’ expectations during this worldwide pandemic is by any metric impressive, and has likely elevated the awareness of the people you work with to the value that we bring to healthcare. I’m very proud to be associated with all of you.

Roger Holliss CHES National president

EARN CONTINUING EDUCATION CREDITS FROM CHES Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Fall 2020 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 https://www.surveymonkey.com/r/R2PJZFD 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.

6 CANADIAN HEALTHCARE FACILITIES


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Ensure a strong level of interoperability by using open protocols which have third-party listing laboratories to verify adherence to your protocol’s form and function.

Lighting

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ART o

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Employ a single sign on (SSO) architecture with compliance to scalable credentialing architectures and secure tunneling methodologies such as BACnet virtual private networks (B/VPN).

Select lifecycle-centric manufacturers who minimize the negative impacts of waste with long-term warranty and repair services while adhering to WEEE, RoHS and LEED directives.

Specify integrated FDD (IFDD) that delivers real-time fault detection, step-by-step root-cause diagnostics while using all your existing cabling structures, including twisted-pair networks.

Enjoy the long-term benefits of suppliers who engineer a path forward to new technologies while remaining backwards compatible without third-party gateways or hardware replacement.

Insist on timely analytics for all stakeholders with complete control of formatting and scheduling while retaining full ownership of your data and the reports generated.

Stay on top of regular advances in technology with supplier-certified, multi-lingual online educational videos, technical documentation, software updates, and advanced face-to-face classroom courses.

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CHAPTER REPORTS

ALBERTA CHAPTER

MARITIME CHAPTER

The cool weather arrived in Alberta in September, and we had our first frost in Calgary. (Nothing to brag about.) The board of directors meeting that usually coincides with the CHES National conference was a virtual event this year. I missed seeing all my exalted executive colleagues and friends in person. It’s great that technology allows us to continue our efforts to promote the goals of CHES, educate members and ensure excellence in healthcare facility management. National Healthcare Facilities and Engineering Week was Oct. 18-24. This was a wonderful opportunity to highlight all the great work we do daily to support the delivery of healthcare in our respective provinces. This year has turned out to be a bit of a dumpster fire but it’s almost over. 2021 offers hope to a return to some normalcy. Most of us are likely busy dealing with the challenges of maintaining our respective facilities during the pandemic. Too many priorities and limited resources. However, our dedication and commitment will see us through. Stay positive. I hope you and your friends and family are safe and have not been negatively impacted by the black cloud hanging over our heads.

It took some time but we are now used to the new norm of our Maritime bubble. Unfortunately, due to COVID-19, we had to postpone our 2020 fall education day at the Best Western Glengarry in Truro, N.S. The planning committee is working on the 2021 CHES National Conference, which will be held Oct. 17-19, at the Halifax Convention Centre. The theme is, ‘Enriching Patient Experiences by Optimizing the Environment.’ The recipient of this year’s Per Paasche bursary, valued at $1000, is Patrick LeBlanc from Bedford, N.S. Patrick is pursuing mechanical engineering at the University of Ottawa. His interest in mathematics, science, problem solving and making a positive change inspired his decision to pursue a career in the engineering field. In his free time, he enjoys playing hockey and guitar, and is an avid runner. Patrick is the son of CHES Maritime member Dave LeBlanc. Dave is a project manager with the Nova Scotia Department of Transportation and Infrastructure Renewal, building project services division, engineering design and construction, in Halifax. The chapter is able to balance its books while offering several financial incentives to members in the way of student bursaries, contributions to Canadian Certified Healthcare Facility Manager (CCHFM) exam fees, webinars, the fall education day and other rebates.

—Dan Ballantine, Alberta chapter chair

BRITISH COLUMBIA CHAPTER

—Helen Comeau, Maritime chapter chair

2020 has seen its share of disappointments with the cancelling of both the B.C. chapter conference and the CHES National conference in Halifax. It has challenged us all to come up with innovative ideas as we move forward and find a new normal during the pandemic. Ensuring our own health and that of our fellow coworkers has become a priority as we continue to serve in healthcare. On July 30, we held our first Zoom annual general meeting, with 30 people in attendance. We officially welcomed Doug Davis as the chapter’s new secretary. I’d like to thank Ken Van Aalst for serving on the executive team as treasurer and secretary for the last 10 years. As part of our education program, we continue to provide CHES webinars at no charge to B.C. members. We added several COVID-19 webinars, which included presentations by Mitch Weimer and Steve McEwan. I encourage all chapter members to take advantage of these webinars as they are a great opportunity to learn and discuss our experiences with healthcare staff across Canada. We are starting to plan for 2021, and our chapter conference in Penticton. At this time, we are looking at presentation options and how we can meet as a membership should our current provincial orders remain.

On behalf of the Saskatchewan chapter, I would like to acknowledge the province’s frontline workers, management staff and teams for their hard work and dedication during this trying time, and express everyone’s gratitude and sincere appreciation for all that you have done and continue to do. Each fall, we are normally frantically preparing for our annual conference and trade show. Unfortunately, as is the case with all chapters, the conference was cancelled because of COVID-19. It has been rescheduled for Oct. 18-20, 2021, at the Delta Hotel in Regina. On June 19, the chapter offered a one-day virtual session for members on programming and design considerations for healthcare facilities in the post-COVID-19 era. CHES Saskatchewan is in a solid financial position. As a result, we have made a sizeable donation to the province’s organ transplant unit. The chapter executive continues to meet via conference calls to keep everyone up-to-date on what’s happening in the province. Our annual general meeting was held Oct. 20. It was a virtual meeting by Zoom, with help provided by CHES National.

—Norbert Fischer, British Columbia chapter chair

—Greg Woitas, Saskatchewan chapter chair

8 CANADIAN HEALTHCARE FACILITIES

SASK ATCHEWAN CHAPTER


CHAPTER REPORTS

NEWFOUNDLAND & LABRADOR CHAPTER If there was ever a time to send a bouquet of f lowers, it is now. A huge thank you to the residents of Newfoundland and Labrador for a job well done with managing COVID-19, and the frontline workers who helped us through the unknown. Near and dear to my heart is everyone in healthcare, especially the facilities people who are easily missed as they work tirelessly behind the scenes. Since March, they’ve prepared sites for the inf lux of COVID-19 patients through renovations, installations and increasing surge capacity, and have continuously adjusted plans based on the latest information. Their hard work, dedication and commitment is greatly appreciated. COVID-19 has a way of kicking you when you are down. Not only has it physically impacted the body of those who have contracted the virus, but it has wreaked havoc on the economy. Husky Energy has delayed the White Rose extension project by another year, effectively putting hundreds of skilled trade construction jobs on hold. While Husky conducts a full review of the project and its future in Atlantic Canada, Newfoundlanders and Labradoreans are bracing for what could be a doom and gloom future. That being said, there is still much to celebrate in the healthcare sector, with the announcement and erection of new hospital, clinic and long-term care home projects by various health authorities in the region. The chapter has always struggled to recruit and retain members for various roles. However, I am pleased to announce Mary Ann Head has joined the CHES National communications committee. Mary Ann has been a member and supporter of CHES for many years and brings extensive infection and prevention control experience to the chapter. The executive team is now full, with members serving on various committees. The chapter is looking to capitalize on the recent announcement of Eastern Health’s first public-private partnership project. We hope to recruit membership from private construction, as well as gain information from this sector. Other chapter goals going forward include finding ways to better communicate with members across the province. The chapter is sitting in a solid financial position. With no travel in the near future, expenses will continue to be next to none. —Colin Marsh, Newfoundland & Labrador chapter chair

