HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY
Volume 42 Issue 4
THE CASE FOR REUSABLE PPE PM#40063056
Reliance on single-use personal protective equipment items not sustainable
CHES Awards winners 2022 conference roundup Climate resilience guidelines
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CANADIAN HEALTHCARE FACILITIES Volume 42
Clare Tattersall firstname.lastname@example.org
Jason Krulicki email@example.com
Kevin Brown firstname.lastname@example.org
SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR
Annette Carlucci email@example.com
GRAPHIC DESIGNER/ GRAPHISTE
Thuy Huynh firstname.lastname@example.org
PRODUCTION COORDINATOR/ COORDINATEUR DE DE PRODUCTION
Ines Louis email@example.com
30 Adapting to Climate Change Guidelines for planning, designing resilient healthcare facilities
36 COVID-19 and PPE Waste A catalyst for a reusable personal protective equipment health system
CIRCULATION MANAGER/ Adrian Hollard DIRECTEUR DE LA firstname.lastname@example.org DIFFUSION
CANADIAN HEALTHCARE FACILITIES IS PUBLISHED BY UNDER THE PATRONAGE OF THE CANADIAN HEALTHCARE ENGINEERING SOCIETY. SCISS JOURNAL TRIMESTRIEL PUBLIE PAR SOUS LE PATRONAGE DE LA SOCIETE CANADIENNE D'INGENIERIE DES SERVICES DE SANTE.
CHES Canadian Healthcare Engineering Society
Société canadienne d'ingénierie des services de santé
20 Readying for Long-term Growth at HSC Winnipeg Le HSC Winnipeg se prépare à une croissance soutenue
Road of Devotion Mitch Weimer’s continued active involvement in CHES comes from desire to always help
A Collective Effort B.C. chapter executive pulls together to win President’s Award in back-to-back years
TREASURER EXECUTIVE DIRECTOR
Craig B. Doerksen Jim McArthur Roger Holliss Reynold J. Peters Beth Hall Donna Dennison
Newfoundland & Labrador: Colin Marsh Maritime: Robert Barss Ontario: John Marshman Quebec: Mohamed Merheb Manitoba: Reynold J. Peters Saskatchewan: Melodie Young Alberta: Mike Linn British Columbia: Sarah Thorn 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: email@example.com www.ches.org Canada Post Sales Product Agreement No. 40063056 ISSN # 1486-2530
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.
Remember our stories Commissionaires.ca/Remember
REAL-WORLD CONSEQUENCES OF SHORT SUPPLY FLU SEASON HAS ARRIVED early and it looks like it’s going to be more severe than it has been in years now that masking is no longer required; the measure helped control seasonal influenza virus transmission during the first two years of the COVID-19 pandemic. For parents, it has been particularly difficult (so far) due to the ongoing shortage of children’s acetaminophen and ibuprofen. There has been unprecedented demand for these products in recent months due to the unexpected circulation of viruses. Unable to find these over-the-counter medicines, I personally turned to a compounding pharmacy for help to bring down my daughter’s raging fever at no small cost — nearly $40 for 50 milligrams of what I call ‘liquid white gold’ that has a shelf-life of just 14 days. Shortages caused by the pandemic have become a major issue worldwide. We can all remember the early days when toilet paper, hand sanitizer and food products like flour were hard to come by. But unlike these items, low supply of non-prescription and behind-the-counter pharmaceuticals and medical materials like personal protective equipment (PPE) can have deleterious consequences. With regard to the latter, shortages at the start of the pandemic left doctors, nurses and other frontline workers dangerously ill-equipped to care safely care for COVID-19 patients, as well as take care of themselves. This is partly behind a movement that promulgates the adoption of reusable PPE. There are also environmental benefits of transitioning to a reusable PPE system in healthcare systems, laid out in the Canadian Coalition for Green Health Care’s article, COVID-19 and PPE Waste. Keeping with the topic of sustainability, Lisa Westerhoff of Integral Group delves into the Climate Resilience Guidelines for B.C. Health Facility Planning and Design in Adapting to Climate Change, which is based off a seminar she co-presented with Craig Dedels of Vancouver Coastal Health and Jolene McLaughlin of EllisDon at this year’s CHES British Columbia chapter conference. The bulk of this issue is dedicated to the CHES Awards winners who were honoured at the 2022 International Federation of Healthcare Engineering (IFHE) Congress/CHES National Conference in Toronto. Health Sciences Centre in Winnipeg was bestowed the Wayne McLellan Award of Excellence in Healthcare Facilities Management for construction of a second central energy plant in 2011, to meet then-recent building and future development goals. Long-time CHES member Mitch Weimer was recognized with the Hans Burgers Award for Outstanding Contribution to Healthcare Engineering. He has taken on numerous roles since joining the organization in 1992, among them serving as CHES National president from 2015-2017. The President’s Award went to the B.C. chapter for a second year in a row. To begin, we look back on the first CHES National event to be held in-person in three years. There were many highlights, including presentation of the Global Energy and International Building awards – both bestowed by IFHE. As everyone who attended can attest, it was an event not soon to be forgotten. Clare Tattersall firstname.lastname@example.org
6 CANADIAN HEALTHCARE FACILITIES
SAVE THE DATE! SAVE THE DATE! TheThe 2023 CHES National Conference inWinnipeg Winnipeg, the RBC Convention CHES 2023 National Conferencewill willbe be held held in MBManitoba, at the RBCatConvention Centre, Centre, September TheConvention RBC Convention Centre is conveniently in thecore downtown September 17-19, 17-19, 2023. 2023. The RBC Centre is conveniently located inlocated the downtown and coreclose and to close to local amenities. local amenities. A block of rooms has beenreserved reservedat at the the Delta starting at $202 plusplus applicable taxestaxes standard A block of rooms has been DeltaHotel, Hotel, starting at $202 applicable standard Queen/King single/doubleoccupancy. occupancy. queen/king single/double
Thetheme themeofofthe the2023 2023conference conferenceis is The “Rejuvenating Healthcare Infrastructure” “Rejuvenating Healthcare Infrastructure” CHES 2023 Education is well underway and will again once again feature tracks talks TheThe 2023 education programProgram is well underway and will once feature dualdual tracks withwith talks on on relevant industry topics from high-profile experts in the field. Isha Khan, CEO, Canadian Human relevant industry topics from high-profile experts in the field. Isha Khan, CEO, Canadian Museum of Rights Museum will be our Keynote Speaker. Human Rights will be our Keynote Speaker. The Call for Abstracts for program submission closes on November 18, 2022. You may submit your
Thecompleted Call for Abstracts for program submission closes on November 18, 2022. You may submit your form at (https://www.xcdsystem.com/ches/abstract/index.cfm?ID=9AqVARj) and/or any inquiries form by email to email@example.com. completed at https://www.xcdsystem.com/ches/abstract/index.cfm?ID=9AqVARj and/or inquiries by email to firstname.lastname@example.org. The Great CHES Golf Tournament will be held at Quarry Oaks Golf Course on Sunday September 17, 2023.
The Great CHES Golf Tournament will be held at Quarry Oaks Golf Course on Sunday, September 17, 2023. Join us for the CHES President’s Reception and Gala Banquet again in 2023 at RBC Convention Centre. The banquet will celebrate the accomplishments of our peers with the 2023 Awards Joinpresentations, us for the CHES Reception and Gala Banquet at the RBC Convention Centre. The whilePresident’s enjoying great food and entertainment with friends.
banquet will celebrate the accomplishments of our peers with the 2023 CHES Award presentations, while enjoying great food and entertainment within friends. See you 2023 in Winnipeg!
Foryou morein info visit our website at See 2023 in Winnipeg! For more info visit our website at www.ches.org
www.ches.org Follow us on Twitter! Follow us on Twitter!
Joins us on! Joins us on!
BITTERSWEET MOMENTS THE WORD THAT COMES to mind as I write my first president’s message is bittersweet. Having just wrapped up the CHES National conference in Toronto — our first in-person event since 2019 — I am filled with bittersweet memories. The conference was particularly exciting as CHES hosted the 2022 International Federation of Healthcare Engineering (IFHE) Congress. With 130 vendor booths and 35 technical, plenary and keynote sessions, there were plenty of opportunities to connect and learn for the 838 registrants. The response from 135 international attendees from 26 foreign countries continues to roll in. Under the guidance of then-Ontario chapter chair Jim McArthur, and with the support and hard work of CHES members, IFHE leaders and Events & Management Plus Inc. staff, the conference was skillfully planned and executed. I won’t soon forget Marcel Dionne and the experiences at the Hockey Hall of Fame, physician and international hockey legend Dr. Hayley Wickenheiser, astronaut and healthcare leader Dr. David Williams, and the gala banquet at the Liberty Grand with Family Feud and its special guest host. (Was that really Roger Holliss under the bald cap?) Another bittersweet memory comes from changes on the CHES National executive. After the pandemic prolonged terms for all board members (to three years from two), we extended gratitude to outgoing immediate past president Preston Kostura and treasurer Kate Butler at our annual general meeting. As an Alberta chapter leader and chair, as well as conference chair, and CHES National vice-president, president and past president, Preston has given selflessly to the organization for years. Kate took over as treasurer in September 2019, and quickly CHES moved, like all organizations, into an unknown and uncharted financial period due to the pandemic. Kate reviewed regular CHES operations, the 2021 virtual conference and 2022 IFHE Congress to ensure fiscal prudence while maximizing member value. Esteemed leader Roger Holliss has moved into the role of immediate past president. A huge thank you to Roger for steering CHES through the pandemic, ensuring the organization’s mission and vision were never lost, and remaining focused on building member expertise through stronger relationships with partner groups like the Canadian College of Health Leaders, Infection Prevention and Control Canada and CSA Group. Elections have seen new executive members added to the board for the 2022-2024 term. Reynold Peters, who has served as Manitoba chapter chair for many years and just completed a term as CHES National secretary, was elected to the role of treasurer. New to the board is Jim McArthur in the role of vice-president. Jim most recently served as Ontario chapter chair and led the planning committee for this year’s IFHE congress/CHES National conference. Another addition is Beth Hall, who was elected to the role of secretary. While we welcome new faces and say goodbye to others, I take comfort in knowing those who left the executive team (there are some new chapter chairs, too) are still part of the CHES family. Also bittersweet, executive director Donna Dennison is retiring in January. Donna has been with Events & Management Plus since 1998, which marks the beginning of CHES’s relationship with the company that manages our organization and conference. She became executive director in 2011, and has touched every committee, conference, election process, bylaw revision, website development, policy creation (and rewrite), form, membership application and renewal associated with CHES. Donna is the face of our great organization. She has served passionately, capably and faithfully (beyond her role), and has been key to supporting the leadership of four past presidents. While she will be sorely missed, we couldn’t be happier for Donna as she moves into the next phase of her life. I am thrilled to have stepped into the role of president for the next two years. I look forward to continuing to work with Roger and now Jim, as we continue to build member expertise and enhance the patient care environment. Craig B. Doerksen 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 2022 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 www.surveymonkey.com/r/XRGY9R3 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. 8 CANADIAN HEALTHCARE FACILITIES
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BRITISH COLUMBIA CHAPTER
The B.C. chapter executive spent the summer months reflecting on this year’s conference, establishing lessons learned to bring forward and preparing for a busy fall. Conference chair Mitch Weimer will lead the planning and preparation for next year’s conference in Penticton. Cost pressures have been identified due to inflation, along with post-pandemic risk mitigation considerations for future venue contracts. The executive team is looking at options for centralized document storage as we want to set up a shared, cloud-based location that allows all executive and committee members to store files and collaborate. One of our many priorities this year is increasing membership. CHES B.C. has gained 62 new members. We’d like this upward trend to continue and see further growth. The chapter executive plans to re-connect with those who have not renewed their membership, as well as promote membership to new faces in the industry and the province’s healthcare facilities. Another focus is succession planning and mentorship. The chapter executive plans to issue an expressions of interest to seek out new volunteers to support CHES B.C. These positions will support current directors, providing mentorship and pathways to fill future chapter executive positions. This initiative led us to discuss job descriptions; they require updates to match current work. The B.C. chapter is currently active on many CHES committees, including partnership and advocacy, membership, social and the Canadian Healthcare Construction Course, as well as CSA. Congratulations to CHES National, the Ontario chapter and the 2022 International Federation of Healthcare Engineering Congress/CHES National Conference planning committee on a successful conference. Your hard work bringing this world-class event to fruition has created an incredible memory for us all.
