CHF Spring 2024

JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY

KEEPING KIDS SAFE HealthcareFacilities Canadian

Design considerations for pediatric spaces to create a positive, protected experience

Reducing the risks of electrical incidents

‘Building’ B.C.’s first-ever virtual hospital unit

Navigating the challenge of supply disruptions

Document point of use product usage and standard reprocessing window.

DELIVERY TO PROCEDURE

Monitor status and deliver patient-ready devices.

STORAGE & DEVICE MAINTENANCE

Manage and maintain your inventory in sterile storage and scope cabinets.

DECONTAMINATION & MANUAL CLEANING

Follow guided workflows at the sink that are customized to the device and your department.

ASSEMBLY & LOANER MANAGEMENT

Properly assemble complete instrument sets and fully manage loaners.

STERILIZATION / SCOPE REPROCESSOR

All cycle results in one easy to access electronic location for AC audit readiness

EDITOR/RÉDACTRICE

SECURITY & LIFE SAFETY

yearly CHES membership fees.

Clare Tattersall claret@mediaedge.ca

GROUP PUBLISHER/ Sean Foley

ÉDITEUR DU GROUPE seanf@mediaedge.ca

PRESIDENT/PRÉSIDENT

Kevin Brown kevinb@mediaedge.ca

SENIOR DESIGNER/ Annette Carlucci

CONCEPTEUR annettec@mediaedge.ca

GRAPHIQUE SENIOR

GRAPHIC DESIGNER/ Thuy Huynh-Guinane

GRAPHISTE roxyh@mediaedge.ca

PRODUCTION Ines Louis

COORDINATOR/ inesl@mediaedge.ca

COORDINATEUR DE DE PRODUCTION

CIRCULATION MANAGER/ Adrian Holland

DIRECTEUR DE LA circulation@mediaedge.ca

DIFFUSION

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

SCISS JOURNAL TRIMESTRIEL PUBLIE PAR

SOUS LE PATRONAGE DE LA SOCIETE CANADIENNE D'INGENIERIE DES SERVICES DE SANTE.

CHES SCISS Canadian Healthcare Engineering Society Société canadienne d'ingénierie des services de santé PRESIDENT Craig B. Doerksen

VICE-PRESIDENT Jim McArthur

PAST PRESIDENT Roger Holliss

TREASURER Reynold J. Peters

SECRETARY Beth Hall

EXECUTIVE DIRECTOR Tanya Hutchison

CHAPTER CHAIRS

Newfoundland & Labrador: Colin Marsh

Maritime: Robert Barss

Ontario: John Marshman

Quebec: Mohamed Merheb

Manitoba: Reynold J. Peters

Saskatchewan: Melodie Young

Alberta: James Prince

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: info@ches.org www.ches.org

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Photo courtesy Jonathan Hillyer

IMPROVING THE PEDIATRIC EXPERIENCE

THERE IS NO PLACE I dislike going to more than the emergency department at the children’s hospital. The most obvious reason is because one of my kids is either sick or injured enough to require immediate medical attention. Combined with the long wait times due to overcapacity, being surrounded by sometimes very ill or hurt little ones — a real heartstring puller — and the inhospitable design of the waiting room and treatment areas, I lament every minute.

My most recent visit was in late February, following an accident at my daughter’s school that resulted in severe dental trauma. Upon speaking with her pediatric dentist prior to hospital admission, I was hopeful this occasion would be different. However, the healthcare facility’s emergency dental clinic was closed, so we were funnelled to a makeshift dental room in what seemed like the bellows of the basement after a five-plus hour wait.

A few days after our hospital trip I received a questionnaire survey that asked how the experience could be improved. My thoughts immediately went to the creation of a more welcoming and kidfriendly environment. After all, it’s a children’s hospital. And this seems more realistically achievable, if budget warrants, than working to reduce wait times given the province’s doctor shortage, which is only going to get worse. According to the Ontario College of Family Physicians, more than two million people do not have a doctor, a number projected to rise to as high as 4.4 million by 2026, given many physicians plan to retire or scale back their work over the next five years.

There are several examples of renovation projects at and new builds of children’s hospitals across North America that epitomize excellence in healthcare design. Architecture and engineering firm Page Sutherland Page is behind several stateside, including the new north pavilion at Driscoll Children’s Hospital in Corpus Christi, Texas, and the Centre for Advance Pediatrics at Children’s Healthcare for Atlanta. These developments also serve as prime examples of how pediatric spaces can be child-friendly and offer enhanced security at the same time, a necessity as these healthcare facilities are seeing increased incidents of violence primarily due to higher levels of patient and family stress. You can read all about how to balance these two often contradictory objectives in our cover story Caring for Kids

Security and life safety combined is a central theme of this issue. Other topics covered are the benefits of consolidating security services into a unified system; ways to mitigate risks associated with workplace electrical safety; and how surveillance technology can enhance facilities management in healthcare settings.