FALL/AUTOMNE 2020 9


CHAPTER REPORTS

ONTARIO CHAPTER

MANITOBA CHAPTER

As the pandemic continues to impact our healthcare organizations and CHES activities, the value of a CHES membership and the networking opportunities with other members and vendors has proven to be indispensable. The information shared through the COVID-19 webinars alone has been worth the cost of membership. The pandemic has also forced many of us to face the disappointment of cancelling our travel plans to attend the CHES National conference in Halifax. I was personally looking forward to all the planned events and seeing my CHES colleagues from across Canada. Although we currently do not have the luxury of meeting in person, virtual Zoom meetings have allowed us to at least remain visually connected. The chapter executive has held regular meetings through Zoom, which included our annual general meeting in June. At the time, a motion was made and adopted that the current executive continue for an additional term, ending at the International Federation of Healthcare Engineering (IFHE) Congress in Toronto, in 2022. Since then, the chapter executive had an opportunity to meet face-toface Sept. 15, in London, Ont., in a socially distanced environment. The chapter continues to engage in reciprocal opportunities with other organizations like the Canadian Centre for Healthcare Facilities, International Association for Healthcare Security and Safety and long-term care associations. The chapter executive is continuously looking for ways to deliver member benefits through other means. CHES Ontario’s spring conference is scheduled for May 16-18, 2021, in Niagara Falls. Ron Durocher and his team are well underway planning the event. There will be no chapter conference in 2022, as we will host the IFHE Congress that year. The 2023 conference is slated to be held in Windsor. Planning continues for the 2022 IFHE Congress. The team convened via Zoom in August, marking our first meeting since February due to COVID-19. There is a wealth of conference planning experience on the team, with members from coast-to-coast, as well as the U.S. and Australia. I am confident it will be a conference to be remembered. On behalf of the Ontario chapter, I would like to congratulate this year’s CHES award winners: Interlake Eastern-Regional Health Authority and the Selkirk Regional Health Centre (Wayne McLellan award), Ron Durocher (Hans Burgers award) and the Maritime chapter (President’s award).

Around the world, daily life as we know it has changed due to COVID-19. The Manitoba chapter has experienced its share of challenges as we work through a new way of doing business virtually as opposed to in person. The chapter, just like all the others, had to cancel our spring conference and trade show. The 2021 CHES Manitoba Conference and Trade Show is scheduled for May 3-4, at the Victoria Inn Hotel and Convention Centre in Winnipeg. The theme is, ‘Renovations in Healthcare Facilities.’ I look forward to seeing everyone again next year, albeit under much different circumstances than 2019. With this year’s CHES National conference in Halifax postponed until 2021, the Manitoba chapter will now host the coveted event in 2023. Planning will continue in the near future. Red River College’s Building Efficiency Technology Access Centre, in conjunction with the Manitoba chapter, has put in a request for funding of a study, COVID-19 Infection Prevention and Control: Assessment of Humidity and Temperature in Long-term Care Homes for Seniors. We are currently awaiting the results of our collective request. CHES Manitoba introduced two new awards of excellence in 2020, one for facilities management and the other for project management. This provides an opportunity for the chapter to recognize individuals who have excelled in their line of work. This year’s Facilities Management Award of Excellence went to Bill Algeo of Health Sciences Centre Winnipeg. The recipient of the Project Management Award of Excellence is Gary Dandeneau, regional director of capital planning and facilities management at the Interlake-Eastern Regional Health Authority. Congratulations to the first awards recipients. We encourage Manitoba chapter members to nominate candidates for 2021. Also new this year, the Manitoba chapter sponsored the Award for Power Engineering Technology at Red River College. The $1,000 bursary was presented to Eric Juskowa, a power engineering technology student who completed the first term of the program with a minimum 3.0 grade point average. As a reminder, the Canadian Certified Healthcare Facility Manager (CCHFM) designation is offered through CHES. Information is on the website. Certification demonstrates you have the necessary education and experience, confirmed by an outside body, to qualify as an elite professional in the healthcare facilities field. The Manitoba chapter will cover the cost of the CCHFM self-assessment exam for members attempting it for the first time. If successful in passing, the chapter will pay for the member to take the certification exam. In support of continuing education, the chapter is committed to paying for regular members to take part in this year’s CHES webinar series. Details are on the Manitoba chapter page of the CHES website.

—Jim McArthur, Ontario chapter chair

—Reynold J. Peters, Manitoba chapter chair

10 CANADIAN HEALTHCARE FACILITIES


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CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

CALL FOR NOMINATIONS FOR AWARDS 2021 Hans Burgers Award for Outstanding Contribution to Healthcare Engineering DEADLINE: April 30, 2021

2021 Wayne McLellan Award of Excellence in Healthcare Facilities Management DEADLINE: April 30, 2021

To nominate: Please use the nomination form posted on the CHES website and refer to the Terms of Reference.

To nominate: Please use the nomination form posted on the CHES website and refer to the Terms of Reference.

Purpose: The award shall be presented to a resident of Canada as a mark of recognition of outstanding achievement in the field of healthcare engineering.

Purpose: To recognize hospitals or long-term care facilities that have demonstrated outstanding success in completion of a major capital project, energy efficiency program, environmental stewardship program or team building exercise.

Award sponsored by

Award sponsored by

For Nomination Forms, Terms of Reference, criteria, and past winners www.ches.org / About CHES / Awards Send nominations to: CHES National Office ches@eventsmgt.com Fax: 613-531-0626 FALL/AUTOMNE 2020 11


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The Rewards of Heat Recovery Why now’s the time to invest in a heat recovery chiller

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s COVID-19 has put additional stress on our HVAC systems, facility managers will need to find ways to save energy and maintenance funds where they can. Heat recovery chillers, widely found in today’s state-of-theart new hospitals, provide a double economic benefit: 1) they reduce the heating load, and 2) they reduce the ancillary power needed to reject the heat, thereby reducing energy costs. Some building owners are turning to heat recovery simply for its environmental benefits and carbon credits. And more good news for facility managers? Heat recovery chiller replacements are gaining traction in existing hospitals too. Energy funds and utility rebates are covering the retrofit costs, freeing up valuable maintenance and capital budgets.

TECHNOLOGY AND PROJECTED SAVINGS: Unlike traditional chillers that waste heat generated from the cooling process, waterside heat recovery chillers capture and apply it to various heating loads—from process and commercial loads, to the potable water used for showers, washing and laundry. Healthcare facilities benefit greatly from these chillers because of the year-round, simultaneous heating and cooling loads required to maintain essential operations. In fact, several hospitals in B.C.—including University of BC Hospital, Vancouver General Hospital, Eagle Ridge Hospital and St. Paul’s Hospital—have already undergone plant upgrades using Trane’s RTWD Heat Recovery Chillers. Units at these five sites range in capacity from 80 tons to 250 tons and account for 10 to 50 per cent of total peak cooling loads. Some of the units run 24/7, providing continuous heat to the hospital. While individual projected energy savings range from 8,000-40,000 Giga-Joules per year of gas savings, all combined, the five projects have projected energy savings of over $1M annually for the province!


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IS MY SITE SUITABLE FOR A HEAT RECOVERY CHILLER RETROFIT? If you have mandates to reduce gas consumption, and your healthcare facility has year-round simultaneous heating and cooling loads (i.e. server rooms, labs, large domestic hot water loads, or high comfort temperatures required for long-term stays), chances are it’s a good candidate. Most medium and large healthcare facilities fit the requirements for energy funding, utility rebates, and a projected payback of 4 to 6 years with waterside heat recovery retrofits. The first step is to consult with your maintenance team to determine which of your heating and cooling assets are nearing end-of-operation. Similarly, once your facility has made the decision to move forward on a replacement project, be sure to involve your hospital’s key personnel at the onset. Your FMO team, consultants, projects team, energy manager, and service provider will all have important perspectives needed when upfront design considerations are being made. FULL STEAM AHEAD At Trane, we are continually amazed at how much excess heat energy hospitals generate that could be captured and put to good use. We’re excited to be at the forefront of this exciting opportunity! Please contact your local Trane Service team to find out if you should be looking for waterside heat recovery to pay for your next retrofit. Email info@tranecanadawest.com or call 1-800-473-5600 to be connected to the Trane office nearest you.