After a quiet summer, planning is well underway for the chapter’s fall education day. It will take place Nov. 15, at the Best Western Glengarry in Truro, N.S. We welcome all CHES Maritime members and nonmember frontline maintenance workers in healthcare and long-term care to attend this free event. Planning has begun on next year’s spring conference. It will be held April 30-May 2, in Moncton, N.B., at the Delta Beausejour. Also on the education front, CHES Maritime will host the Canadian Healthcare Construction Course May 30-31, in Halifax. The Maritime chapter sent three executive members to the 2022 International Federation of Healthcare Engineering Congress/ CHES National Conference in Toronto. We will host the twice postponed CHES National conference in Halifax, Sept. 6-10, 2024. Much of the planning has already been completed. Samantha Benoit is the successful applicant for this year’s $1,000 Per Paasche bursary. Samantha is the daughter of CHES Maritime member David Benoit. The chapter is offering several financial incentives to members in the form of student bursaries, contribution to Canadian Certified Healthcare Facility Manager exam fees, and covering the cost of webinars and the fall education day, among other benefits.
—Sarah Thorn, British Columbia chapter chair
SASK ATCHEWAN CHAPTER The Saskatchewan chapter executive worked through summer to prepare for a mini-conference in Regina, Oct. 2425. The two-day event consisted of a social outing on the evening of Oct. 24, followed by a day of education sessions. The common theme of the presentations was project delivery in the challenging times created by the COVID-19 pandemic. The conference was free to CHES members in active standing. Non-members could attend if they purchased a membership; this was the only fee. CHES Saskatchewan is currently challenged by low membership numbers, undoubtedly a result of the last few years. The pandemic broke out shortly after the chapter hosted the successful 2019 CHES National Conference. Since then, there has been little CHES activity as many members and the executive team have been consumed with pandemic priorities. The chapter executive is hopeful the fall miniconference has bolstered interest in the association and membership. The Saskatchewan chapter was fortunate enough to sponsor one representative to attend the 2022 International Federation of Healthcare Engineering Congress/CHES National Conference in Toronto. —Jim Allen, Saskatchewan chapter past chair 10 CANADIAN HEALTHCARE FACILITIES
—Robert Barss, Maritime chapter chair
NEWFOUNDLAND & LABRADOR CHAPTER After all the turbulence generated from COVID-19, the downward spiral in the oil industry, increased fuel prices and staffing shortages in many healthcare disciplines, I am proud to announce CHES Newfoundland and Labrador pulled off the largest and most successful chapter conference in our history. The chapter executive decided to incorporate a round table discussion, lessons learned session and live demonstration on ductwork sealing. The all-expenses paid conference was so well-received that attendees asked if it could become a two-day event. Right now, the date and duration of next year’s chapter conference is still to be determined; however, May is the preferred month. Chapter membership is holding steady, which is good news given the current provincial fiscal climate. We are actively pushing recruitment on vendors/suppliers, consultants and other healthcare dependents to improve membership enrolment. Financially, the chapter is in a solid position. As a result, the executive team is looking to give back to chapter members and invest in their betterment. Whether through education opportunities, sending additional members to the CHES National conference — two persons attended this year along with the chapter chair — paying for more webinars and/or supporting members who take on the role of chair of a national committee, we are committed. —Colin Marsh, Newfoundland & Labrador Chapter chair
Planning for next year’s CHES National conference is well underway. It will take place Sept. 17-19, at the RBC Convention Centre in Winnipeg. The conference theme is Rejuvenating Healthcare Infrastructure. The call for abstracts deadline is Nov. 18. There will be facility tours of HSC Winnipeg Women’s Hospital and HSC Energy Centre. The opening night reception will be held at the Canadian Museum for Human Rights. The museum’s CEO Isha Khan will give the keynote address. Social events include golfing at the Quarry Oaks. The companion program is still being worked out. Possibilities include Journey to Churchill exhibit, Winnipeg Art Gallery, Royal Aviation Museum of Western Canada, Winnipeg City Tour, Gardens at the Leaf, The Forks and a Hermetic Code tour of the Manitoba Legislative Building. Since CHES Manitoba will host this esteemed event, our next chapter conference will take place in 2024. The Manitoba chapter, together with the Winnipeg Construction Association (WCA), held a second sold-out Canadian Healthcare Construction Course this year at the WCA office, October 4-5. Once again, I’d like to thank the WCA for partnering with CHES Manitoba. The Manitoba chapter also held a session at the Manitoba Building Conference & Expo Oct. 8, at the Victoria Inn & Convention Centre. CHES Manitoba covered the cost for regular member registration.
It has been more than two and a half years since COVID-19 was declared a global pandemic. Modifications were made to accommodate a new type of patient and new protocols introduced to protect the workforce. The pandemic also brought with it reallife complications, such as absenteeism and increased workload. Facility managers have prioritized innovation and relied on internal resources and their knowledge to navigate this unpredictable time. Belonging to a community of like-minded individuals has helped us through and remains a continued need. This year, the Quebec chapter held online education sessions on multiple subjects, such as HVAC in relation to COVID-19 and operations and maintenance of heat exchangers. The chapter was successful in securing an audience with a representative from the provincial health ministry, as well as all technical services directors. A presentation conveyed the vision of CHES, and strength and diversity of our community. Afterwards, we fielded numerous calls from hospital-based individuals. On the operational side, the chapter executive has lost a member of its team. Presently, there is no replacement. We are looking at rebooting the chapter amid this new COVID world.
—Reynold J. Peters, Manitoba chapter chair
—Mohamed Merheb, Quebec chapter chair
CHAPITRE DU QUEBEC
CHES Alberta hosted the Clarence White Conference & Tradeshow Oct. 24-25, at the Cambridge Hotel & Conference Centre in Red Deer. The first in-person event in more than two years, more than 175 delegates were in attendance. The conference featured education sessions, up to 90 exhibit booths and closing speaker Rebecca (Beckie) Scott. Beckie is Canada’s most decorated cross-country ski racer in the history of the sport. In 2002, she won a gold medal in the Salt Lake Winter Olympics, becoming the first Canadian (and first North American woman) to win an Olympic medal in cross-country skiing. She followed that up with a silver Olympic medal in Torino, Italy, in 2006, and finished second overall in the World Cup standings. That same year, she retired as a three-time Olympian with a recorded 17 World Cup podium finishes. I’d like to give a ‘shout out’ to everyone who helped make the 2022 International Federation of Healthcare Engineering Congress/CHES National Conference a huge success. The venue was fabulous and the events were incredible but most importantly, it was great to finally meet folks in person again. National Healthcare Facilities and Engineering Week kicked off Oct. 16. A big thank you to all staff and volunteers that keep our healthcare facilities running and well-maintained.
Cela fait plus de deux ans et demi que l’organisation mondiale de la santé a déclaré la pandémie de COVID-19, ce qui a obligé les réseaux de santé à s’adapter rapidement pour faire face à la propagation du virus. Des modifications ont été apportées pour accueillir un nouveau type de patients et de nouveaux protocoles ont été introduits pour protéger le personnel. La pandémie a également entraîné des complications concrètes, telles que l’absentéisme, l’augmentation de la charge de travail et la hausse du coût de la vie, pour n’en citer que quelquesunes. Les gestionnaires d’établissements ont privilégié l’innovation et se sont appuyés sur les ressources internes et leurs connaissances pour traverser cette période imprévisible. Plus que jamais, l’appartenance à une communauté nous a aidés à traverser cette période et demeure un besoin constant. Cette année, le chapitre du Québec a organisé des sessions de formation en ligne sur plusieurs sujets, tels que les systèmes CVC en relation avec COVID-19 et le fonctionnement et l’entretien des échangeurs de chaleur. Le chapitre a réussi à obtenir une audience avec un représentant du ministère provincial de la Santé, ainsi qu’avec tous les directeurs des services techniques. Une présentation de 15 minutes qui a permis de transmettre la vision de la SCISS, ainsi que la force et la diversité de notre communauté. Après la présentation, nous avons reçu de nombreux appels de personnes travaillant dans les hôpitaux. Sur le plan opérationnel, l’exécutif du chapitre a perdu un membre. Il n’y a pas de remplaçant pour le moment. Nous envisageons de redémarrer le chapitre dans ce nouveau monde COVID.