Another key focus of the spring edition is innovation and technology. To begin, Making Virtual a Reality delves into the creation of the first-ever virtual hospital unit in British Columbia. Fraser Health’s facilities management team played a significant role in this project, which launched in fall 2022, and has been well-received. Then, Mitigating Supply Chain Risks addresses the impacts of supply disruptions and offers up a program that reduces the risk of occurrence.

Rounding out this issue, Hidden Hazards explores an incident in an operating room that took place not once but twice and lessons learned.

As we look to summer, please consider writing for CHES’s journal. Specifically, we are looking for submissions related to the theme of the association’s 2024 national conference: Enriching Patient Experiences by Optimizing the Environment. If interested in sharing a story, contact me.

Clare Tattersall claret@mediaedge.ca

SAVE THE DATE!

The 2024 CHES National Conference will be held in Halifax, Nova Scotia, at the Halifax Convention Centre, September 8-10, 2024. The Halifax Convention Centre is conveniently located in the downtown core and close to local amenities.

A block of rooms has been reserved at the following hotels:

Cambridge Suites, starting at $205 plus applicable taxes standard queen/king single/double occupancy

Prince George, starting at $245 plus applicable taxes for standard queen/king single/double occupancy.

The theme of the 2024 conference is “Enriching Patient Experiences by Optimizing the Environment”

The CHES 2024 education program is well underway and will once again feature dual tracks with talks on relevant industry topics from high-profile experts in the field. Alan Mallory will be our Keynote Speaker.

The Great CHES Golf Tournament will be held at the Glen Arbour Golf Course on Sunday, September 8, 2024

Join us for the CHES President’s Reception and Gala Banquet at the Halifax Convention Centre The banquet will celebrate the accomplishments of our peers with the 2024 CHES Awards presentations, while enjoying great food and entertainment with friends.

See you in 2024 in Halifax!

For more info visit our website at www.ches.org

Follow us on Twitter! @CHES_SCISS

Joins us on!

REFLECTIONS AND LOOKING FORWARD

LEADING TO BETTER: MISSION, VISION AND VALUES

SEPTEMBER WAS A BUSY month with three events: the 2023 CHES National Conference, Saskatchewan chapter conference and trade show, and Quebec chapter souper-conférence (dinner conference). As I wrote in my last message, CHES members see these conferences as a reunion of sorts. They provide an opportunity for those in the healthcare industry to come together, learn, share and investigate how to make our healthcare system more efficient and effective, with the goal of improving the patient experience and healthcare outcomes.

LIKE MOST, the last several months have been filled with planning for a new fiscal year, new projects and vacations. CHES, too, has been preparing for the year ahead, which will include transitions in CHES National executive leadership, chapter conferences and events, and the 2024 CHES National Conference in Halifax, Sept. 8-10.

In my last message, I asked how you were preparing for your future. Where you put your finances and time are indications. The recent annual CHES budgeting process demonstrates this by committing to free webinars for all CHES members; free read-only access to CSA standards and deeply discounted enhanced access; co-funding with CSA Group the development of medical gas qualified operator and technician courses; supporting standards development by sponsoring members to represent CHES on committees; having CHES representation at partner events like Infection Prevention and Control Canada and Canadian College of Health Leaders’ conferences; and making the Canadian Healthcare Construction Course a continuously refreshed program.

We’re putting finances toward supporting our mission to build member expertise and our values of knowledge. I encourage you to take advantage of these investments and many others. The soonto-be-launched new CHES website will provide an improved portal for information, connection and access.

While at the national conference in Winnipeg, the entire CHES board and four committee chairs gathered over two days for strategic planning sessions and meetings. I’ve had the honour of serving on the CHES National board under three previous presidents. We have built on this legacy of leadership and planning, and again this year we spent time reflecting on the organization that CHES has become and where it is going. We discussed how to make CHES more effective, which included an assessment of our leadership model, promote the value of CHES membership, and shape the future of our flagship Canadian Healthcare Construction Course (CanHCC). Time was also spent discussing goals and aspirations. To meet the ever-changing healthcare landscape, CHES must continue to grow, mature and expand. This requires the involvement and engagement of CHES members in national and chapter leadership roles and on committees. Look for ongoing dialogue, information and plans as CHES moves forward — together with you, its members.

Investment of time also builds on our mission within our vision and toward the value of collaboration. CHES committee chairs are now regular attendees at board meetings, which means the work, priorities and needs of these committees are directly being presented at the board level. This is a key outcome of fall 2023 strategic planning sessions. Expect by this fall a fulsome presentation of the strategic plan and how CHES operates.