HEAT RECOVERY SYSTEM DELIVERS PROVEN RESULTS

Believing in sustainability and that conservation of resources is a corporate and individual responsibility, Morguard, working with Trane, implemented a heat recovery system in 2016 to reuse waste heat at Coquitlam Centre. Trane engineers, Morguard Operations Team, and SES Consulting worked together to verify design details and the feasibility of the heat recovery system for the 9,350,000 sq. ft. retail shopping mall. Knowing the configuration of the centre’s mechanical room with chillers and boilers in the same area, the team developed a sequence of operations to maximize the use of the recovered heat and compiled energy savings projections for the project. Using a Trane Series R (model RWTD) heat reclaim chiller and boiler plant, the system operates in a staged configuration to maximize the use of lowgrade heat. The heat recovery chiller’s evaporator (cold side) is piped into the condenser loop (warm side) of the main building chiller to capture the waste heat from the main chiller before it is sent to the cooling tower. The heat recovery chiller then boosts the temperature up to the heating water supply temperature setpoint (140 F/60 C) and injects it into the heating loop. Based on the projected energy savings, the upgrade earned a substantial incentive from FortisBC to help fund the heat recovery improvements. The project is generating considerable energy savings, with early results showing a 55 per cent reduction in total natural gas consumption on site. Based on the year over year savings, the project is expected to have a four- and half-year total payback. See the full case study at: www.tranecanadawest.com/casestudies


A HOSPITAL OF FIRSTS

Un hôpital innovant

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wice as large as the 1983-obsolete facility it replaced, Sel k irk Reg iona l Hea lt h Centre (SR HC) has changed the way healthcare is delivered in rural Manitoba since it opened in June 2017. Situated on what was once 30 acres of commercial vacant lands that was transformed into a park-like setting, the 184,750-squarefoot, two-storey hospital is a healing hub for the more than 124,000 people that call the Interlake-Eastern Health Region home. It houses a family birthing unit, dialysis, surgery, rehabilitation services, community cancer outreach, palliative care, outpatient programs and a diagnostic imaging department, which includes the area’s first-ever MRI machine. As well, with Indigenous populations representing 22 per cent of the region’s residents inclusive of 17 First Nations communities, SRHC has a spiritual health centre that can accommodate smudging ceremonies. “It was designed and constructed with a whole different concept of care in mind,” says Gary Dandeneau, regional director of capital

14 CANADIAN HEALTHCARE FACILITIES

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eux fois plus grand que l’établissement obsolète de 1983 qu’il a remplacé, le Centre régional de santé de Selkirk (SRHC) a changé la façon dont les soins de santé sont dispensés dans les régions rurales du Manitoba depuis son ouverture en Juin 2017. L’hôpital de deux étages et 184,750 pieds carrés est un centre de soins pour plus de 124,000 personnes qui habitent la région sanitaire InterlakeEastern. On y trouve une unité familiale de naissance, des services de dialyse, de chirurgie, de réadaptation, de sensibilisation communautaire au cancer, des soins palliatifs, des programmes de consultation externe et un service d’imagerie diagnostique, muni du tout premier appareil d’IRM de la région. De plus, les populations indigènes représentant 22% des résidents, y compris 17 communautés des Premières nations. Le SRHC dispose donc d’un centre de santé spirituelle qui peut accueillir les cérémonies de purification. “Il a été conçu et construit en tenant compte d’un tout autre concept de soins,” déclare Gary Dandeneau, directeur régional de


CHES AWARDS

Photos courtesy Gerry Kopelow Photography

planning and facilities management for the Interlake-Eastern Regional Health Authority, about SRHC. As a result, it boasts a number of firsts, not the least of which is the coveted Wayne McLellan Award of Excellence in Healthcare Facilities Management. The honour was formally bestowed Sept. 11, during a socially distanced presentation, with Dandeneau in attendance to graciously accept it on behalf of the health authority. “We were really excited and humbled to be selected,” he says. “Some fantastic facilities were considered for the award, which really speaks to the level of excellence in healthcare design and construction throughout the country.” SRHC is the only healthcare facility in Manitoba to have received accolades from the Canadian Healthcare Engineering Society. It’s also the first in the province to attain Leadership in Energy and Environmental Design (LEED) Gold.

la planification des immobilisations pour la Interlake-Eastern Regional Health Authority. Par conséquent, l’hôpital se targue d’un certain nombre de premières, notamment le très convoité Wayne McLellan Award of Excellence in Healthcare Facilities Management. Ce prix a été officiellement attribué le 11 Septembre 2009. “Nous avons été très émus de cette sélection,” dit-il. “Nous étions en concurrence avec des établissements fantastiques.” Le SRHC est le seul établissement de soins de santé au Manitoba à avoir reçu des éloges de la Société canadienne d’ingénierie des soins de santé. C’est aussi la première fois dans la province à obtenir la certification Or du programme Leadership in Energy and Environmental Design (LEED). “Comme l’exige la politique de construction écologique de la province, nous nous sommes efforcés d’obtenir la certification LEED Argent, si bien que nous étions ravis d’atteindre le niveau suivant,” déclare Dandeneau. FALL/AUTOMNE 2020 15


CHES AWARDS

“As required by the province’s green building policy, we strove for LEED Silver, so we were ecstatic to reach the next level,” says Dandeneau. This was achieved, in part, through a 43 per cent reduction in water use (compared to the baseline hospital standard) with the inclusion of low-flow technologies; and 44 per cent energy savings (compared to the 1997 Model National Energy Code for Buildings) as a result of the high-performance envelope, heat recovery from exhaust air, LED lighting design, condensing boilers, variable speed drives on all primary heating/cooling pumps and supply fans, and the central heat pump plant that’s coupled to a geothermal ground loop. The heat pump system stores heat energy in the ground during summer cooling months and extracts the heat in winter. When the heat pump capacity has been exceeded, a system of condensing gas-fired boilers provides additional heating in winter, while a fluid cooler rejects excess heat during summer. “It’s the largest horizontal loop geothermal system of any hospital in Manitoba,” says Dandeneau. “The 550,000-squarefoot field below the parking lots drives 16 high-tech heat 16 CANADIAN HEALTHCARE FACILITIES

Ce résultat a été obtenu, en partie, grâce à une réduction de 43% de la consommation d’eau (par rapport à la norme hospitalière de base) grâce à l’utilisation de technologies à faible débit; et 44% d’économies d’énergie (par rapport à la norme du Code modèle national de l’énergie pour les bâtiments de 1997) grâce à l’enveloppe haute performance, à la récupération de chaleur de l’air évacué, à l’éclairage DEL, aux chaudières à condensation, aux variateurs de vitesse de toutes les pompes de chauffage/refroidissement pr i ma i res, à des vent i l ateu r s d’a l i ment at ion et à l’installation de pompe à chaleur centrale couplée à une b ouc le souter r a i ne g éot her m ique. L e s y stème de thermopompe échange l’énergie thermique avec le sol. Un système de chaudières à gaz à condensation fournit un ch au f fa ge supplément a i re en h iver, t a nd i s qu’u n refroidisseur à f luide rejette la chaleur excédentaire en été. “C’est le plus grand système géothermique à boucle horizontale de tous les hôpitaux du Manitoba,” précise Dandeneau. “Le terrain de 550,000 pieds carrés alimente