—Mike Linn, Alberta chapter chair
—Mohamed Merheb, chef du conseil d’administration du Québec
FALL/AUTOMNE 2022 11
2022 International Federation of Healthcare Engineering Congress/CHES National Conference in Toronto. Photos courtesy Kent Waddington.
My time as Ontario chapter chair has been filled with ups and downs, the latter fuelled by the COVID-19 health crisis. During the first two years of the pandemic, we continued to deal with chapter business or other issues by phone, e-mail or Zoom meetings. Unfortunately, the virus put a damper on our 2021 conference in Niagara Falls, and any potential face-to-face education opportunities; however, life has returned to a bit of normalcy with some CHES chapters holding in-person conferences this year. I had the pleasure of attending the Manitoba and B.C. chapter conferences, as well as the American Society for Health Care Engineering (ASHE) Region 6 conference in Minnesota, and the ASHE national conference in Boston. Our main focus this past year was the continued planning for the 2022 International Federation of Healthcare Engineering Congress in Toronto, Sept. 17-21. The congress was combined with the CHES National conference and replaced the Ontario chapter’s conference as CHES Ontario hosted the esteemed event. We had an excellent conference planning committee comprised of members from across Canada, as well as a few international representatives. This was the first in-person event held in Ontario since 2019. 2022 was an election year for the chapter. John Marshman assumed the role of chapter chair at our annual general meeting in September, and I moved into the position of past chair. Elections were held for the remainder of the chapter executive. Beth Hall was elected to the position of vice-chair, Ken Paradise remains as treasurer and we welcomed Chris MacKey to the role of secretary. Rounding out the executive team is Ron Durocher (conference planning), Derek Lall (education), Jeff Weir (membership) and Larry Erwin (communications and public relations). Another new face is Alex Sullo (partnerships and advocacy), replacing Richard White. We also said goodbye to Roger Holliss who moves on from the position of past chair. On behalf of the Ontario chapter, I’d like to thank both Richard and Roger for their dedication to CHES and many years of service on the executive. I am also grateful for the efforts of all executive members, as well as the support of chapter members. I have enjoyed my time serving as chapter chair and want to thank members of the executive, past and present, for their dedication during my tenure. I will continue to support the chapter in my new role as immediate past chair. —Jim McArthur, Ontario chapter past chair
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2016-11-22 10:48 AM
CHES Canadian Healthcare Engineering Society
Société canadienne d'ingénierie des services de santé
CALL FOR GRANT SPONSORSHIP & SUBMISSIONS 2023 Young Professionals Grant DEADLINE: April 30, 2023 CHES is seeking both sponsors and candidates for the 2023 Young Professionals Grant. The application forms for Sponsors and Candidates are available on the CHES Website.
Call for Sponsors: • The YPG sponsorship application form must be completed by the sponsoring organization/company and submitted to the CHES National Office. • CHES National Office will invoice sponsoring organization/company for $2,000 once candidate applications have been received and approved.
Call for Candidates: • Young professionals who are or will become architects, engineers (i.e. mechanical, electrical, power, and civil, etc.), technicians or similar technical disciplines are eligible. • Eligible candidates are those working within a healthcare organization or a company supplying goods or services to healthcare facilities or organizations. • Eligible candidates must be working in the healthcare field for less than 5 years. • The YPG application form must be completed by the eligible candidate and submitted to the CHES National Office. In this form, the eligible candidate will be required to provide information on their recent employment and future career aspirations. • Confirmed candidates will receive complimentary registration for the 2023 National Conference and complimentary membership for the remainder of the 2023-2024 membership year.
For Nomination Forms, Terms of Reference, criteria, and past winners www.ches.org / About CHES / Awards Send nominations to; CHES National Office firstname.lastname@example.org Fax: 866-303-0626
SUCCESS OF 2022 IFHE CONGRESS/CHES NATIONAL CONFERENCE A CELEBRATORY OCCASION FOR ALL ALMOST THREE YEARS to the day of the last in-person CHES National event, hundreds of people from across the country gathered together at the 2022 conference. After a long hiatus due to the COVID-19 pandemic, which dealt a heavy blow to events, the conference’s return couldn’t have come at a better time as the CHES community was yearning to meet face-to-face again. Hosted by the Ontario chapter at the Westin Harbour Castle in Toronto, Sept. 17-21, the much-anticipated event was held in conjunction with the International Federation of Healthcare Engineering (IFHE) Congress — a planning feat not easy to pull off given the unpredictability wrought by the pandemic. The committee charged with bringing the combined event to fruition did not disappoint, as the nearly 820 attendees and more than 400 delegates can attest. Among them was Victoria Styrna, the recipient of the Young Professionals Grant (YPG). A planner in Hamilton Health Sciences’ capital development department, Styrna was selected for her desire to attain Project Management Professional (PMP) certification, as well as to learn and network with seasoned healthcare industry professionals to further her career in the field. The grant came with the opportunity to attend the conference, with registration fees and travel expenses up to $2,000 covered, and a one-year complimentary CHES membership. “The value of attending the conference, especially for the first time, is endless,” says Ontario chapter chair Jim McArthur, who 14 CANADIAN HEALTHCARE FACILITIES
has since moved into the role of past chair. “It offers the occasion to meet with vendors and peers that work in healthcare engineering, and it provides education sessions unique to our industry. This is particularly valuable to a newcomer in healthcare. Anyone attending for the first time recognizes the worth of a CHES conference, and it makes it easier to justify to our employers the importance of attendance.” The YPG is given annually to young professionals who are or will become architects, engineers or technicians, or work in similar technical disciplines. Eligible candidates must be employed by a healthcare organization or company that supplies goods or services to healthcare facilities or organizations, and have worked in the healthcare field for less than five years. The number of grants awarded each year is dependent on the number of sponsors. “I was stunned when I was notified I was the recipient of the grant (as) I do not come from an engineering background,” says Styrna, who holds an honours bachelor in interior design degree. Styrna’s career in the healthcare industry began in 2020, two years after graduating from Sheridan College. She originally joined Hamilton Health Sciences on an 18-month contract filling in for a maternity leave as a planner at Juravinski Cancer Centre. She was hired full-time this past April, as a planner at Hamilton General Hospital, where she completes capital projects and fulfills day-to-day healthcare facility requests.
Photos courtesy Kent Waddington
Styrna says she applied for the grant because “I knew the CHES National conference would be a once in a lifetime opportunity I would enjoy to the fullest.” And that she did. As in years past, the Great CHES Golf Game kicked off the multi-day event, held at the Lionhead Golf Club and Conference Centre, followed by the opening night reception at the Hockey Hall of Fame. The sold-out trade show floor boasted 130 booths and the educational program covered a wide variety of topics based around the conference theme, Unleashing Innovation: Healthcare Innovation Excellence. Conference highlights included the keynote address by four-time Olympic gold medallist Hayley Wickenheiser who is regarded as one of the best female hockey players in the world and is currently working toward a medical degree, while employed simultaneously as senior director of player development for the Toronto Maple Leafs; facility tours of the second largest pediatric research hospital in the world, affably known as SickKids, and St. Michael’s Hospital; a day trip to Niagara Falls; and sightseeing bus tour of Toronto as part of the companion program. Styrna’s most notable networking experience occurred at the Hockey Hall of Fame, where she conversed with members of one of Scandinavia’s top hospital architects, Link Arkitektur, amid the relaxed yet awe-inspiring atmosphere. Two days later, she attended the session, Augmented Healthcare Design of the Future, whose two
speakers were from the firm. “Their presentation was very eye-opening for me in terms of how a leading architect is using artificial intelligence in their planning, design and construction of large hospital projects,” she says. Styrna appreciated the diverse lineup of international speakers and product vendors — a bonus of CHES hosting the IFHE Congress — and the ability to ‘rub elbows’ with a wide range of healthcare industry professionals at a multi-faceted single event, which has had a profound effect on her. “The conference paved the way for the expansion of my professional network literally overnight. When do you ever get this opportunity?”, says Styrna, who hopes to attend the 2023 CHES National Conference in Winnipeg. “The biggest impact (has been) the incredibly diverse industry connections I have made. Who knows what new career opportunity may arise next!” Styrna’s sentiments about the conference are shared by many, which accounts for the strong turnout. But for some, the main draw was the gala banquet. This year, Dwayne Gretzky, a 10-person band that sings renditions of classic rock and pop songs from more than 60 artists, provided the night’s entertainment. However, the high point was the presentation of awards. Health Sciences Centre Winnipeg (Wayne McLellan Award of Excellence in Healthcare Facilities Management), Mitch Weimer (Hans Burgers Award for Outstanding Contribution to Healthcare Engineering) and the FALL/AUTOMNE 2022 15
B.C. chapter were honoured by CHES, along with two other groups who were praised by IFHE. Members of the Kaiser Permanente Vacaville Medical Centre in California took to the stage to accept the first-ever Global Energy Award for the 64 per cent energy reduction at their chemical dependency reduction program facility, and 24 per cent energy curtailment at their hospital campus. The Alberta Health Services (AHS) team involved in the Grande Prairie Regional Hospital project received the International Building Award, which recognizes the importance of the design of healthcare facilities. “(It) was a nice way to close out the project for the team, as well as to thank the contractors and staff for their hard work and perseverance throughout the project,” says AHS clinical liaison Sabrina McCormack, who represented the health authority through all phases of the project and worked with Alberta Infrastructure to ensure project objectives were reached. More than a decade in the making, Grande Prairie Regional Hospital is a new 64,000-square-metre acute care hospital with 243 single inpatient rooms, 11 operating suites, cancer centre that features two radiation vaults, a 4,000-square-metre education program area (in partnership with Northwestern Polytechnic) for the training of nurses and other healthcare professionals, and a parkade that has 1,100 parking stalls for staff and the public, plus an additional 250 surface stalls on-site. 16 CANADIAN HEALTHCARE FACILITIES