Finally, plan for and invest time in yourself and your loved ones. Breakaway and enjoy another Canadian season.

This year’s national conference is now ‘in the books’ but there are still plenty of activities taking place. I attended the International Federation of Healthcare Engineering (IFHE) Congress in Mexico City Nov. 4-6, chaired by current IFHE president and former CHES president Steve Rees. Chapters across the country are planning next year’s conferences, and the CHES National conference planning committee, under the leadership of Robert Barss, is preparing the Maritime chapter to host the 2024 CHES National Conference in Halifax, Sept. 8-10. CHES’s webinar series, CanHCC sessions, social media platforms and regular e-blasts of timely news articles, as well as other partner organizations’ events promoted to CHES members, are significant value-added benefits.

Craig B. Doerksen CHES National president

And let’s not forget the enormous value found in our quarterly journal, Canadian Healthcare Facilities. It’s a forum to share your successes, learnings and challenges with design professionals and vendor teams, and internally with infection prevention and control, environmental services, laboratory and/or security teams at your facility. Reach out to the journal’s editor, Clare Tattersall, at claret@mediaedge.ca to relay your ideas to help impact Canada’s healthcare system.

Craig B. Doerksen CHES National president

EARN CONTINUING EDUCATION CREDITS FROM CHES

EARN CONTINUING EDUCATION CREDITS FROM CHES

Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Spring 2024 issue of Canadian Healthcare Facilities and passing a quiz based on articles in the issue. Once you’ve read the issue from cover to cover, simply go online to https://www.surveymonkey.com/r/YWCRVCR 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.

Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Fall 2023 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/6QDKXP8 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.

ELIMAGEN SURFACE PROTECTION

SAFE EFFEECTIVE LONG LASTING

www.elimagentechnologies.com

www.microban.com

Microban® antimicrobial product protection is limited to the product itself and is not designed to protect the users of these products from disease causing microorganisms, food borne illness, or as a substitute for normal cleaning and hygiene practices.

Microban® international, Ltd makes neither direct or implied health claims for the products containing Microban® antimicrobial product protection. Data, photomicrographs, and information presented are based on standard laboratory tests and are provided for comparative purposes to substantiate antimicrobial activity for non-public health uses.

Microban is a registered trademark of Microban® Products Company.

BRITISH COLUMBIA CHAPTER

British Columbia experienced a mild winter. As a result of low snow pack and minimal rain, drought and wildfire risks are increased for the upcoming season. This means we will need to be ready for urgent issues that impact healthcare like heat domes and smoky conditions through summer and fall.

Our spring chapter conference is scheduled for June 2-4, in Whistler. Conference planning, spearheaded by Mitch Weimer, is in full swing. The conference theme is Surviving and Thriving: Stories of Hope Amidst Disaster. We hope to share lessons learned and find solutions that may help us prepare for challenging conditions.

CHES B.C. remains committed to increasing membership. We are busy encouraging membership renewals for those that have lapsed. I am pleased to report the chapter continues to see strong membership support in the province.

The education committee is exploring increasing marketing efforts so members take advantage of educational offerings, including the bursary program and CHES webinar series. We are also considering targeted funding for each health authority to send a resource for CSA medical gas technical training.

The B.C. chapter recently closed an expression of interest for additional volunteers, as part of our succession planning efforts. These members will start assisting the chapter executive over the next year.

Chapter executives and members remain actively engaged in various committee work, including support for CSA Group, CHES partnership and advocacy, professional development, membership, social committee, standards and the Canadian Healthcare Construction Course (CanHCC).

CHES B.C. is looking to host the CanHCC this fall and is exploring dates for November. We have reached out to the CHES National office to request availability of faculty. We are also looking at different venues that have a central location.

I want to remind members to submit nominations for this year’s Hans Burgers Award for Outstanding Contribution to Healthcare Engineering, Wayne McLellan Award of Excellence in Healthcare Facilities Management and Young Professionals Grant. The deadline for submissions is April 30. Awards details can be found on the CHES website. I also encourage submissions for the CHES B.C. Healthcare Award.

This is an election year for CHES B.C. We have received several nominations. It’s exciting to see so many members are interested in volunteering on the chapter executive. It’s also great for succession planning and growth.

CHES B.C. recently worked through an issue with our official incorporation. One of the challenges we faced was permission to utilize the term ‘engineering’ in our name. I’m pleased to report we have received approval from Engineers and Geoscientists B.C., and we can now move forward with the process of incorporation.

Finally, I'd like to thank the chapter executive, directors, volunteers and members for their continued dedication and hard work.