CHES AWARDS pumps for 100 per cent of the cooling and 60-70 per cent of the required heating by the hospital in any given year.” Other notable sustainable measures include the diversion of 63 per cent of construction waste from landfill disposal through recycling efforts, a green roof, smart power outdoor parking receptacles that regulate power flow, electric vehicle charging stations to help reduce greenhouse gas emissions and a renewable energy certificate that offsets 100 per cent of the building’s regulated electricity. The electrical components are extensive and converge all data and communication onto one common network. This approach — a first for any healthcare facility in the province — is designed for true resiliency, with emergency backup generators that can run the entire facility through extended power failures. “The facility has fully redundant systems, making it completely self-sufficient in addition to being a beautiful site,” says Dandeneau. Upon entering SRHC, it’s evident that patient well-being was a guiding principle throughout the design process. The state-of-the-art structure features 17,000 square feet of windows to allow as much natural light as possible into the building. Glazed curtain walls are also located in all public areas, starting at the front entrance and completely surrounding the interior open-air contemplation courtyard. Several studies have documented the importance of light in reducing depression, decreasing fatigue and improving alertness. Incorporating light into a healthcare setting can be beneficial for staff, too. The presence of windows has been linked with increased satisfaction with the work environment. Interior architecture and design elements reflect the special geography and history of the Interlake region, which is rich in aspen forests, inland lakes, grasslands and wetlands. The colours and finishes of the building echo the water, sky and earth. Shades of aqua and warm terra cotta balance the golden buff, locally quarried Tyndall limestone on the walls, terrazzo floors, warm wood and other natural materials. For improved comfort and privacy, 80 per cent of beds are in single rooms. Private bedrooms were uniquely designed to allow bed position, with a preferred orientation at a 45-degree angle to the windows for enhanced sightlines to nature. Semiprivate rooms were created to allow privacy curtains to be drawn while maintaining access to the exterior views for both patient beds. Ambulatory care components were planned with direct access from t he ma in ent rance. For instance, t he emergency area has a three-bay ambulance drive-thru, which allows paramedics to unload patients in a climatecontrolled area that is well-lit 24 hours a day. Access to the outdoors is abundant, with three roof terraces, a family/staff courtyard, sun decks and an outdoor kitchen. Extensive walkways run the xeriscaped landscape that includes more than 200 native trees and grasslands, all of which serve to uplift spirits and support the healing journey. “SRHC is a hospital that doesn’t really feel or look like one,” says Dandeneau. “Whether a patient, visitor or staff member, it’s evident that we care about your experience at the facility.”

16 thermopompes de haute technologie pour 100% du refroidissement et 60 à 70% du chauffage.” Parmi les autres mesures, mentionnons le réacheminement de 63% des déchets de construction, un toit vert, des prises de stationnement extérieures intelligentes qui régulent la circulation de l’électricité, des bornes de recharge pour véhicules électriques et un certificat d’énergie renouvelable. Les composants électriques sont vastes et font converger toutes les données et les communications vers un réseau commun. Cette approche — une première pour tout établissement de soins de santé de la province — est conçue pour une véritable résilience, avec des générateurs de secours. “L’insta l lat ion possède des systèmes ent ièrement redondants, ce qui la rend autosuff isante,” explique Dandeneau. Il est évident que le bien-être des patients a été un principe directeur tout au long du processus de conception. La structure à la fine pointe de la technologie comprend des fenêtres de 17,000 pieds carrés. Des murs-rideaux vitrés sont également installés dans tous les espaces publics, en commençant par l’entrée principale et entourant complètement la cour intérieure à l’air libre. Plusieurs études ont documenté l’importance de la lumière pour réduire la dépression, diminuer la fatigue et améliorer la vigilance. L’intégration de la lumière dans un contexte médical peut également être bénéfique pour le personnel. La présence de fenêtres a été associée à une satisfaction accrue à l’égard du milieu de travail. L’architecture intérieure et les éléments de conception reflètent la géographie et l’histoire particulières de la région Interlake, qui est riche en peupliers faux-trembles, en lacs intérieurs, en prairies et en terres humides. Les couleurs et les finitions du bâtiment font écho à l’eau, au ciel et à la terre. Les nuances d’eau et de terre cuite équilibrent le chamois doré, le calcaire de Tyndall extrait localement, les sols en terrazzo, le bois chaud et d’autres matériaux naturels. Quatre-vingts pour cent des lits se trouvent dans des chambres individuelles. Les lits sont disposés à un angle de 45 degrés par rapport aux fenêtres pour une meilleure visibilité vers la nature. Les chambres à deux lits ont été aménagées pour permettre de tirer des rideaux d’intimité tout en maintenant l’accès aux vues extérieures. Les éléments de soins ambulatoires ont été planifiés avec un accès direct à partir de l’entrée principale. Par exemple, la zone d’urgence est desservie par une baie à trois places qui permet aux ambulanciers paramédicaux de décharger les patients dans une zone climatisée bien éclairée 24 heures sur 24. On compte trois terrasses sur le toit, une cour pour la famille et le personnel, des terrasses solaires et une cuisine extérieure. De vastes passerelles parcourent le paysage qui comprend plus de 200 arbres indigènes. “Le SRHC est un hôpital qui n’a pas vraiment l’air d’en être un,” conclut Dandeneau. “Que vous soyez un patient, un visiteur ou un membre du personnel, il est évident que nous nous soucions de vot re ex pér ience dans l’établissement.” FALL/AUTOMNE 2020 17


CHES AWARDS

A HAPPENING OF MONUMENTAL PROPORTIONS Unanticipated career shift paved way for Ron Durocher’s contribution to healthcare engineering

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ometimes a career may take a different path than originally expected and it works out for the better. This is the case for Ron Durocher who got his start in the workforce as a project engineer at Holcroft Canada Ltd. in 1982, after graduating from the University of Windsor with a bachelor’s degree in electrical engineering. Durocher spent nine years there designing industrial heat treat furnaces before making the switch to the healthcare industry. What prompted the move? Ironically, it was Holcroft’s decision to relocate its Canadian operations to its main headquarters in Livonia, Mich. At first, Durocher was onboard, even moving his family to Windsor from London, Ont., so he could easily commute to and from work across the Canada-U.S. border. But he soon realized travel would be an issue. “Part of my job involved going overseas to China and Russia to help with startup projects, and that could last anywhere from six to 12 months at a time,” he says. “I had young children and I just 18 CANADIAN HEALTHCARE FACILITIES

didn’t want to be away from them and my wife for that long.” Resolved to put his family first, Durocher’s father-in-law suggested he apply for the facilities manager position at Salvation Army Grace Hospital, which was later demolished in 2013. Much to his delight he was hired in 1991, and has never looked back. Starting over in a new field filled Durocher with excitement and nervousness as there was much to learn. Afraid that what he didn’t know would hurt him, he joined the Canadian Healthcare Engineering Society (CHES) upon an introduction by his predecessor at the Windsor hospital. “I soaked up everything I could at the quarterly meetings,” he says. “Everyone was so knowledgeable and willing to guide and support me that they not only became mentors, but also friends.” Soon after he became a CHES member, Durocher answered the call to serve on the regional executive team. From 1993-2004, he volunteered in various positions, including secretary,

vice-chair and chair. When the regions fell to the wayside, Durocher continued in his dedication to CHES and held the same roles on the Ontario chapter executive from 2004-2011. During his tenure as chair, the chapter forged relationships with the Recycling Council of Ontario and Canadian Coalition for Green Health Care, effectively endorsing the green movement in its early days. (He subsequently served on the Coalition’s executive for 12 years, only stepping down this past June.) Durocher was also active in the creation of a reward system for long-term members and was a strong advocate of expanding the chapter’s college bursary program that brought St. Clair College, Mohawk College and Durham College into the fold. “We wanted to do something constructive with the money earned from the chapter’s annual provincial conference,” explains Durocher, who has played a pivotal role in ensuring its financial success for well over a decade. Since 2009, Durocher has served on


CHES AWARDS

every chapter conference planning committee, except 2012, and chaired seven to date. He’s also worked on several national conferences, including both held in Niagara Falls, Ont., in 2013 and 2017. One of his key focuses is seeking out sponsors so that participant registration costs are reduced. This supports his guiding principle that there should always be a benefit to members. “I thoroughly enjoy working with vendors in putting together the chapter conference,” he says. “It’s such a rush when everything comes together.” Now with CHES for nearly 30 years, Durocher also relishes other committee work. He has served on the national governance committee representing the Ontario chapter (2008-2011), the partnerships and advocacy committee (2010-2012) and the membership committee (2012-2018), which he chaired for four years. This in addition to sitting on the CHES National board as treasurer from 2012-2014. Given his unwavering devotion to the organization, it’s no wonder that Durocher

was selected as this year’s recipient of the Hans Burgers Award for Outstanding Contribution to Healthcare Engineering by his CHES peers. “There are so many people who are worthy of this award and that have done every bit as much for healthcare engineering,” he says. “I am humbled and truly honoured. I couldn’t have stumbled into a better career.” One that has spanned nearly three decades and included several prominent roles and projects valued at more than $200 million. Presently the facilities project manager for Hotel-Dieu Grace Healthcare, a 313-bed regional provider of post-acute care services in WindsorEssex, Durocher served in the same role at both Windsor Regional Hospital and Hotel-Dieu Grace Hospital for a combined total of 12 years, after being named director of engineering services at Salvation Army Grace Hospital where his healthcare career first began. Over the course of this time, Durocher was instrumental in the development and construction of a replacement facility for

the regional renal centre at Windsor Regional Hospital, the completion of four dialysis expansions, and the diagnostic and treatment addition at Hotel-Dieu Grace Hospital, which included a major electrical system replacement and mechanical plant update. “Being a part of such monumental changes has been one of the most fascinating parts of my career,” he says. In spite of this, he’s enjoying the ‘downtime’ experienced in recent months while working largely from his northern office (known as his cottage) in Parry Sound, Ont., amid the pandemic. At 63 years old, Durocher has recently rediscovered the joy of reading and painting, and sees a smooth transition to retirement in two years. “I used to live by the motto, the busier the better. Now, because of COVID-19, I feel like I could really enjoy the time off,” he says. “But then again, I might be able to go a little longer.” A testament to his commitment to the dream profession he happened upon by chance. FALL/AUTOMNE 2020 19