Hospital inpatient units fan out along the ‘curved spine’ as three Y-shaped wings. This design was adopted to optimize site utilization and light penetration to patient and staff spaces, increase net-togross area efficiency and to provide connections between adjacent units. The ‘Y’ also minimizes walking distances for staff within the various inpatient units. Every inpatient room is single-occupancy, with the exception of twin rooms in the neonatal intensive care unit, and has a fold-down sleep space to accommodate a family member or caregiver staying with the patient. Each room is also equipped to allow for patient direct input over their environmental settings and ergonomic positioning of their bed. Access to areas of respite were design priorities. The main public corridor, known as Main Street, that connects the inpatient side to the diagnostic wing includes seating, and there are quiet areas for families on the inpatient units and family lounges in critical care areas. Two courtyards exist off Main Street for patients, students, staff and the public to enjoy. The Prayer and Reflection Room is a space for meditation, reflection, quiet time and prayer for individuals of all religious faiths and non-religious beliefs. Also of importance was providing connections to the outdoors for its calming effect. This was achieved by the inclusion of large windows in the main public corridor and patient rooms, the latter of which provide views of nearby Bear Creek, ceiling graphics of
nature in the radiation vaults, and more than 60 images showcasing the beauty and talent of the surrounding region displayed on walls in key zones throughout the facility like entries, waiting lobbies and areas of respite. “Several photos, shot and submitted by area residents, have been transformed into large-scale graphics,” says McCormack. “These images, selected (from more than 1,300 photos) by a working group of local staff and stakeholders, serve as a unique reflection of the spirit of the region.” Indigenous stakeholders from the region worked with AHS representatives at the site with the goal of making the new hospital a culturally safe space. An art installation and traditional drum created by Indigenous artists are displayed in the main entrance along with a land acknowledgement. As a result of this engagement work, smudging is available by request in patient rooms. Staff work with facilities personnel to ensure appropriate ventilation to the areas where the smudging will take place. Grande Prairie Regional Hospital opened in December 2021, after years of delay attributed to a myriad of factors, including a change in contractors in 2018, and COVID-19. The pandemic presented several unique challenges that were both unanticipated and beyond the health authority’s control. “From supply chain issues and changing travel restrictions to uninstalling and sending equipment to COVID-19 field hospitals,
the project encountered it all,” says McCormack. For instance, “We were made aware of delays in the manufacturing of hospital-grade textiles and upholstery related to the COVID situation in certain jurisdictions. In addition, specific specialized equipment was in high-demand throughout North America and the world due to the pandemic, leading to limited availability. Thankfully, we were able to work with our various suppliers to find solutions and move forward.” Travel during the pandemic presented challenges with vendor site visits and coordination. At times, in lieu of site visits, virtual video reviews were conducted and site photos sent to vendors to assess construction progress before equipment shipment and installation. McCormack says the process ended up working well; timely and detailed documentation and clear communication were required so vendors could confidently make decisions. Another challenge stemmed from several specialty vendors being located in the United States. This presented delays in workers arriving on-site. Construction progress had to pivot accordingly to accommodate the change in schedule. Now, almost a year into its operation, the wait was well worth it, as the hospital is receiving critical acclaim and, more importantly, providing much-needed healthcare services, including emergency and trauma services, surgery, obstetrics, inpatient mental health, critical care, outpatient clinics and more. FALL/AUTOMNE 2022 17
UNLOCK SUPERIOR HYGIENE AND RESTROOM CLEANLINESS
o keep germs at bay, it is imperative for health care providers to maintain a sanitary and clean facility. That’s why some facilities are revamping their restrooms by throwing in the towel—replacing paper with high-speed, energy-efficient electric hand dryers to foster a hygienic environment that benefits patients, staff and visitors alike. Today’s facilities have quite a few options when it comes to paper towel alternatives, but many choose hand dryers made by Excel Dryer, the company that first established the high-speed, energy-efficient category for hand dryers. In addition to the original, flagship XLERATOR® Hand Dryer, the company has expanded its product line with three additional models: • XLERATORsync® Hand Dryer, a sink-mounted, elegant dryer that elevates the look and feel of any restroom • XLERATOReco® Hand Dryer, an extremely environmentally friendly product that uses no heat technology to dry hands fast using only 500 watts • ThinAir® Hand Dryer, a sleek, space-saving model designed to be fully ADA-compliant when surface mounted
SPONSORED CONTENT While these products differ in capabilities and design, facilities rely on all of them for improved hand hygiene and a cleaner, more efficient restroom experience. Let’s explore why Excel Dryer’s products are the right choice for your health care facility. A LOOK AT THE FACTS There is no question that hand drying is an essential aspect of proper hand hygiene. In fact, the United States Centers for Disease Control and Prevention state that “germs spread more easily when hands are wet, so make sure to dry your hands completely, whatever method you use.” Relying fully on paper towels can lead to issues that don’t occur when electric hand dryers are in use. Have you ever walked into a restroom and noticed used, wet paper towels strewn across the countertops, covering the floors or overflowing in a trash bin? These used paper towels are a breeding ground for viruses and bacteria and contribute to creating a very unhygienic restroom. It’s not just used paper towels that help create unsanitary restroom environments—according to one study in the American Journal of Infection Control, 100- to 1,000fold more bacteria were found on recycled paper towels than a virgin wood pulp brand, and bacteria may be transferred to people after handwashing. Not only do Excel Dryer’s innovative products create a sanitary environment by eliminating dirty paper towels, but they also help reduce the overall spread of germs throughout a facility by reducing the number
of touchpoints in the restroom. Each hand dryer made by Excel Dryer uses automatic sensors that turn the dryer on when it detects hands underneath, fostering a more hygienic facility as 80 percent of all germs are transmitted by touch. While it’s impossible to eliminate germs in bathrooms entirely, there are some hand drying solutions that provide greater protection than others. A HEPA filtration system is available as an optional feature on some of the dryers on the product line—it comes standard on one model and can be easily retrofitted on others. Results of testing from LMS Technologies found that this HEPA filtration system removes 99.999% of viruses and 99.97% of potentially present bacteria at 0.3 microns from the airstream. A HOSPITAL THROWS IN THE TOWEL Some health care facilities have already made the switch to using electric hand dryers in their restrooms and have seen major benefits. When Northwestern Memorial Hospital (NMH) began its refurbishment program to reduce maintenance needs and improve sanitation in its many staff and public restrooms, it turned to Excel Dryer for help. Going into the project, the hospital was constantly plagued by restroom plumbing and maintenance issues related to paper towels, as well as issues with dirty
and wet paper towels piling around and in trash receptacles. The NMH Infection Control board eventually concluded that dryers with traditional high-velocity heated air streams were the most hygienic option for the restroom refurbishment project, citing concerns that trough-style dryers could lead to unwanted bacteria growth from stagnant water that collects at the bottom of the trough. The hospital subsequently installed over 120 XLERATOR® Hand Dryers at their main campus, meeting their infection control board’s rigorous hand hygiene standards and reducing maintenance problems caused by paper towels. If you are inspired by Northwestern Memorial Hospital’s successes, or if you are committed to creating a more hygienic environment in your health care facility’s restrooms, consider partnering with Excel Dryer to install high-speed, energyefficient and hygienic hand dryers. Visit ExcelDryer.com to learn more and to get started.
READYING FOR LONG-TER GROWTH AT HSC WINNI Le HSC Winnipeg se prépare à une croissance soutenue
ocated in Winnipeg, Health Sciences Centre (HSC) is not only the largest healthcare facility in Manitoba, but among the biggest in Canada. Comprised of 32 distinct buildings on a 39-acre campus co-located with the University of Manitoba, a provincial laboratory and CancerCare Manitoba, the facility embarked on construction of a second central energy plant in 2011, to meet then-recent building and future development goals. The need was identified five years’ prior during an evaluation of the HSC master plan; the existing central energy plant built in the ‘70s when four facilities — Winnipeg General Hospital, Children’s Hospital of Winnipeg, Manitoba Rehabilitation Hospital and D.A. Stewart Centre — were amalgamated under one administration had reached its physical footprint, cooling and emergency power system capacities. “We were at a point where we were actually in a deficit for chilled water and emergency power,” says Craig Doerksen, executive
20 CANADIAN HEALTHCARE FACILITIES
itué à Winnipeg, le Health Sciences Centre (HSC) est non seulement le plus grand établissement de santé du Manitoba, mais aussi l’un des plus grands du Canada. Composé de 32 bâtiments distincts sur un campus de 39 acres où se trouvent également l’Université du Manitoba, un laboratoire provincial et CancerCare Manitoba, l’établissement a entrepris la construction d’une deuxième centrale énergétique en 2011, afin de répondre aux objectifs de construction et de développement futurs. Le besoin a été identifié cinq ans auparavant lors d’une évaluation du plan directeur de l’HSC; la centrale énergétique existante, construite dans les années soixante-dix lorsque quatre établissements — l’hôpital général de Winnipeg, l’hôpital pour enfants de Winnipeg, l’hôpital de réadaptation du Manitoba et le centre D. A. Stewart — ont été fusionnés sous une seule administration, avait atteint ses capacités en termes d’empreinte physique, de refroidissement et de système d’alimentation de secours.