—Sarah Thorn, British Columbia chapter chair

NEWFOUNDLAND & LABRADOR CHAPTER

In Newfoundland and Labrador, we are transitioning from four healthcare authorities to one. In doing so, there are many items that are yet to be resolved, including structure, policy and process. Because of this, the chapter executive has decided to postpone our annual conference to fall, when stability has been established. Planning is in full swing and we continue to set the bar higher. The conference will move to a new venue to accommodate the increase in both vendors and attendees. Although one of the smaller chapters, we deliver a large conference. For those who have been involved in the planning process, you know there is much more to the yearly event than meets the eye.

Last fall was relatively quiet with pockets of construction work spread across the province. One large-scale project is the new acute care hospital in Corner Brook. The $723-million build, seven-story structure will be a state-of-the-art facility with 164 beds, all in separate rooms. In St. John’s, where expansion seems to be the norm these days, there is lots of chatter around a new cardiovascular institute, urgent care centres and ambulatory clinics, among other construction initiatives.

The chapter executive has been strategizing how to better deliver CHES events to our members. While we await new policy from the newly formed Newfoundland and Labrador Health Services, we continue to follow past suit — promote education and training when we can, plan for larger chapter conferences and send more people to CHES National conferences.

Chapter membership is status quo, which is positive news. The chapter continues to find new ways to encourage CHES membership to those who have not joined. We are also reaching out to those who have not renewed. The chapter is actively pushing recruitment on vendors/suppliers, consultants and others to improve membership enrolment.

Financially, the chapter is in a solid position. The chapter executive is focused on investing in the betterment of our members. Whether that is providing greater education opportunities, sending additional members to the CHES National conference or paying for more webinars, we want to give back to our membership.

—Colin Marsh, Newfoundland & Labrador chapter chair

The 2024 CHES National Conference will be held in Halifax, N.S., at the Halifax Convention Centre, Sept. 8-10.

ALBERTA CHAPTER

In light of fiscal constraints due to collaboration between the provincial government and Alberta Health Services, our chapter is facing challenges with travel and conference attendance. Consequently, the Clarence White conference has been rescheduled to fall. We remain optimistic that potential easing of restrictions in the new fiscal year will allow us to uphold the high standards our attendees expect. Even in the presence of travel limitations, plans are in motion for a scaledback yet quality-filled conference.

Further, we are committed to hosting the Canadian Healthcare Construction Course, tied to the fall conference. Despite the circumstances, our dedicated volunteers are ready to contribute, ensuring an excellent event regardless of the direction it takes.

Successful training events have transpired in the southern part of the province. The South Health Campus in Calgary organized a session in collaboration with Milwaukee and Grainger, focusing on minimizing noise in healthcare facilities. Foothills Hospital in Calgary is in the process of planning a training event with Trane, concentrating on optimizing chiller performance.

Preparations for the 2025 CHES National Conference in Calgary are in the early stages. We appreciate the continued support of our members and partners as we navigate these challenging times. The Alberta chapter remains committed to delivering valuable events for the healthcare engineering community.

—James Prince, Alberta chapter chair

ONTARIO CHAPTER

The chapter executive continues to meet quarterly via virtual means, focused on membership development and member benefits, including bursaries, the Young Professionals Grant and education events. We hosted two virtual education sessions on decarbonization — one in February, the other in March. Building on growth in membership over the past year, we are conducting analytics work to better understand membership complexion and identify opportunities for further development. We are also engaged in longrange financial planning to continue to optimize member benefits.

The conference planning committee under Ron Durocher’s leadership is busy planning the chapter spring conference at Blue Mountain, May 26-28. The CHES Ontario family will congregate in Collingwood, around the theme Embracing Change and Transformation.

The chapter executive continues to engage in networking and advocacy opportunities. Last November, I attended the Canadian Centre for Healthcare Facilities conference, where the theme, Innovating Health Environments, proved to be thoroughly engaging. In March, I travelled to San Diego for the International Summit and Exhibition on Health Facility Planning Design and Construction, presented by the American Society for Healthcare Engineering (ASHE). I attended the ASHE Region 6 conference in Rochester, Minn., in April. We continue to work to further our partnerships with our long-term care colleagues at AdvantAge Ontario through participation in their spring convention, also in April.

—John Marshman, Ontario chapter chair

MARITIME CHAPTER

Planning continues for this year’s CHES National Conference in Halifax, Sept. 8-10. Educational sessions have been tentatively approved. Many abstracts were received. A big thank you to Gordon Burrill and the abstract review team for putting together a fantastic line-up of speakers and topics. The opening reception will be held at Pier 21, the gateway to Canada for one in five Canadians. Delegates are invited to visit the Pier 21 website to find out if they have family connections and are encouraged to sign-up for a free tour to be held during the conference reception. We hope to see members from across the country join us for some homegrown Maritime hospitality and what will be an exceptional event.