CHES AWARDS

RISING TO THE CHALLENGE

Maritime chapter overcomes obstacles to secure second straight award win

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20 CANADIAN HEALTHCARE FACILITIES

LEFT TO RIGHT: Helen Comeau with photo of Mark McNeill, Ken Morriscey, Robert Barss, Andrew Bradley and Gordon Jackson with photo of Kerry Fraser. The Maritime chapter has now won the President's Award three times, in 2015, 2019 and 2020.

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t’s hard to believe the outlook for 2020 was so rosy at the start of the year. In what seems like an instant yet forever ago, the world changed and so did everyone’s way of life. Telecommuting has replaced the traditional office for most and virtual me et i n g s a r e now t he nor m i n response to the coronavirus threat. No industry or organization has been exempt from the impact of COVID19, not even the Canadian Healthcare Engineering Society (CHES). As the country locked down in midMarch, the associat ion’s reg ional chapters opted to forego their annual spring conferences in the name of safety, but perhaps the decision was no mor e d i f f i c u lt t h a n for t he Maritime chapter. Host of the 2020 CH E S Nat iona l Con ference, t he chapter had spent more than a year planning the event in collaboration with the national executive, which amounted to hundreds of volunteer hours that were swiftly discounted by the virus. “It was disappointing,” says chapter chair, Helen Comeau, frankly. However, receiving the news that CHES Maritime won the President’s Award for a second straight year has since lifted her spirits, as well as those of the executive team: Robert Barss, Mark McNeill, Gordon Jackson, Ken Mor r i scey, A nd rew Br ad ley a nd Kerry Fraser. “I was extremely honoured as each year it is such a close competition between our chapters,” says Comeau, who accepted the award on behalf of the chapter.

This is the third time the Maritime chapter has been recognized with the award, the first being in 2015. CHES Ontario is the only other chapter to have achieved such a feat. The President’s Award is presented annually to the CHES chapter that demonstrates its commitment to educ at ion , a d m i n i st r at ion a nd r e p resentation in the activities of the

chapter and national board. Each chapter is scored on accounting pract ices , con ference/educ at ion d ay, membership, chapter executive practices, committee work and additional offerings (from submitting articles to Canadian Healthcare Facilities to prov i d i n g e x t r a me m b e r b e n e f it s). Specif ica l ly, points are g iven for activities that benefit members and


CHES AWARDS

the work of CHES, such as number of meetings attended in the course of committee work and special education sessions. The recipient of the much-coveted award receives two CHES national conference registrations and expenses to a maximum of $2,500 each, as well as a trophy engraved with the victorious team’s names. “The continued dedication of our team paid off in what has been an extremely challenging time,” says Comeau. Despite bei ng unable to meet i n person this year (up until Sept. 24 for the award presentation in Moncton, N.B., thanks to the creation of the Atlantic bubble), each member of the chapter executive diligently carried out their dut ies in add it ion to t heir reg u lar healthcare roles, which have become even more demand ing a m id t he pandemic. This on top of the fact that the cancellation of the 2020 CHES National Conference and subsequent rescheduling to next year increased the chapter’s workload, says Comeau. “We needed new contracts and some of the venues were no longer available so we had to move the conference to October,” she explains. “This change in timing then affected some of our planned events for the companion program.” On the plus side, the financial impact of the upheaval has been minimal. “Ever yone was so understanding,” says Comeau, who is delighted they were able to secure their preferred venue — the Halifax Convention Centre. The 2021 CHES National Conference will take place Oct. 17-19, barring any unforeseen setbacks. The theme is still, ‘E n r ich i ng Pat ient E x per iences by Optimizing the Environment.’ In lieu of the chapter’s fall education day, which was scheduled for November

in Truro, N.S., and also cancelled due to COVID-19, CHES Maritime is considering hosting a virtual learning day sometime next spring. The chapter is currently exploring ways to increase its membership, too. The executive team is focused on gaining the support of long-term care facilities to achieve this goal. Despite all the hardships of the past year, Comeau is particularly proud the chapter has been able to balance its books while offering several financial incentives to members, including free webinars, contributions to Canadian

Certified Healthcare Facility Manager (CCHFM) exam fees, student bursaries and other rebates. In August, Patrick LeBlanc was named the recipient of this year’s Per Paasche bursary. The $1,000 grant is presented annually to a family member of a Maritime chapter member to assist with their post-secondary education. Patrick is the son of chapter member Dave LeBlanc, who works with the Nova Scotia Department of Transportation and Infrastructure Renewal. Patrick is pursuing mechanical engineering at the University of Ottawa.

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The truth about Healthcare-associated infections. Healthcare-associated infections (HAIs) are infections that patients get while receiving treatment for medical or surgical conditions. Many HAIs are preventable.1 Where do they happen? In the news. Some infectious diseases that start in the community such as severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS) and COVID-19, the cause of the current pandemic, may also spread in healthcare facilities. 2

HAIs occur in all types of care settings, including acute care hospitals, ambulatory surgical centres, dialysis facilities, outpatient care facilities (e.g., physicians’ offices and healthcare clinics), and long-term care facilities (e.g., nursing homes and rehabilitation facilities).1 According to the Canadian Nosocomial Infection Surveillance Program (CNISP), one in 217 patients acquired an infection while in hospital in 2017. While some HAIs were reduced over time, such as Clostridium difficile infections which were reduced by 25% from 2013 to 2017, other HAIs such as vancomycin-resistant enterococci (VRE) infections increased by 25%. 3 Device-associated infections, such as ventilator-associated pneumonia, catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs) associated with a prosthetic implant and central line–associated bloodstream infection (CLABSIs), accounted for 35.6% of all health care-associated infections in 2017.4

Common types of HAIs.

Prevention is critical.

Common types of HAIs include: 2

Environmental cleaning and disinfection is a critical strategy for HAI prevention. According to the Provincial Infectious Disease Advisory Committee (PIDAC), environmental cleaning in the healthcare setting must be performed on a routine and consistent basis to provide for a safe and sanitary environment.7

• Central line-associated bloodstream infections (CLABSI) • Catheter-associated urinary tract infections (CAUTI) • Surgical site infections (SSI) • Clostridium difficile infections • Methicillin-resistant staphylococcus aureus (MRSA) infections • Vancomycin-resistant enterococci (VRE) infections • Carbapenem-resistant Gram-negative bacterial infections

The burden of HAIs. HAIs constitute a significant burden to society, as they cause significant morbidity and mortality in hospitalized patients. More than 200,000 patients are infected every year while receiving healthcare in Canada and estimates suggest that HAIs are linked to between 8,500 and 12,000 deaths per year, making these infections the fourth leading cause of death for Canadians (behind cancer, heart disease, and stroke). 5 Treatment costs for HAIs are high as the cost of containment and control of these outbreaks can really add up. 6 Additionally, after discharge, patients with HAIs have significantly higher personal medical costs than uninfected patients. They require more visits from community nurses, greater reliance on hospital outpatient and emergency services, and more visits to their family doctor. 2

Cleaning and disinfecting products must be approved by environmental services, infection prevention and control and occupational health and safety.7 Disinfectants must have Health Canada approval and should be compatible with surfaces, finishes, furnishings, items and equipment to be cleaned and disinfected.7 Additionally, they must be used according to the manufacturer’s recommendations and be effective against the microorganisms encountered in the healthcare setting.7

Researchers estimated that about 70% of some types of HAIs could reasonably be prevented if infection prevention and control strategies are followed. 8 Make CloroxPro™ part of the process. CloroxPro™ offers multiple Health Canada–registered disinfectants based on three categories of active disinfectant ingredients – quaternary ammonium compounds (or “quats”), chlorine releasing compounds (such as bleach), and peroxygen compounds (such as hydrogen peroxide), to help meet your healthcare facility’s unique needs.