RM IPEG director of capital and facilities management at HSC. “If we had lost one of the machines at that time or we had a complete blackout, we would have run out of chilled water and there was not enough generator capacity to carry the campus.” Completed in 2015, the new 35,000-square-foot energy plant was built with 4,500 tonnes of cooling capacity and 6 megawatts (MW) of emergency electrical power generation. Three highefficiency variable speed chillers, three variable speed cooling towers and an all-variable pumping system are tied to a state-ofthe-art energy control system using Hartman Loop technology that provides full automation and optimization of chiller loading and sequencing. This system complements the existing 7,700 tonnes of cooling capacity in the original plant, while still providing a redundant chiller for overall system reliability. Emergency power is generated by three 2 MW 4,160-volt diesel-powered generators that have enough stored diesel fuel to operate well beyond 48 hours
“Nous étions à un moment où nous étions en déficit pour l’eau froide et l’alimentation de secours,” explique Craig Doerksen, directeur général de la gestion des immobilisations et des installations au HSC. “Si nous avions perdu l’une des machines à ce moment-là ou si nous avions eu une panne totale, nous aurions manqué d’eau glacée et la capacité du générateur n’était pas suffisante pour transporter le campus.” Achevée en 2015, la nouvelle centrale énergétique de 35,000 pieds carrés a été construite avec une capacité de refroidissement de 4,500 tonnes et une production d’énergie électrique de secours de 6 mégawatts (MW). Trois refroidisseurs à vitesse variable à haut rendement, trois tours de refroidissement à vitesse variable et un système de pompage entièrement variable sont reliés à un système de contrôle de l’énergie de pointe utilisant la technologie Hartman Loop qui permet l’automatisation et l’optimisation complètes de la charge et du séquençage des refroidisseurs. Ce système complète la FALL/AUTOMNE 2022 21
LEFT TO RIGHT: Jeremy Newhook of Honeywell with Health Sciences Centre Winnipeg's Gerald Hebert, Bill Algeo, Sally Plante and Craig Doerksen. t
without refuelling. These generators operate on an electrical system separate from the existing 4.8 MW emergency power system; however, manual interconnections are possible for redundancy. What’s more, the plant has the physical and piping distribution capacity to add a further three 1,500-tonne chillers and a fourth 2 MW generator when the need arises. “What we were able to build and position was something that was going to take us from opening day to 2030, and then there’s actually some space within this to expand, which should take us to upwards of 2045,” says Doerksen. The $37.9 million project garnered HSC this year’s Wayne McLellan Award of Excellence in Healthcare Facilities Management, presented at the 2022 CHES National Conference in Toronto. “The award validated HSC as a leader in the energy efficiency industry,” says Gerry Hebert, first-class chief power engineer and manager of HSC’s central energy plant. “HSC is regarded as a contributor to protecting the environment and it proves that we are committed to a sustainable future.” Using 2018 verified efficiency numbers, the new plant is operating at 0.676 kilowatts per tonne (kw/tonne) versus the old plant operating efficiency of 0.728 kw/tonne. Verified utility savings are just over 1.5 million kilowatt-hours annually, with the plant not yet operating at full capacity. When the new plant reaches maximum capacity, it’s estimated that greenhouse gas emissions will be reduced by the equivalent of releasing 25,920 kilograms of carbon dioxide into the atmosphere. HSC has also experienced a 190 kilovolt-ampere demand reduction equating to approximately $105,000 per year. The chiller plant performance optimization incremental cost was nearly $1.2 million with a utility incentive of $250,000 from Manitoba Hydro’s Power Smart program. Based on the plant operating at maximum capacity, the simple payback for this project was 4.7 years. The new system with its optimization software allows Hebert and his team of seasoned second and third-class power engineers to remotely monitor the chiller plant and, subsequently, energy consumption, enhancing operational control. “Most of the time, plant operators have the chillers very close to them. In this case, our plant operators are in the old plant and 22 CANADIAN HEALTHCARE FACILITIES
capacité de refroidissement existante de 7,700 tonnes de l’usine d’origine, tout en fournissant un refroidisseur redondant pour la fiabilité globale du système. L’alimentation de secours est générée par trois générateurs diesel de 2 MW et 4,160 volts, qui disposent d’une réserve de carburant diesel suffisante pour fonctionner bien au-delà de 48 heures sans ravitaillement. Ces générateurs fonctionnent sur un système électrique distinct du système d’alimentation de secours existant de 4.8 MW; toutefois, des interconnexions manuelles sont possibles à des fins de redondance. De plus, l’usine a la capacité physique et de distribution de tuyauterie pour ajouter trois autres refroidisseurs de 1,500 tonnes et un quatrième générateur de 2 MW lorsque le besoin s’en fera sentir. “Ce que nous avons pu construire et positionner, c’est quelque chose qui allait nous permettre d’aller du jour de l’ouverture jusqu’en 2030, et il y a même de l’espace pour l’expansion, ce qui devrait nous permettre d’aller jusqu’à 2045,” dit Doerksen. Le projet, d’une valeur de $37.9 million, a valu au HSC le prix Wayne McLellan d’excellence en gestion des installations de soins de santé, décerné lors de la conférence nationale 2022 de la SCISS à Toronto. “Le prix a validé le HSC en tant que leader dans l’industrie de l’efficacité énergétique,” déclare Gerry Hebert, ingénieur en chef de l’énergie de première classe et gestionnaire de la centrale énergétique du HSC. “HSC est considéré comme un contributeur à la protection de l’environnement et cela prouve que nous sommes engagés dans un avenir durable.” Sur la base des chiffres d’efficacité vérifiés en 2018, la nouvelle usine fonctionne à 0.676 kilowatt par tonne (kw/tonne), contre une efficacité de 0.728 kw/tonne pour l’ancienne usine. Les économies vérifiées pour les services publics sont légèrement supérieures à 1.5 million de kilowattheures par an, la centrale ne fonctionnant pas encore à plein régime. Lorsque la nouvelle usine atteindra sa capacité maximale, on estime que les émissions de gaz à effet de serre seront réduites de l’équivalent de la libération de 25,920 kilogrammes de dioxyde de carbone dans l’atmosphère. HSC a également connu une réduction de la demande de 190 kilovoltsampères, ce qui équivaut à environ $105,000 par an. Le coût différentiel de l’optimisation de la performance de la centrale de refroidissement s’est élevé à près de $1.2 million, avec une incitation de $250,000 de la part du programme Power Smart
CHES AWARDS they’re viewing what’s happening from there,” explains Myles Boonstra, director of environmental sustainability and energy at HSC, about the unmanned chiller plant that’s located threequarters of a kilometre away and accessible by tunnel. The software also provides operational insight on the new automated portion of the system and the existing manual plant operation. (The two are hydronically connected, which originally posed a challenge as the new plant uses an all-variable frequency (VFD) drive primary flow configuration while the existing plant uses a partial VFD application with primary/secondary flow configuration.) “The amount of information coming back to the operators is really good,” says Boonstra. “It allows them to see what’s going on in real-time so they can make informed decisions.” Initially, the automated system posed challenges to operators who were used to being hands-on. Significant effort was made by Hebert to train, orientate and coach existing power engineering staff to rely on the software that looks at weather conditions, plant demand, optimized operation of chillers, cooling towers, and primary and secondary pumping flows — a significant departure for this group. “Gerry had to walk around with a wrench and smack some of his power engineers on the hand,” says Doerksen in jest. “The power engineering group was used to operating the way they learned because the way they learn works. When Gerry introduced the automation system and said it’s going to make decisions for you on the new plant and tell you what to do in the existing plant, staff
CHES Canadian Healthcare Engineering Society
de Manitoba Hydro. En supposant que l’usine fonctionne à sa capacité maximale, la période de récupération simple pour ce projet était de 4.7 ans. Le nouveau système, avec son logiciel d’optimisation, permet à Hebert et à son équipe d’ingénieurs chevronnés de deuxième et troisième classe en électricité de surveiller à distance l’installation de refroidissement et, par conséquent, la consommation d’énergie, ce qui améliore le contrôle opérationnel. “La plupart du temps, les opérateurs de l’usine ont les refroidisseurs très près d’eux. Dans ce cas, les opérateurs de l’usine sont dans l’ancienne usine et regardent ce qui se passe à partir de là,” explique Myles Boonstra, directeur de la durabilité environnementale et de l’énergie chez HSC, à propos de l’usine de refroidissement sans personnel située à trois quarts de kilomètre et accessible par un tunnel. Le logiciel fournit également un aperçu opérationnel de la nouvelle partie automatisée du système et du fonctionnement manuel existant de l’usine. (Les deux sont connectées hydrauliquement, ce qui a posé un défi à l’origine, car la nouvelle usine utilise une configuration d’écoulement primaire avec un entraînement à fréquence variable (VFD) alors que l’usine existante utilise une application VFD partielle avec une configuration d’écoulement primaire/secondaire). “La quantité d’informations qui reviennent aux opérateurs est vraiment bonne,” dit Boonstra. “Cela leur permet de voir ce qui se passe en temps réel afin qu’ils puissent prendre des décisions éclairées.”
Société canadienne d'ingénierie des services de santé
CALL FOR NOMINATIONS FOR AWARDS 2023 Hans Burgers Award For Outstanding Contribution to Healthcare Engineering DEADLINE: April 30, 2023
2023 Wayne McLellan Award of Excellence In Healthcare Facilities Management DEADLINE: April 30, 2023
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 email@example.com Fax:866-303-0626 FALL/AUTOMNE 2022 23
The new 35,000-square-foot energy plant at Health Sciences Centre in Winnipeg was built with 4,500 tonnes of cooling capacity and 6 megawatts of emergency electrical power generation. t
had to learn to trust that the system was doing all it said it could do. It was a challenge for them to overcome their fears and concerns.” With time, they did and it has been smooth sailing ever since. The implementation of this project at HSC, which entailed the first application of the Hartman Loop technology of this magnitude in Manitoba, has shown that not only can new chiller systems be optimized but by integrating with an existing plant, hydronic distribution and use points can achieve significant energy improvements while enhancing operational control.
Au départ, le système automatisé a posé des problèmes aux opérateurs qui avaient l’habitude d’intervenir directement. M. Hebert a déployé des efforts considérables pour former, orienter et encadrer le personnel d’ingénierie électrique existant afin qu’il puisse utiliser le logiciel qui prend en compte les conditions météorologiques, la demande de l’usine, le fonctionnement optimisé des refroidisseurs, des tours de refroidissement et des flux de pompage primaires et secondaires — une première pour ce groupe. “Gerry devait se promener avec une clé à molette et frapper certains de ses ingénieurs sur la main,” dit Doerksen en plaisantant. “Le groupe d’ingénierie de l’énergie était habitué à fonctionner de la manière dont il avait appris parce que la manière dont il avait appris fonctionnait. Lorsque Gerry a présenté le système d’automatisation en disant qu’il allait prendre des décisions pour vous dans la nouvelle usine et vous dire quoi faire dans l’usine existante, le personnel a dû apprendre à avoir confiance dans le fait que le système faisait tout ce qu’il disait pouvoir faire. C’était un défi pour eux de surmonter leurs peurs et leurs inquiétudes.” Avec le temps, c’est ce qu’ils ont fait, et depuis, tout va bien. La mise en œuvre de ce projet à HSC, qui impliquait la première application de la technologie Hartman Loop de cette ampleur au Manitoba, a montré que non seulement les nouveaux systèmes de refroidissement peuvent être optimisés, mais qu’en s’intégrant à une usine existante, les points de distribution et d’utilisation hydroniques peuvent réaliser d’importantes améliorations énergétiques tout en améliorant le contrôle opérationnel.