Post-conference, the chapter will host the Canadian Healthcare Construction Course Sept. 11-12, at the Prince George hotel in Halifax. We have been meeting with various groups, including construction associations from all three Maritime provinces, to promote this first-class training session. If planning to attend the CHES National conference and you’d like to complement your healthcare facility education, consider signing up for the two-day program. Information can be found on the CHES website.

Chapter Kate Butler and Helen Comeau are part of the backbone of Women in CHES. They gathered input and ideas during a successful virtual 2024 planning session. Expect exciting news from this group in the future as they continue to grow.

A spring education session is planned for May 14, at the Four Points by Sheraton in Moncton, N.B. The program is open to hospital and long-term care maintenance staff at no expense and includes breakfast, lunch and door prizes. Presenting companies and others have sponsored to cover the costs. There will be seven presentations on a variety of topics, including computerized maintenance management systems, asbestos, infection prevention and control hoarding techniques, power quality, water management, roofs and chiller maintenance.

The Maritime chapter is pleased to offer the Per Paasche bursary again this year in his memory. From New Brunswick, Per dedicated his career to the advancement of engineering, particularly in healthcare. He served at the Institute of Biomedical Engineering, a research institute within the University of New Brunswick, and devoted much time developing hospital commissioning initiatives across the province. Per’s working career, knowledge in his field of expertise and work ethic were exemplary. He was a devoted CHES member and contributed to the foundation on which the organization stands today. The $1,000 bursary is open to immediate family members (daughters, sons, grandchildren, nieces, nephews, spouse) of Maritime CHES members, including yourself.

Maritime chapter members are encouraged to submit nominations for this year’s Hans Burgers Award for Outstanding Contribution to Healthcare Engineering and Wayne McLellan Award of Excellence in Healthcare Facilities Management. The deadline is April 30. Awards details can be found on the CHES website.

The chapter continues to offer several financial incentives to CHES Maritime members, including financial contributions to Canadian Certified Healthcare Facility Manager exam fees, spring and fall education days, among other benefits.

—Robert Barss, Maritime chapter chair

QUEBEC CHAPTER

Building on our commitment to provide value to members, non-members and the healthcare community, CHES Quebec will hold its inaugural chapter conference May 15. The one-day event will feature four technical sessions and is expected to attract more than 150 attendees.

Then, June 5-6, the chapter will host the Canadian Healthcare Construction Course in collaboration with the Quebec Construction Association for the first time ever. This unique training opportunity is the only program in Canada specifically focused on healthcare construction.

To expand our reach, the chapter actively participated in the Corporation des Entrepreneurs Généraux de Quebec congress in Trois-Rivières in February. This provided a platform to showcase our dedication to CHES, further solidifying our connection with the general contractor community. We were fortunate to have CHES National treasurer and Manitoba chapter chair Reynold Peters join us, further emphasizing our commitment and collaboration.

CHES is actively leveraging social media platforms like LinkedIn and Instagram to build a robust communication network. I encourage you to follow to stay informed on the latest events and initiatives. Your continued support and active engagement are invaluable as we collectively strive to advance healthcare engineering in Canada.

—Mohamed Merheb, Quebec chapter chair

MANITOBA CHAPTER

CHES Manitoba held its annual education day April 16, at the Victoria Inn Hotel and Convention Centre in Winnipeg. The theme was Transformative Healthcare Infrastructure. The Manitoba chapter awards in project management and facility management were handed out at the event.

Our annual general meeting took place at the education day, during which we welcomed a new chapter executive. Vice-chair Stephen Cumpsty agreed to move into the role of chapter chair in April. This is a change from my last chapter report, as I anticipated serving as chair until the 2024 CHES National Conference.

From May 22-23, the chapter will host the Canadian Healthcare Construction Course with the Winnipeg Construction Association at their office. Registration information is on the CHES website.

Looking ahead to fall, the Manitoba chapter will be well represented at the CHES National conference Sept. 8-10, in Halifax. Stephen will attend as chapter chair and be accompanied by the newly elected vice-chair. As Jeremy Kehler is now CHES National professional development subcommittee chair, he will also attend alongside myself as CHES National treasurer. Current CHES National president and Manitoban Craig Doerksen will be present, too. There he will pass the torch to Jim McArthur and move into the role of past president for a two-year term.

—Reynold J. Peters, Manitoba chapter chair

CHAPITRE DU QUEBEC

S’appuyant sur notre engagement à offrir de la valeur aux membres, aux non-membres et à la communauté de la santé, le chapitre québécois de la SCISS est ravi de partager quelques nouvelles passionnantes.

Tout d'abord, nous sommes ravis d'annoncer la tenue du premier cours de construction destiné aux entrepreneurs oeuvrant dans les établissements de santé. Ceci est fait en collaboration avec l'Association de la Construction du Québec. Cette formation unique est la seule au Canada spécifiquement axée sur la construction des soins de santé et se tiendra les 5 et 6 juin.