Learn more, or request a product demo at CloroxPro.ca | healthcare@clorox.com References: 1. Healthcare-associated infections. Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections Accessed March 10, 2020. 2. Evaluation of healthcareassociated infection activities at the Public Health Agency of Canada 2012-13 to 2016-17. March 2018. https://www.canada.ca/content/dam/phac-aspc/documents/corporate/transparency/corporate-management-reporting/ evaluation/HAI_evaluation-eng.pdf Accessed March 12, 2020. 3. Healthcare-associated infection rates in Canadian hospitals. Public Health Agency of Canada. Canadian Nosocomial Infection Surveillance Program (CNISP). https://www.canada.ca/content/dam/canada/public-health/services/publications/science-research-data/healthcare-associated-infection-rates-canadian-hospitals-infographic/CNISP-2013-2017-infographic-eng.pdf Accessed March 13, 2020. 4. Mitchell R, et al. Trends in healthcare-associated infections in acute care hospitals in Canada: An analysis of repeated point-prevalence surveys. CMAJ 2019;191(36):E981-8. 5. Health care associated infections: A backgrounder. Canadian Union of Public Employees, 2009. https://cupe.ca/sites/cupe/files/healthcare-associated-infections-cupe-backgrounder.pdf Accessed March 9, 2020. 6. Dik J-W H, et al. Cost-analysis of seven nosocomial outbreaks in an academic hospital. PLoS ONE 2016;11(2):e0149226. 7. Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Best practices for environmental cleaning for prevention and control of infections in all health care settings. 3rd ed. Toronto, ON: Queen’s Printer for Ontario; 2018. 8. The Chief Public Health Officer’s Report on the state of public health in Canada 2013: Infectious Disease – The Never-ending Threat. https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/cphorsphc-respcacsp/2013/assets/pdf/2013-eng.pdf Accessed March 16, 2020.

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LET’S ‘DEW’ IT Desiccant dehumidification technology allows critical spaces to operate at lower temperatures ideal for patient health By John Gowing

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he facility management team at Chatham-Kent Health Alliance (CKHA) has a reputation for its progressive approach to continuous building renewal. The 200-plus bed hospital has undertaken numerous updates, some of which were completed through a program driven by utility savings. The latest initiative addressed the lack of control over high humidity in both the surgical suites and medical device reprocessing department (MDRD). 24 CANADIAN HEALTHCARE FACILITIES

RISING TO THE CHALLENGE

Today’s surgical teams are required to wear heavy protective gowning. As a result, lower space temperatures are preferred. At the same time, some medical procedures require a lower ambient temperature in order to lessen the patient’s metabolic rate and help prepare for a safer surgery. These reduced temperatures demand lower dew points to keep moisture away from critical surfaces and maintain relative humidity in an operating range acceptable for essential services.

CKHA’s then-manager of engineering services, Harrie Bos, was familiar with desiccant dehumidification technology and some of its successful humidity control projects in surgical suites. He consulted the hospital’s moisture control specialist about CKHA’s high humidity challenges. Throughout most of the season, the facility’s chilled water systems were capable of producing a low temperature fluid, allowing critical spaces to maintain tolerable humidity and temperature specifications; however, during


OPERATIONS & MAINTENANCE

peak summer humidity periods, the air handling units (AHUs) were challenged to maintain acceptable relative humidity levels when lower space temperatures are preferred. As discussion and research continued, a decision was made to separate the endoscopy suite from the other operating room (OR) suites. The endoscopy system redesign provided an excellent opportunity to evaluate and measure the impact of humidity control with desiccant dehumidification technology. The successful humidity control in the endoscopy suites formed a solid internal reference (or talking) point for future meetings about the remaining systems. CONTROLLING FOR HUMIDITY

To advance the dehumidification project, the facility operators hosted a meeting with management from both surgery and MDRD. Attending individuals were interested to hear that the technology used to control humidity in the endoscopy suites could provide the same control in these areas. Following a chiller disruption and the resulting interruption to essential services, funding for the desiccant dehumidification systems for the surgical suites and MDRD was fast-tracked. Three identical units were installed, all designed to pre-condition and dehumidify outdoor air to an ideal low dew point level. A single unit supplies dry ventilation air to the MDRD AHU, while the other two supply dry air to the existing OR AHU. The cooling coils inside the existing AHUs are no longer required to sub-cool and dehumidify ventilation air. Essentially, the cooling capacity requirements for the existing coils are significantly reduced. Previously, the chiller plant’s lowest fluid operating temperatures were dictated by the two critical spaces (OR and MDRD). However, with the installation of the desiccant dehumidification units, chilled water supply temperature can be raised while improving both chiller capacity and efficiency. Recognizing the

“WITH THE INSTALLATION OF THE UNITS, WE HAVE BEEN ABLE TO ACCURATELY CONTROL HUMIDITY LEVELS IN THE DEPARTMENT, LIMITING RISK AND ELIMINATING THE NEED TO DELAY SURGICAL PROCEDURES AND INSTRUMENT PROCESSING.” desiccant units are performing all the latent work (dehumidification), the existing AHUs now have a single task of conditioning the space sensible (dry-bulb temper at u re) load requ i rement s. De-coupling the existing cooling coils from having to perform both sensible and latent work significantly reduces the reheat energy requirements for the OR suites. REAPING THE REWARDS

The dehumidification systems used at CKHA yield some of the highest moisture removal efficiency levels in the industry. The direct expansion system utilizes both the cooling energy from the compressor and the heat-reclaim to regenerate the desiccant rotor (exceeding the criteria of ASHRAE 90.1, Energy Standard for Buildings Except Low-Rise Residential Buildings). Building operators bring the new dehumidification systems online whenever the outdoor ambient conditions rise above 5 C, ensuring the critical spaces will always maintain the required low dew points. Preliminary results of controlling space humidity in the critical areas with the new dehumidification technology are very promising. For the first time, the affected OR suites are able to maintain 50 per cent relative humidity at critically lower space temperatures rang ing between 18 C and 20 C. James Woodall, who succeeded Bos as CKHA’s manager of engineering services upon his retirement, has already recognized some additional merits of the installation. During a brief interruption in the chiller’s operation, he discovered the des-

iccant dehumidification units continued to maintain humidity control in the critical spaces. This allowed space temperatures to be quickly reestablished once the chiller operation was restored. Managers are pleased they are no longer seeing interrupted procedure hours that were the result of high humidity. “Patient safety is our number one priority and with the installation of the units, we have been able to accurately control humidity levels in the department, limiting risk and eliminating the need to delay surgical procedures and instrument processing,” says MDRD manager, Tina Cousineau. As the technology becomes more familiar to the facility operators, there will be additional saving opportunities during shoulder months — the chillers can be off while the desiccant dehumidification units continue to dehumidify the air. What’s more, this project puts CKHA in a leadership role amongst its peers in the province, specifically when it comes to efficient and successful humidity control in critical spaces. John Gowing serves in sales and engineering roles at EI (Energy In-Hybrid) Solutions Inc., which has specialized in desiccant dehumidification technology since 1999. The company is the Canadian supplier of Munters commercial climate control products, including the HCU-6000 units installed at Chatham-Kent Health Alliance. EI Solutions served as the moisture control specialist on the dehumidification project. FALL/AUTOMNE 2020 25


THE HEART OF HOSPITAL COMFORT Improving HVAC system resilience by understanding flow By Steven Lane

26 CANADIAN HEALTHCARE FACILITIES


OPERATIONS & MAINTENANCE

T

he healthcare industry wrestles with the long-running problem of patient non-adherence. The consequences are waste of medication, disease progression, reduced functional abilities, lower quality of life and increased use of medical resources, such as nursing homes, hospital visits and admissions. The built env ironment grapples with its own version of non-adherence. Buildings of all types and sizes, including healthcare facilities, are designed, constructed and commissioned with mechanical systems to regulate the indoor environment, in particular temperature and humidity.