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ROAD OF DEVOTION Mitch Weimer’s continued active involvement in CHES comes from desire to always help
he last time Mitch Weimer attended the CHES National conference in person (prior to the pandemic), he passed the baton of past president to Preston Kostura, with the assumption he’d move into the shadows of the organization to work behind the scenes, while he carried on as director of facilities maintenance and operations with Fraser Health. But a lot can change in a few years, as everyone can attest. This past spring, Weimer stepped away from his 31-year career in the healthcare industry, taking early retirement, and moved into a familiar position on the B.C. chapter executive. “They sucked me back in,” laughs the long-time member of the Canadian Healthcare Engineering Society (CHES). Kidding aside, Weimer says he was humbled to be elected once again as vice26 CANADIAN HEALTHCARE FACILITIES
chair, which comes with the responsibility of planning the annual chapter conference — an event he helped elevate on his initial time around on the executive committee (2006-2014). In 2006, Weimer replaced mentor Tim Kelly as vice-chair (at Kelly’s request), marking the start of a new level of service to the organization. While a staunch supporter of CHES previous to this, and member since shortly after he attended his very first chapter conference in Kamloops in 1992, the new role ignited a passion in Weimer to further the work of CHES and raise its status in the healthcare industry. “It’s an organization that if you don’t have the answer or you have challenges, you can always find somebody to help and support you,” he says.
Early on in his tenure, Weimer helped expand the number of chapter-supported student bursaries to include six provincial colleges — British Columbia Institute of Technology, Okanagan College, College of New Caledonia, Camosun College, Selkirk College and Thompson Rivers University — and established a grassroots program that provides targeted funding to aid those unable to obtain financial assistance from their healthcare facility to attend the chapter conference. These ‘education dollars’ cover the cost of transportation, accommodation and registration for a set number of people per organization. Weimer also worked to grow and modernize the B.C. chapter conference. This helped bring financial stability to the chapter, as well as ushered in a period of interest in CHES B.C. unparalleled in its
history that resulted in a long stretch of personnel consistency on the executive. “You build the brand and people will come, and we did that by planning and pulling off a great conference,” says Weimer. “It got people excited to get involved, remain and run through the progression of positions on the chapter executive. We didn’t have any turnover.” Weimer, like his CHES colleagues, stayed the course, moved into the role of chair and, in tandem, took a seat at the table of CHES National representing B.C. In 2012, he was approached by former president Mike Hickey about putting his name forward for vice-president. The rest, he says, is history, as he was elected the following year, which began his six-year term as vice-president (2013-2015), president (2015-2017) and past president (2017-2019). “My overall CHES career has been a series of fortunate events of being asked by some of my mentors to join in and my inability to say no,” says Weimer in jest. While much was accomplished over the course of those six years, Weimer is most proud that CHES became a truly coast-tocoast organization with representation from all provinces — a goal set into motion by previous presidents. In fall 2015, past president Peter Whiteman organized the successful campaign in Saskatchewan where the Health Facility Resource Council merged with CHES to become the Saskatchewan chapter. Two years later, in spring 2017, the organization welcomed the Quebec chapter into the fold. Another outstanding ‘moment’ was when the board decided to move forward with a bid to host the 2022 International Federation of Healthcare Engineering (IFHE) Congress. Weimer put forth the motion in 2016, and after “a fair amount of lobbying and cajoling,” it was approved. CHES was selected to host the esteemed event at the 2018 IFHE Congress in Brisbane, Australia. Competition was fierce, with the Canadian association up against those in the United States and South Africa. After a two-stage voting process, which eliminated the South African Federation of Hospital Engineering after the first round, CHES was victorious in a count of 14-6 against the Health Care Institute from the U.S. Attending the congress this past September, held in conjunction with the 2022 CHES National Conference, held
particular significance to Weimer, as he got to experience what he set in motion all those years ago that past presidents Preston Kostura and Roger Holliss, and the hardworking planning committee led by thenOntario chapter chair Jim McCarthur brought to fruition. The proverbial icing on the cake is he received his 30-year pin at the esteemed event, commemorating decades of service with CHES, and he was recognized with the Hans Burgers Award for Outstanding Contribution to Healthcare Engineering, an accolade he graciously accepted but was not originally expecting. “I was stunned,” says Weimer about the call he received in June, notifying him of the award win. “With so many excellent and deserving people across Canada, I'm just honoured to have even been considered.” Since retiring in April, Weimer has had time to reflect on his three decades long career in the healthcare industry, beginning in 1991, when he was hired as a maintenance engineer for the long-term residential care facility, George Pearson Centre, in Vancouver. In 1993, he was promoted to become the physical plant manager, a position he held for seven years before moving to Fraser Health where he served in various roles, including both manager and director of plant services and construction, up until his most recent position. In hindsight, he says his greatest achievement was putting a retention program in place that went a long way in keeping top talent and increasing job satisfaction. “We invested in education and training staff to provide a more defined path and process for advancement within the organization,” explains Weimer. “As a result, we only hired two people (in my department) from outside the organization. Virtually all my supervisory and managerial positions came from within.” Looking to the future, Weimer can’t wait to see the completion of the new Surrey hospital and cancer centre in 2027, and redevelopments of Burnaby and Royal Columbian hospitals in 2026 — all three of which he advocated for during his time at Fraser Health. In the meantime, he’s enjoying downtime with family, including camping and coaching soccer, and volunteering for associations like CHES and CSA Group until he finds his next passion. “I’m waiting to see what speaks to me,” says Weimer. “I want to do something for the right reasons.”
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A COLLECTIVE EFFORT
B.C. chapter executive pulls together to win President’s Award in back-to-back years
LEFT TO RIGHT: B.C. chapter members Norbert Fischer, Mark Swain, Dawn Chan, Sarah Thorn, Steve McEwan, Rick Molnar, Mitch Weimer and Arthur Buse with Luis Rodrigues of Trane (left of centre). Missing from photo is CHES B.C.'s Caroline Reid.
fter another uncertain year fuelled by an unpredictable virus, the Canadian Healthcare Engineering Society (CHES) was once again challenged. Unsure of what the coming months would hold at the start of 2022, due to the emergence of the Omicron variant and subsequent surge in infections, local chapters began to reassess plans to hold in-person events scheduled for spring. While some cancelled, others cautiously continued making arrangements in the hopes their respective annual conferences could be face-to-face again. Time was on their side as provinces began lifting COVID19 restrictions in late winter soon after the peak of the largest wave, as Canada’s chief public health officer said the country had to find a more “sustainable” way to deal with the pandemic since the virus is here to stay. In early June, nearly 520 28 CANADIAN HEALTHCARE FACILITIES
people convened in Whistler for CHES British Columbia’s conference to the delight of Sarah Thorn, who assumed the role of chapter chair at the annual general meeting held during the event. “We were worried about whether people would want to attend and if they’d get the approvals to travel, but it ended up being a great success,” says Thorn. “We had a huge turnout in terms of attendance, and sponsorships and booths were both sold out. This speaks to how eager everyone was to get back together for face-to-face interactions.” The industry’s reaction in B.C. was a good indication of what to expect at this year’s CHES national conference in Toronto. Held in conjunction with the International Federation of Healthcare Engineering (IFHE) congress, Sept. 17-21, the event was doubly exciting for members of CHES B.C.’s executive, who not only got
to experience another in-person event in a matter of months but also took the stage at the gala banquet to accept the President’s Award for a second year in a row. “It was a really proud moment,” says Thorn, who was joined by Mitch Weimer (vice-chair), Rick Molnar (treasurer), Norbert Fischer (past chair), Dawn Chan (secretary), Mark Swain (website/written communications) Arthur Buse (membership) and Steve McEwan (conference support). (Caroline Reid (education) was unable to attend.) “The CHES B.C. executive always works incredibly hard.” This is the third time the chapter has been bestowed the recognition. The first was in 2014, when the President’s Award launched, and then again in 2021. Thorn, who sat on the chapter executive (along with other existing members) during the inaugural award win, attributes this year’s accomplishment to the unwavering dedication of her CHES colleagues who often “work off the side of their desk” given the voluntary nature of their roles, and to the solid foundation laid by previous iterations of the chapter executive. “The work we do is a baton of history that we continue to pass forward year to year,” says Thorn. “We carry all the legacies of those before us who have done the heavy lifting.” 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 CHES’s journal, Canadian Healthcare Facilities, to providing extra member benef its). 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. The
CHES AWARDS recipient of the much-coveted award receives two CHES national conference registrations and expenses paid up to a maximum of $2,500 each, as well as a trophy engraved with the victorious team’s names. Since the chapter’s last crowning achievement, the executive has focused on providing added value to members in order to sustain numbers and attract new recruits. This led to the creation of the Healthcare Award in late 2021. Presented for the first time ever at this year’s conference, Steve McTaggert was bestowed the honour for his outstanding contribution to healthcare engineering in B.C. “Steve’s legacy speaks for itself — his work has touched numerous healthcare facilities in the province,” says Thorn about the nearly 40-year industry veteran who retired in 2019 to pursue other interests. “He has made endless contributions to the field, both professionally and as a member of CHES, for more than 20 years, but his mentorship and continued desire to pay it forward is one of his greatest achievements.” McTaggart was among nearly two dozen chapter members acknowledged at this year’s event. Longstanding achievement plaques were handed out to 21 others in celebration of their support of CHES for upwards of 25 years. “There are countless people making a difference to our organization that aren’t on the chapter executive and it’s important to recognize them for their service,” says Thorn. “Plus, not everyone can go to the CHES national conference and experience the awards gala, so it’s great to host our own celebrations.” Aware of the challenges of even travelling locally, the chapter executive decided to make a day pass available at a reduced rate to accommodate engineers, architects and other industry partners unable to attend all three days the B.C. conference due to work commitments. The event was also not exclusive to CHES B.C. members; non-members, including frontline workers ineligible for conference funding from their health authority, were invited to attend at no cost. “Budgets are getting tighter, so we wanted to support opportunities for learning wherever we could,” says Thorn. Because of its good financial standing, the chapter has remained committed to cover-
ing the Canadian Certified Healthcare Facility Manager (CCHFM) exam fee for anyone interested in pursuing the designation, and continues to offer a $1,000 tuition grant to members in good standing who want to take education programs that will help further their careers within hospital engineering services departments. As well, the chapter has maintained its support of bursaries at six colleges — British Columbia Institute of Technology, Okanagan College, College of New Caledonia, Camosun College, Selkirk College and Thompson Rivers University. These member benefits have helped reverse the national trend in declining participation in CHES; the B.C. chapter has added 62 new members so far this year. Thorn also attributes the uptick in enrolment to diversification — the executive has reached out to facilities groups outside the normal member base, such as capital projects, infection prevention and control, energy and sustainability, clinical planners, integrated protection services and workplace health leaders, who play a critical role
in managing, maintaining, renovating and building the province’s healthcare facilities. In addition to opening up membership to more groups, CHES B.C. is welcoming new faces to the chapter executive as part of its succession planning efforts. Many of the same people have resided on the executive for upwards of a decade and even more, including Thorn who has served in various roles for the past 12 years. While she, like all long-time executive members, thoroughly enjoys being a part of the professional circle and the high-value connections it affords, Thorn recognizes it’s necessary to bring younger volunteers into the fold. “They offer new ideas and a different perspective to meet the challenges of today, while allowing us to prepare to meet the future needs of CHES B.C.,” says Thorn. “Now is the time to mentor the next generation. This is the best way to pass on the knowledge and learnings acquired through years of experience, while providing opportunities for growth, network expansion and to effect change in CHES and the healthcare industry as a whole.”