Deuxièmement, pour élargir notre portée, le chapitre a activement participé au congrès de février de la Corporation des Entrepreneurs Généraux de Québec à Trois-Rivières. Cela nous a fourni une excellente plateforme pour mettre en valeur notre dévouement à la communauté de la SCISS, renforçant ainsi notre lien avec la communauté des entrepreneurs généraux. Nous avons également eu la chance d'avoir Reynold Peters, trésorier de la SCISS, parmi nos intervenants, soulignant ainsi notre engagement et notre collaboration.

Marquez vos calendriers. Nous sommes également ravis d'annoncer notre première conférence du chapitre du Québec le 15 mai. Cet événement d'une journée comprendra quatre conférences techniques et devrait attirer plus de 150 participants.

Enfin, nous exploitons activement les plateformes de médias sociaux comme LinkedIn et Instagram pour construire un réseau de communication solide. Nous vous encourageons à nous suivre sur ces canaux pour rester informé de tous nos derniers événements et initiatives. Votre soutien continu et votre engagement actif sont inestimables alors que nous nous efforçons collectivement de faire progresser l'ingénierie aux sein des etablissements de santé au Canada.

—Mohamed Merheb, chef du conseil d’administration du Québec

SASKATCHEWAN CHAPTER

Similar to other chapters, CHES Saskatchewan is focused on developing its membership. We are looking to promote CHES to our broad network of partnerships and connections, encouraging them to attend our fall conference and the informational webinar sessions planned for this year. Our hope is they will see the incredible benefits the organization has to offer and become members. We are also keen to find opportunities to have a stronger presence at the CHES National conference and other chapter conferences.

Planning for the Saskatchewan chapter’s fall conference continues. In late March, an in-person meeting was held to discuss how we can improve this year’s event based on feedback from our last conference. We hope to increase delegate and vendor attendance with another great event that will include ample networking opportunities.

—Melodie Young, Saskatchewan chapter chair

CHES SCISS

Canadian Healthcare Engineering Society Société canadienne d'ingénierie des services de santé

CALL FOR GRANT SPONSORSHIP & SUBMISSIONS

2024 Young Professionals Grant

DEADLINE: April 30, 2024

CHES is seeking both sponsors and candidates for the 2024 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, 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 2024 CHES National Conference and complimentary membership for the remainder of the 2024-2025 membership year.

For Nomination Forms, Terms of Reference, criteria and past winners

www.ches.org / About CHES / Awards

Send nominations to: CHES National Office info@ches.org

MAKING VIRTUAL

A REALITY

Transformer le virtuel en réalité

By/Par Martine Janicki & Jeneen Rankin-Bayer

Fraser Health’s digital transformation vision has led to the creation of British Columbia’s first-ever virtual hospital unit. This new model of care enables eligible patients to receive psychiatric interventions safely and conveniently away from hospital. Their homes are turned into a virtual hospital room with digital connections to care teams who make house calls if needed.

Fraser Health’s facilities management team played a significant role in transforming administrative space into an efficient built environment for this virtual hospital unit. Upon review of the health authority’s owned and leased facilities and space, facilities management identified an existing corporate area in Surrey — a shopping mall with office towers — to set up the virtual entity.

Months of staff engagement, space planning, furniture purchases and challenging infrastructure upgrades resulted in the successful

La stratégie de transformation numérique de Fraser Health a engendré une première en ColombieBritannique: l’unité hospitalière virtuelle. Ce modèle novateur offre des soins psychiatriques aux patients éligibles, directement chez eux. Leur foyer devient une extension de l’hôpital, connecté numériquement aux équipes médicales. Ces dernières interviennent à domicile lorsque le besoin se présente.

L’équipe chargée des installations chez Fraser Health a joué un rôle clé dans la mutation d’espaces administratifs en un centre hospitalier virtuel performant. En scrutant les lieux possédés et loués, elle a sélectionné un espace commercial à Surrey. Ce centre, avec ses tours de bureaux, accueille maintenant l’unité virtuelle.

Des mois de consultation du personnel, de planification de l’espace, d’achats de meubles et de mises à niveau difficiles de l’infrastructure ont abouti au lancement réussi de ce nouveau service virtuel où le personnel administratif, le personnel clinique et les

launch of this new virtual service, with administrative staff, clinical staff and physicians providing around-the-clock virtual healthcare by web chat and telephone.

VISION AND INCENTIVE

One of Fraser Health’s key objectives was to deliver seamless and digitally-enabled services to facilitate access and empower people to actively participate in their care and well-being. This goal led to the establishment of an innovative virtual hospital unit with a foundational infrastructure that has the capability of expanding in the future to alleviate pressure on conventional health services and enable patients to use virtual health services.