The challenge facility managers face is HVAC systems experience what is referred to as ‘performance drift.’ On the day a hospital is commissioned and perhaps for the first few months afterward, the cooling system operates flawlessly. Over time, though, component efficiency, operating settings and system conditions drift away from the originally installed and commissioned system. Not surprisingly, efficiency and system performance degrade incrementally. The consequences of this version of ‘non-adherence’ are reduced occupant comfort, unnecessary use of energy, related costs and carbon emissions. HVAC systems that don’t work as intended result in the unnecessary con-

sumption of energy. Without automated maintenance alerts and regular recommissioning, most buildings will experience performance drift of 10 to 30 per cent in just two years. Reversing and preventing that loss in efficiency is important and not just for the cost savings. Research shows commercial buildings are responsible for nearly 50 per cent of electrical energy-related greenhouse gas emissions. Buildings are operating below their optimal ef f icienc y because ma ny operators don’t get the data that’s necessary to understand the HVAC system or if received, they lack the tools to discern it. Most performance drift can be attributed to changes that take place within the mechanical system: filters become clogged; sensors become fouled or simply lose calibration; valves are adjusted and never returned to their settings; and digital control settings are changed and not properly reset. In some instances, digital controls intended to monitor and modulate equipment operation are turned off or even disconnected entirely. A smaller portion of performance problems can be related to the operating environment. Buildings often go through retrofits for new lighting, windows or shading. Occupancy numbers can change along with tenant makeup, particularly in commercial environments as businesses evolve and shift locations. Fortunately, there are technologies and methods to detect and reverse performance drift in mechanical systems. THE HUMAN COMPARISON

HVAC systems are similar to the human body, with a large percentage being hydronic. This means they rely on fluid to add or reject heat from the indoor environment. In the same way that a strong heart and good circulation of blood are key measures of human health, the flow rates in an FALL/AUTOMNE 2020 27


OPERATIONS & MAINTENANCE

An integrated plant controller, new chiller and cooling tower converted Methodist Dallas Medical Center's cooling system to an all variable speed format.

t

HVAC system are an important indicator of how well that system is functioning. In a standard annual checkup, pulse and blood pressure are key data points collected. Just those few measures are a strong indicator of overall health, especially when viewed in comparison to values recorded in previous annual checkups. Like the human body, the flow rates in an HVAC system indicate how well it is operating and where any problems lie. Without information on system flow, it is difficult to diagnose and optimize performance. With it, the picture changes entirely. In any chilled water system, knowledge of the cooling load is the starting point. The cooling load is equal to flow multiplied by system delta T. In non-technical terms, load is the amount of cooling required to reach or maintain acceptable indoor temperatures. Traditionally, buildings have been designed to function only by observing whether temperature setpoints in the system are being maintained; the HVAC system operates if a threshold temperature is reached. Flow meters are rarely installed in these systems and almost never on the associated cooling tower loops. As a result, system performance drift is common. In the secondary circuit, changes in flow rate that 28 CANADIAN HEALTHCARE FACILITIES

can’t be explained by demand may indicate clogging, leakage, changes in settings or valve malfunction. In a cooling tower or condenser circuit where water circulates between a chiller and cooling tower, the efficiency of the heat rejection is rarely known or even tracked. Understanding flow and changes in flow rates is a key first step in building a true load profile of the chiller and the heat rejection process equipment, whether open or closed circuit. The flow data alone can be used to diagnose a clog or decreased cooling tower function. With the addition of readily available temperature data, the process of optimizing the entire cooling system can begin. Flow data provides new abilities for diagnostics and clues for new optimization approaches. It gives more data for performance commitments and condition-based maintenance. Using flow data from both sides of heat transfer devices also enables heat balance calculations to assess the performance of those heat transfer or mechanical cooling devices long before they become problematic for maintaining setpoints. ACTIVE PERFORMANCE MANAGEMENT

Another industry innovation is to think of the intelligent pump as an accurate flow

meter. New design envelope pumps provide flow data accuracy within five per cent of a reading, as well as a host of higher level solutions that leverage accurate flow data to optimize system performance and detect degradation. These are known as active performance management solutions. Active performance management takes a systems management approach that will optimize a HVAC system at any stage of a building’s life cycle, drawing on analytics from flow information and heat balance models of the system. Accessing and learning from a broad network of installations and responding to changing HVAC requirements, the technology includes machine learning that is enabled through the system flow of information. Active performance management is available to customers as a set of services and solutions, but the underlying technologies are built into every design envelope product and enabled with a subscription-based service. This service provides asset management tools, system diagnostics, performance reports and continuous upgrades learned through the combined operating experience of many installations. All this is made available through mobile performance dashboards and remote connectivity that continuously validate system savings. Even with the sophistication of modern building automation systems and the data they provide, many building operators are still left trying to optimize HVAC systems using a trial and error approach. Active performance management ensures longterm efficiency of a mechanical system through informed, data-driven responses to changes in load and system performance. The important point for facility managers and healthcare administrators is to understand that performance drift in buildings and mechanical systems isn’t a condition that has to be accepted. Better options exist in the form of advanced mechanical solutions and services to optimize performance. Although the changes involve an investment, payback is usually within three to five years. Steven Lane is communications manager at Armstrong Fluid Technology, a manufacturer of intelligent fluid-flow equipment, including pumps, valves, heat exchangers and control solutions.


HEALTH & SAFETY

INVESTING IN COMMUNITY HEALTH Safety considerations for designing, operating supervised injection sites By Katie Subbotina & Breanna Guy

F

irst established in Europe in the 1970s, safe injection sites (SIS) have since opened in both Australia and Canada. As drug-related harms peaked in Vancouver in the mid-to-late 1990s, the country’s first legally supervised SIS was established. Insite, originally a three-year pilot project launched in 2003 in the city’s downtown eastside, contained 13 injection spaces available for 19 hours a day. It saw approximately 700 injections performed daily and was the focus of more than 40 peer-reviewed published studies that showcase the benefits of operating these sites. These include safe spaces to inject pre-obtained substances under nurse supervision; access to sterile injec-

tion equipment; emergency overdose response; and referrals to both internal and external social and health services. Insite illustrated SIS reduced public disorder, infectious disease transmission and overdose. It was successful in referring people to outside programs, such as detoxification and addiction treatments. Not only was it not increasing crime or promoting substance use, Insite was also found to be cost-effective. The experience of SIS in Canada, however, is closely intertwined with the country’s politics. After the pilot study, a newly elected government publicly voiced opposition to Insite. To prevent its closure, the

Portland Hotel Society, which operated the facility, and two local drug users took the federal government to the B.C. Supreme Court. The final ruling was 9-0 in favour of Insite, since it had proven to save lives with no discernible negative impact to public safety and the country’s health objective. In 2015, a public health emergency was declared in Canada, due to an influx of fentanyl-related overdoses. The federal government’s response to the opioid crisis involved identifying supervised consumption sites (SCS). This was due to their observable benefits, which include a reduction of overdose morbidity and mortality when clients inject at SCS; a rise in the FALL/AUTOMNE 2020 29


HEALTH & SAFETY number of SCS users accessing additional treatment services; and increased feelings of safety by people who inject at SCS compared to those who do so publically. SAFE CONSUMPTION SITE