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ADAPTING TO CLIMATE CHANGE Guidelines for planning, designing resilient healthcare facilities By Lisa Westerhoff
ith record-breaking temperatures increasingly becoming the new normal across Canada, and catastrophic wildfires and floods a nottoo-distant memory, the time for climate resilience planning was yesterday. Globally, we have seen 1.1 C of warming since pre-industrial times and Canada is warming faster than the global average, due to its northern latitude. At the CHES B.C. chapter conference in Whistler this year, I was joined by Craig Dedels, manager of climate risk and resilience for Vancouver Coastal Health, and Jolene McLaughlin, sustainability director at EllisDon, in a session titled, Planning and 30 CANADIAN HEALTHCARE FACILITIES
Designing for Climate Resilience in Health Facilities. Together, we unpacked and demystified how to integrate climate resilience into healthcare facilities and showed how sector leaders could drive meaningful change in the collective efforts for a resilient, low-carbon future. Here is a summary of that session to inspire healthcare design teams to consider their shared responsibility in building a climate-resilient Canada. A CALL TO ACTION
Climate resilience in the healthcare sector begins with the health authorities. The Energy and Environmental Sustainability (EES) team is a regional collaborative that
supports Fraser Health, Providence Health Care, Provincial Health Services Authority and Vancouver Coastal Health in the transition toward low-carbon, climate-resilient and environmentally sustainable health systems in British Columbia. The EES team categorizes these efforts into seven interrelated focus areas: climate change; energy and carbon; materials; transportation; water; food; and leadership and innovation. The strategic framework, presented as an infinity symbol to reflect the work as a journey that requires continual improvement, acts as a guide to support staff in enacting transformation across the healthcare sector.
PROJECT MANAGERS MUST CONSIDER CLIMATE RESILIENCE EARLY AND ITERATIVELY THROUGHOUT THE PROJECT LIFE CYCLE TO MEANINGFULLY INFORM DESIGN DECISIONS, WHILE ENGAGING A DIVERSE, CROSS-DISCIPLINARY AND WELL-INFORMED TEAM TO MITIGATE RISKS.
Events of the last few years have shown how climate-related hazards are already impacting health infrastructure, operations and supply chains, creating challenges for healthcare workers and the communities they serve. But while it has been clear there’s an immediate need to take action within the healthcare sector, where to begin has yet to be identified. In 2019, Integral Group began working with the EES team to create the Climate Resilience Guidelines for B.C. Health Facility Planning and Design. Launched in late 2020, after more than a year of multi-sector collaboration with health organizations, industry experts and others, the guidelines provide planners and designers with information necessary to identify and address the key impacts of climate change on new healthcare facilities. Overall, the guidelines help users in identifying potential strategies to manage risk and enhance resilience; strategizing site planning, facility design,
equipment selection or long-term operations; and prioritizing measures that work synergistically to advance goals for the facility, making the most of resources, strengthening health service delivery and enhancing livability for users. LESSONS FROM THE FIELD
Design teams have begun to apply these guidelines to different stages of the design process, from planning to procurement to implementation, of various acute and longterm care projects across the province. They include Cowichan District Hospital, Royal Columbian Hospital and St. Paul’s Hospital. The process has resulted in tangible successes, such as using future climate projections to limit overheating and enhanced filtration approaches to account for increasing instances of wildfire smoke. These projects have also served to build internal and industry capacity to understand how changes in climate are likely to impact healthcare facilities and how to address them.
COWICHAN DISTRICT HOSPITAL
The Cowichan District Hospital replacement project involves construction of a new community hospital on a nine-hectare greenfield site in a relatively undeveloped rural area on Vancouver Island. Integral Group was asked to conduct a high-level exposure screen and climate risk assessment to identify the main hazards and impacts that could threaten the facility, and to establish strategies necessary to mitigate them. Working to identify these issues at an early stage allowed the team to define resilience objectives and criteria that could be considered throughout the project, acting as a touchstone to ensure their meaningful integration into design outcomes. The study also showcased the value of multi-stakeholder interviews and workshops, which enabled the consultant team to acquire in-depth knowledge of health authority protocols and initiatives relevant to the owner, harness the design team’s diverse and deep technical expertise, and pinpoint local governments, First Nations and other external groups who could bring valuable insight into the work. ROYAL COLUMBIAN HOSPITAL
The Royal Columbian Hospital redevelopment is one of the largest healthcare projects in the province’s history, consisting of a multi-year, three-phase approach to transform the entire facility. EllisDon was selected as the design-builder for Phases 2
The Climate Resilience Guidelines for B.C. Health Facility Planning and Design follow a four-step process for major capital projects. FALL/AUTOMNE 2022 31
SUSTAINABLE HEALTHCARE ST. PAUL’S HOSPITAL
The strategic framework, presented as an infinity symbol to reflect the work as a journey that requires continual improvement, acts as a guide to support staff in enacting transformation across the healthcare sector.
and 3, construction of the acute care tower and hospital expansion, with a climate risk assessment being a key element of the project scope. The design-build team was joined by hospital planning and operations team members in a two-day workshop to identify the most significant hazards and determine how the design might perform in the future. After setting the stage with future climate scenarios, the team worked through a series of activities to prioritize risks based on their likelihood of occurring
and consequences should they take place. With key risks identified, the groups looked to solutions, using cross-representation to help evaluate options from different perspectives. Risk mitigation measures deemed low-cost and high reward were prioritized for review by all workshop participants. In the end, a list of measures that could improve the overall climate resilience of the building was developed for consideration, including both design and operational solutions to support the longevity of the asset.
Once climate risk assessments are complete, it falls to the project team to integrate the resilient design strategies necessary to address the highest risks into the actual design and construction of the facility. The new St. Paul’s hospital, a large-scale redevelopment of a major acute care complex, is emerging as a prime example of sustainability and climate resilience integration. Using the owner’s statement of requirements as the basis, the climate resilience compliance team developed two tools to help implement design goals through an iterative cycle aligned with LEED (Leadership in Energy and Environmental Design) review practices. The first consisted of a self-assessment checklist that outlined all resilience-related requirements and created a feedback mechanism for the design team to ensure those requirements have been met and provide evidence for each item. The compliance team’s role was to assess the adequacy of each response to determine if more information was needed before final review and sign-off.
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The second tool was the resilience summary report that details how climate resilience was incorporated into the final design. This was essential in obtaining relevant input from each design discipline to provide a holistic picture of the project and build a clear narrative for further communications. By keeping the owner’s needs at the fore of each design stage, the team maintained climate resilience continuity through the design process. KEY TAKEAWAYS
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Overall, the experience has shown each team member has a critical role to play in the successful design and construction of climate-resilient facilities. Health authorities are key in pushing for greater facility resilience by creating or leveraging standards and developing benchmarks for climate resilience in the healthcare sector. Their involvement throughout the process as resilience champions, coupled with clinical stakeholder engagement, is vital to the success of resilient facility design. Project managers must consider climate resilience early and iteratively throughout the project life cycle to meaningfully inform design decisions, while engaging a diverse, cross-disciplinary and well-informed team to mitigate risks. Design-build teams need to engage in the project assessment process to understand the context and implications of different design choices. It’s imperative they acknowledge old standards are not suited for future climate conditions and collaboration is critical to everyone’s success. Resilience teams must be involved throughout the process, from developing the statement of requirements to ensuring proper measurement, documentation and compliance. They are there to provide climate information and guidance, and to help define and navigate what elements should be considered across all disciplines. Lisa Westerhoff leads the climate policy and planning team at Integral Group in Vancouver. She works with local governments, universities, developers and industry organizations to create policies and strategies for a low-carbon built environment. With a PhD in urban sustainability from the University of British Columbia, Lisa brings expertise in climate change, sustainability and resilience planning to projects ranging from zero-emissions building plans and post-occupancy evaluations to energy and carbon disclosure policies, and citywide climate and energy strategies.
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he impact from the pandemic on the long-term care homes has brought to light the importance of optimal indoor air quality (IAQ) for the health and safety of occupants. But optimizing buildings for better IAQ requires HVAC systems to work harder, use more energy and involves regular monitoring and maintenance — which in turn increases operational costs. Integrating smarter building management systems such as Schneider Electric’s EcoStruxureTM for Healthcare solution helps you tackle this challenge by boosting the operational and energy
efﬁciency of your long-term care facility by up to 30%. The future-ready EcoStruxure for Healthcare solution is tailored to your facility to give visibility and control over the building’s conditions - allowing you to optimize energy efficiency for running the building. In terms of automation, the solution can set up schedules for systems like HVAC and lighting remotely further reducing labour costs. Multi-site portfolio management is also simplified and automated with visualizations for analysis and control of setpoints and schedules.