While a virtual hospital is a transformative approach to delivering healthcare, it is still, at its heart, a hospital that extends health services beyond the traditional brick-and-mortar model. It requires some of the same infrastructure as a traditional hospital, thoughtfully adapted to virtual care delivery.

To ensure consensus and success, the space conversion project team in the facilities management department held a series of engagement meetings with clinical and administrative stakeholders to understand their head counts, models of care and workflows.

PLANNING AND IMPLEMENTATION

The goal of establishing a virtual hospital unit triggered facilities management to rapidly establish a physical hub to host the technology, administration and dedicated space for care teams. This required housing more than 100 clinical and administrative staff in a safe, secure and accessible location 24-7.

Martine Janicki, director of strategic land and facilities development at Fraser Health, was instrumental in bringing British Columbia's first-ever virtual hospital unit to fruition.

médecins fournissent des soins de santé virtuels 24 heures sur 24 par clavardage et par téléphone.

VISION ET INCITATION

L’un des principaux objectifs de Fraser Health était de fournir des services transparents et numériques pour faciliter l’accès et permettre aux gens de participer activement à leurs soins et à leur bien-être. Cet objectif a conduit à la mise en place d’une unité hospitalière virtuelle innovante dotée d’une infrastructure de base qui a la capacité de se développer à l’avenir pour alléger la pression sur les services de santé conventionnels et permettre aux patients d’utiliser les services de santé virtuels.

Bien qu’un hôpital virtuel soit une approche transformatrice de la prestation des soins de santé, il reste, en son cœur, un hôpital qui étend les services de santé au-delà du modèle traditionnel de brique et de mortier. Il nécessite une partie de la même infrastructure qu’un hôpital traditionnel, soigneusement adaptée à la prestation de soins virtuels.

Pour assurer le consensus et le succès, l’équipe du projet de conversion de l’espace dans le département de gestion des installations a organisé une série de réunions d’engagement avec les parties prenantes cliniques et administratives pour comprendre leurs effectifs, leurs modèles de soins et leurs flux de travail.

PLANIFICATION ET MISE EN OEUVRE

L’objectif d’établir une unité hospitalière virtuelle a incité la direction des installations à établir rapidement un centre physique pour héberger la technologie, l’administration et l’espace dédié aux équipes de soins. Ce projet a nécessité l’hébergement de plus de 100 membres du personnel clinique et administratif dans un endroit sûr, sécurisé et accessible en permanence.

La planification du centre a conduit à l’élaboration d’un programme fonctionnel complet et d’un plan d’allocation d’espace composé de ‘quartiers’ pour 17 équipes.

La première étape de la mise en place de l’unité d’hôpital virtuel s’est concentrée sur les services de santé mentale pour un large éventail de populations de patients, suivie de la relocalisation des centres d’appels virtuels et aigus.

Planning for the hub led to the development of a comprehensive functional program and space allocation plan consisting of ‘neighbourhoods’ for 17 teams.

The first stage of setting up the virtual hospital unit focused on mental health services for a broad range of patient populations, followed by the relocation of the virtual and acute call centres.

A six-month planning and implementation period was needed to deliver the project. The scope of work for facilities management included identifying location options, space planning and allocation, design and validation, and furniture procurement and configuration to align with Fraser Health’s administrative space guidelines.

Upon reviewing the clinical service plan, the space conversion project team developed a regional functional program to support a hub-spoke model, current state space assessment and inventory of existing devices to inform and develop a detailed furniture and technology implementation plan.

Extensive work and documentation led to a detailed space design and furniture layout aligning with organizational space guidelines and electrical infrastructure drawings. The space was upgraded with electrical infrastructure to provide uninterrupted power, lighting, HVAC and network connections so staff could confidently provide care 24-7 without downtime. Adding some interior enhancements, wayfinding and signage completed the built environment.

TRANSITIOIN TO OPERATIONS

Facilities management worked with the commercial building management team to upgrade the exterior building for improved security and ease of entry to parking after hours. Staff ID cards were updated with appropriate levels of access inside the building. After-hours security patrols were arranged as well as parking lot escorts to provide an added layer of safety for staff.

Upon moving in, the team identified additional storage needs for basic medical supplies, patient kits and electronics, which were addressed with small furniture solutions.

Given virtual services are dependent on technology, it was essential to develop a contingency plan in the case of technology failure. When this contingency plan is activated, clinical staff are redirected to an alternative healthcare location to minimize downtime and ensure continuity of virtual care.

In early September 2022, Fraser Health launched an internal activation to ensure all systems were working as designed. By end of month, following some minor access adjustment, the virtual hospital unit went live.