In 2017, SafePoint opened in Surrey, B.C., to become the third SIS in the Lower Mainland and the first facility outside of downtown Vancouver dedicated to reducing the increased number of overdoses in the province. It is operated by the Lookout Emergency Aid Society and staffed by four people at all times (16 hours a day), including a registered nurse. Surrey was selected since the city has the second highest number of deaths related to drug overdose in B.C. Prior to establishing SafePoint in the city’s core, this particular area witnessed a significant increase in homelessness, similar to what occurred in Vancouver’s downtown eastside. In 2016 alone, there were 113 deaths as a result of overdoses. Fraser Health’s Integrated Protection Services and Canada’s largest independent security provider supported the design and build of SafePoint, by providing recommendations on the consumption area, access and staff safety. This information was gathered from a security vulnerability assessment conducted for the site and surrounding area. Community, technology and staff training considerations were at the forefront of the assessment. This was due to open needles, the expected high volume of clients that would access the facility, increased trafBiomedical_CHF_Winter_2017_FINAL.pdf fic flow, drug use, aggression incidents1 related to substance usage and potential overdoses. Initial pushback from the surrounding community was expected. To ensure suc-

cessful integration, local community partners and stakeholders were engaged. A comprehensive closed-circuit television (CCTV) system was set up in the facility so that staff have live viewing capabilities. Staff also have panic duress devices in order to illicit an urgent response from local law enforcement, if necessary. Restricted access into the facility allows staff to visually and audibly confirm clients prior to providing entry into the reception area. There is also an area of refuge inside for staff in the event of an incident. It is critical for staff to be both confident and knowledgeable when responding to and managing a multitude of scenarios, such as aggression and overdoses. As a result, extensive training in Naloxone, a medication used to block the effects of opioids, and emergency team response was key to securing a successful program and staff safety. LEARNING OUTCOMES

Despite the rigorous planning and assumptions made, not all scenarios were accounted for in the assessment. As the client’s needs evolved, there was a request for a safe smoking space in addition to the safe injection area. Subsequently, another structure was built for clients to use for smoking. It was discovered the staff only area did not provide a sufficient barrier to act as a place of refuge during an incident. This resulted in additional access measures being put in place on the interior and exterior of the building in order to 2017-10-23 4:45 PM entry points in the provide multiple event of emergency. An overdose outside the facility led to the discovery that the CCTV system was not comprehensive enough to capture

the entire exterior grounds, which resulted in blind spots. THE ROAD FORWARD

To date, SafePoint has had more than 61,500 visits, which is approximately 200 visits per day. In addition to this staggering number, staff at the site have reversed more than 620 overdoses and no one has died. The number of opioid-related overdoses in the community has significantly reduced, too. SafePoint continues to help clients find recovery from drug addictions by providing immediate access to resources. Previous studies have shown one-third of persons who inject drugs in Vancouver, disproportionately women, require assistance with injections resulting in increased vulnerability to violence, HIV infection and overdose. Individuals who smoke crack cocaine in public are also vulnerable to being arrested and subjected to violence. The public’s understanding of the needs of drug users will continue to evolve along with the ability to build sites that adequately support these people. Lessons learned from existing SIS like SafePoint will help with future site designs. One lesson above all else is the need for flexible design so that areas can be converted and adapted to suit the needs of the clients using the space. Katie Subbotina is director of global risk consulting at Paladin Risk Solutions, which offers a suite of services to identify, mitigate and respond to risk. Breanna Guy is a healthcare area security lead at Paladin Security, one of the largest privately owned, full-service security companies in Canada that specializes in healthcare security. Paladin Security supported the design and build of SafePoint, a supervised consumption site in Surrey, B.C.

MEDICAL GAS INSPECTION & CERTIFICATION MEDICAL EQUIPMENT REPAIR & INSPECTION SCC Accredited third party Inspection Body with 38 years in business inspecting and certifying medical gas systems. Also, specialized in medical equipment preventative maintenance, calibration and repair. Contact us today to book an appointment for your certification or annual inspections. MW Biomedical Inspection Services Ltd. British Columbia – Alberta – Saskatchewan info@mwbiomed.ca | www.mwbiomed.ca P: 780 463 3877 30 CANADIAN HEALTHCARE FACILITIES

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Costa advised that he no longer wished to occupy his role as president. The emergency meeting took place at the defendant’s (MTCC 1292’s) premises. At the emergency meeting, the plaintiff and Mr. Da Costa entered into a heated argument, which led Mr. Da Costa to “lose it” and strike the plaintiff on the head with a chair. Mr. Da Costa was charged by the police and received a conditional discharge for assault with a weapon. iff commen The plaintiff commenced a civil action against Mr. Da Costa fo for his use of force as well as MTCC TCC 1292 for fo failing to ensure her safety and nd failing to employ security meet measures at board meetings. MTCC 1292 brought a motion summary judgment otion for su to dismiss the plaintiff’s plaintiff’ claim against it nly opposed by Mr. Da Costa which was only given his crossclaim MTCC 1292 ossclaim against ag on and indemnity. inde for contribution

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In Omotayo v. Da Costa, 2018, the defendant occupier, Metro Toronto Condominium Corporation 1292 (MTCC 1292), was successful in dismissing the plaintiff’s claim and the assailant’s crossclaim when a member in attendance at a condominium board meeting struck another meeting attendee with a chair. Justice Nishikawa found that the duty the condominium corporation owed to the plaintiff did not include preventing an assault that occurred during their condominium board meeting. Facts of the case T he plaintif f, J ac queline O mot ayo, was a resident and former chair of the condominium corporation. The defendant, Jose Da Costa, was also a resident and former president of the condominium corporation. An emergency board meeting was held on Oct. 4, 2011, to discuss the future organization of the board as Ms. Omotayo had recently been removed from her position as chair and Mr. Da

By Steven Chester

SERVING THE FACILIT Y CLE ANING & MAINTENANCE INDUSTRY

Let’s face it, we all want our businesses to be social media rock stars, and we know it ain’t easy. It’s becoming more prevalent that some of the most popular social media platforms have been infiltrated by those who game the system. This includes those that buy fake followers and “likes” in order to create the illusion that their social media profile is more popular than it is. These fake followers are predominantly bots – accounts run by software designed to look and act like real people.

APRIL/MAY 2017

New services are also popping up that allow authentic social media accounts to become part of the bot game. By signing up for the service, the user authorizes their account to automatically like, follow and randomly comment on other users’ posts, and in turn they trade that fake engagement with other users. Sound harmless enough? The thing is you have no say in in the message your account is spreading or where it ends up.

CARING FOR FRAGILE FLOORS

Summary judgment motion udgment m positi MTCC took the position that its duty w is confined confine to the physical under the law condition of the premises premise and foreseeable e unforese risks, not the unforeseeable conduct of individuals in attendan attendance. Meanwhile, Mr. Da Costa that MTCC 1292’s a argued th s to having rules of conduct duty extends s, policies re for meetings, relating to abusive l an gu a g e, thre at s aan d intimid atin g d a duty to h behavior, and hire and supervise competent professional professionals to oversee its luding, if appropriate, ap business (including, security Cos further argued personnel). Mr. Da Costa ult was foreseeable fore that the assault given the M quarrelsome nature of MTCC 1292’s board nd a prior unrelated u meetings and incident involving the plaintiff and another member of MTCC 1292 wherein the police was 292 wherei called. ng her dec In reaching decision, Justice Nishikawa looked Coleiro v. Premier ooked to C s where summary sum Fitness Clubs judgment d in favour of the defendant was granted

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Ask yourself this: What’s more important, having 50,000 cosmetic followers, or having

500 followers who are in your target market REMEDYING FOUR that actually want to hear from you? COMMON CARPET As a consumer, it’s even simpler, as PROBLEMS deceptive tactics are easy to spot. If you’re using underhanded methods to promote your business, this can be viewed as a reflection of your product or service. Your integrity is at stake. This is one of the more complex topics that can’t be fully covered in this space. As always, I invite you to stay social and continue the conversation on Twitter at @Chestergosocial where I’ll share a link to the full article.

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SUCCESS Steven Chester is the Digital Media Director of MediaEdge Communications. With 15 years’ experience in cross-platform communications, Steven helps companies expand their reach through social media and other digital initiatives. To contact him directly, email gosocial@mediaedge.ca.

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