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COVID-19 AND PPE WASTE A catalyst for a reusable personal protective equipment health system By Kent Waddington, Linda Varangu & Mia Sarrazin
OVID-19 was first confirmed in Canada at the end of January 2020. With this came great urgency to respond in a way that embraced existing infection control and treatment protocols while battling a rapidly expanding and unfamiliar enemy, as well as an unprecedented demand for personal protective equipment (PPE). Early in the pandemic, Health Canada predicted an estimated 63,000 tonnes of plastic PPE would end up as waste and ultimately in landfills. In November 2020, a project — Towards a Safe, Secure and Sustainable Reusable PPE System in Canadian Health Care — was initiated with financial support from 36 CANADIAN HEALTHCARE FACILITIES
Environment and Climate Change Canada. It set out to demonstrate that hospital-use of PPE and some medical single-use plastic (mSUP) materials could be successfully and safely managed by focusing on the preferred principles of a circular economy: reduction and reuse. First by addressing opportunities to reduce and then by choosing products that can be reused; only after these two have been optimized, recycle as much as possible. Government of Canada priorities to move Canadians toward zero plastic waste by 2030 were key driving factors for this project. The federal government supports the development of a new, ambitious, legally-binding global agreement that takes a life cycle
approach to addressing plastic pollution and reducing micro plastics in the environment. Other complimentary government priorities include supporting a climate resilient, sustainable and low carbon health system, and moving toward circular economy practices within the Canadian economy. PROJECT STEPS
Knowledge development steps included an environmental scan of the literature on PPE and mSUP activities within the country’s circular economy, followed by one-on-one engagement with more than 75 representatives from a multitude of sectoral stakehold-
In most instances, when purchasers or the healthcare workforce referred to PPE, they were describing disposable products, not reusables. This aligns with the global trend in healthcare toward increasing use of disposable PPE and mSUP. “Our health system has developed increasing reliance on single-use items, including disposable N95 respirators and gowns, creating more waste and other emissions. As we experienced in the early days of the pandemic, this is not sustainable,” says Dr. McNeill, surgeon, clinical associate professor and director of the Planetary Health Lab at the University of British Columbia. “It's a lot easier to scale up your reuse cycles, such as laundering gowns or replacing the filters in reusable respirators, than it is to actually manufacture more of something. And it creates less pollution.” In the United States health system, an estimated 85 per cent of PPE gowns were disposable in 2020, while more reusables were worn in Europe and Canada. Key Canadian healthcare leaders are starting to buck the disposables trend and many actions were undertaken by members of the healthcare workforce during the pandemic that supported reusables for safety, security and sustainability reasons.
Idealized circular economy system with a future focus on reusable plant-based personal protective equipment gowns.
ers, including PPE and mSUP users, specifiers, medical practitioners, waste management professionals, manufacturers and reprocessors. Using information gathered from this phase, seven roundtables were developed incorporating four design scenarios — throw away, industrial recycling/disposable, prevention/reduce and redesign, and prolonged service/reusable — which were created to assess participant support for specific elements of the circular economy. Key takeaways from these workshops included support for reduction, reuse and recycling of PPE and mSUP, and participants’ surprise that reuse was a much cheaper alternative to recycling and disposal options. Further outreach to the healthcare workforce occurred through surveys geared to understanding current practice, challenges and opportunities as they related to PPE and mSUP use in Canada’s health system. The individual PPE products of interest in the project were gloves, gowns, medical-grade surgical masks, reusable elastomeric respirators, goggles and face shields.
Most purpose-made reusables used in healthcare have shown to be safe. “The idea of safety of single-use disposable consumables has been very successfully perpetuated by industry such that the entire landscape has shifted, making it easier for hospitals to be reliant on single-use disposables when in fact there are no data to back up that claim of improved safety from an infection prevention and control perspective,” says Dr. McNeill. Health Canada provides standards for the material integrity of gowns, protective nature they provide and safe use of reusable PPE. CSA Group has a series of standards dealing with infection prevention and control, and specifically with decontamination, disinfection and sterilization through CSA Z314, Canadian Medical Device Reprocessing. The evidence for gown safety is further supported by the fact many large Canadian hospitals and health systems have safely deployed reusable isolation and surgical gowns, elastomeric respirators, a variety of clinical products like rigid sterilization containers (to replace plastic ‘blue wrap’), laryngoscopes blades and handles, and anesthesia breathing circuits. Increased domestic manufacturing of PPE will help provide greater assurance that reusable PPE meet strict Canadian medical device standards, as some imported products during the pandemic were found not to meet them.
The pandemic is believed to have helped reverse some of the disposable trend in Canada, particularly in locations where hospital laundry service was accessible to clean and sterilize reusable PPE, such as gowns, and medical device reprocessing capabilities or localized sterilization were available for reusable elastomeric respirators. In the case of Mackenzie Health, reduced availability of disposable PPE contributed to the Ontario health authority’s decision to use reusable PPE to increase security and access to these critical supplies. “During the early days of the pandemic when PPE supply was at risk, Mackenzie Health leadership was laser focused on procuring PPE and other supplies we needed to ensure our staff and physicians were safe,” says Mackenzie Health president and CEO Altaf Stationwala. “The reusable isolation gown solution Ecotex provided — at the most challenging time in healthcare for basic supplies of commodities — was fundamental to delivering patient care. Not only was the initial supply timely, it also immediately introduced a predictable supply of product for the foreseeable future. The fact that it also reduced our environmental footprint was an added benefit.” It is important to support domestic manufacturers striving to develop and refine safe, high-quality PPE, which can provide security in the supply chain. New domestic development of PPE during the pandemic FALL/AUTOMNE 2022 37
“THE IDEA OF SAFETY OF SINGLE-USE DISPOSABLE CONSUMABLES HAS BEEN VERY SUCCESSFULLY PERPETUATED BY INDUSTRY SUCH THAT THE ENTIRE LANDSCAPE HAS SHIFTED, MAKING IT EASIER FOR HOSPITALS TO BE RELIANT ON SINGLE-USE DISPOSABLES WHEN IN FACT THERE ARE NO DATA TO BACK UP THAT CLAIM OF IMPROVED SAFETY FROM AN INFECTION PREVENTION AND CONTROL PERSPECTIVE.” includes Canadian companies developing isolation gowns, plant-based medical masks and healthcare-specific reusable elastomeric respirators to replace disposable N95s. Homegrown PPE solutions mean less reliance on the unstable global supply chain and its unpredictable price swings, increased access to local supplies, such as raw materials, enhanced local/on-site reprocessing and disinfection — all of which support improved resilience of Canada’s healthcare system.
drapes demonstrated substantial sustainability benefits over the same disposable product in natural resource energy (200 to 300 per cent), water (250 to 330 per cent), carbon footprint (200 to 300 per cent), volatile organics, solid wastes (750 per cent) and instrument recovery. These sustainability benefits exist even in comparison with the required cleaning and sterilization of the reusable PPE, and support a more robust circular economy and enhanced planetary health.
Sustainability encompasses financial, social and environmental aspects. A reusable PPE system supports all three of these dimensions. With respect to cost savings, BC GreenCare estimates the per use price for a reusable gown is approximately nine times cheaper than that of a disposable one, resulting in $2 million in savings over a six-month period, as well as nearly $50,000 in avoided waste disposal costs. Similarly, Toronto’s University Health Network claims a 60 per cent savings after switching to reusable gowns. Reduced costs for reusable elastomeric respirators have been made by users, too. Social benefits also accrue from increased use of reusable PPE, including support for local jobs and growth in regional manufacturing companies (enhanced research and development/innovation and new job creation/opportunities), safe domestic workforces, growth in both on-site and off-site cooperative and commercial laundries, as well as medical device reprocessing facilities. This is in contrast to the offshore manufacture of PPE where some facilities were identified as using forced labour. The environmental benefits of utilizing reusable gowns include reduced use of fossil plastics, decreased healthcare-generated plastic waste and lower overall greenhouse gas emissions. One study that evaluated a number of science-based life cycle studies reported that reusable surgical gowns and 38 CANADIAN HEALTHCARE FACILITIES
An optimal reusable PPE gown system within the context of a circular economy was envisioned by the project team. Various components need to be in place to ensure a circular economy, including at the hospital, followed by the user and various reuse (cleaning/sterilizing, repair and repurpose) and recycling/composting options, sourcing of domestic raw materials, the converter, packaging plant, manufacturer and distributor. All of these will have minimized their use of fossil plastic and energy. What drives these activities is healthcare green purchasing, resulting in a safe, secure and sustainable reusable PPE system that provides maximum benefit on many levels of the health system. While no reusable gown made of domestically grown plant-based fibres exists yet, there’s no need to wait for it to start reaping the many benefits of a reusable PPE system now. A circular economy approach for PPE gowns is just one of many opportunities for hospitals to engage in reduction and reuse practices to curtail the use of single-use plastics. Others include: virtual care, which cuts down on the use of PPE and transportation emissions; optimizing the use of gloves according to infection prevention and control guidelines, resulting in a reduction of glove use with enhanced hand hygiene practices; asking patients with scheduled admissions to bring in their own
garment bags; requesting removal of unneeded items in pre-packed trays for surgeries; encouraging manufacturers to replace fossil plastic with plant-based plastics as a raw material for reusable products and packaging; cleaning and sterilizing purpose-built reusables (PPE isolation and surgical gowns, elastomeric respirators, goggles and face shields, underpads and bibs, sharps containers and clinical products like anesthesia breathing circuits) within appropriate supporting infrastructure; employing patch kits like CleanPatch for damaged patient touch surfaces, such as vinyl/polyurethane mattresses; sharing products with other hospitals when they’re no longer required; and repurposing spent surgical gowns as PPE for non-sterile clinical applications or using them to make smaller reusable PPE, such as shoe covers used in surgery. PPE use is expected to increase several-fold over the next five years, particularly after COVID-19 caused pent-up demand for surgeries. Hospitals can lead by purchasing safe, secure and sustainable reusables, which will save the Canadian healthcare system money, help protect the environment by reducing consumption of fossil plastics and waste generated, cut down on climate emissions, create domestic jobs to build thriving communities and help establish a resilient health system. For more information on this project, got to https://greenhealthcare.ca/ppe-msup/. Kent Waddington is the communications director at the Canadian Coalition for Green Health Care. Linda Varangu is the coalition’s senior advisor on climate change and the lead on the Towards a Safe, Secure and Sustainable Reusable PPE System in Canadian Health Care project. Mia Sarrazin is the coalition’s bilingual environmental healthcare coordinator. They can be reached at kent@greenhealthcare., firstname.lastname@example.org and email@example.com, respectively.
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