A post-occupancy evaluation was scheduled in spring 2023 to assess whether Fraser Health’s vision of an innovative virtual hospital unit had been fulfilled. Feedback was overwhelmingly positive.

Martine Janicki is director of strategic land and facilities development at Fraser Health. Jeneen Rankin-Bayer is senior facilities planner with the B.C. health authority. Fraser Health is the heart of healthcare for nearly two million people in 20 diverse communities from Burnaby to Fraser Canyon on the traditional, ancestral and unceded territories of the Coast Salish and Nlaka’pamux Nations, and is home to six Métis chartered communities.

Une période de planification et de mise en œuvre de six mois a été nécessaire pour mener à bien le projet. La portée des travaux pour la gestion des installations comprenait l’identification des options d’emplacement, la planification et l’attribution des espaces, la conception et la validation, ainsi que l’approvisionnement et la configuration des meubles pour s’aligner sur les lignes directrices de Fraser Health en matière d’espace administratif.

Après avoir examiné le plan de service clinique, l’équipe du projet de conversion de l’espace a développé un programme fonctionnel régional pour soutenir un modèle à rayons concentriques, une évaluation de l’état actuel de l’espace et un inventaire des dispositifs existants afin d’informer et d’élaborer un plan détaillé de mise en œuvre du mobilier et de la technologie.

Un travail et une documentation approfondis ont conduit à une conception détaillée de l’espace et à une disposition du mobilier alignée sur les lignes directrices de l’espace organisationnel et les dessins de l’infrastructure électrique. L’espace a été mis à niveau avec une infrastructure électrique pour fournir une alimentation, un éclairage, un système CVC et des connexions réseau ininterrompus afin que le personnel puisse fournir des soins en toute confiance sans temps d’arrêt. L’ajout de quelques améliorations intérieures, de l’orientation et de la signalisation a complété l’environnement bâti.

TRANSITION VERS LES OPÉRATION

La gestion des installations a travaillé avec l’équipe de gestion de l’immeuble commercial pour améliorer l’extérieur du bâtiment afin d’améliorer la sécurité et de faciliter l’accès au stationnement en dehors des heures de bureau. Les cartes d’identité du personnel ont été mises à jour avec des niveaux d’accès appropriés à l’intérieur de l’immeuble. Des patrouilles de sécurité après les heures de travail ont été organisées ainsi que des escortes de stationnement pour fournir une couche de sécurité supplémentaire au personnel.

En emménageant, l’équipe a identifié des besoins de stockage supplémentaires pour les fournitures médicales de base, les kits de patients et l’électronique, qui ont été traités avec de petites solutions de mobilier.

Étant donné que les services virtuels dépendent de la technologie, il était essentiel d’élaborer un plan d’urgence en cas de défaillance technologique. Lorsque ce plan d’urgence est activé, le personnel clinique est redirigé vers un autre site de soins de santé afin de minimiser les temps d’arrêt et d’assurer la continuité des soins virtuels.

Au début de septembre 2022, Fraser Health a lancé une activation interne pour s’assurer que tous les systèmes fonctionnaient comme prévu. À la fin du mois, à la suite d’un ajustement mineur de l’accès, l’unité d’hôpital virtuel a été mise en service.

Une évaluation post-occupation était prévue au printemps 2023 pour évaluer si la vision de Fraser Health d’une unité hospitalière virtuelle innovante avait été réalisée. Les commentaires ont été extrêmement positifs.

Martine Janicki est directrice du développement stratégique des terrains et des installations chez Fraser Health. Jeneen Rankin-Bayer est planificatrice principale des installations auprès de l’autorité sanitaire de la Colombie-Britannique. Fraser Health est au cœur des soins de santé pour près de deux millions de personnes dans 20 communautés diverses, de Burnaby à Fraser Canyon, sur les territoires traditionnels, ancestraux et non cédés des nations Salish de la côte et Nlaka'pamux, et abrite six communautés à charte métisse.

Hans Burgers Award for Outstanding Contribution to Healthcare Engineering

DEADLINE: April 30, 2024

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.

Award sponsored by 2024

Wayne McLellan Award of Excellence in Healthcare Facilities Management

DEADLINE: April 30, 2024

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

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

Award sponsored by

For Nomination Forms, Terms of Reference, criteria and past winners www.ches.org / About CHES / Awards Send nominations to: CHES National Office info@ches.org

CHAIN RISKS MITIGATING SUPPLY

Supply disruption management program provides better value to hospitals, supports improved patient care

By Grant Beamish, Caitlin Gaudet & Aimee Gavin

Many of the public health consequences of the COVID-19 pandemic were immediately obvious. But shortly after governments around the world imposed lockdowns to slow the spread of the disease, another issue became glaringly clear — the impact of the pandemic on the global supply of everything from computer chips to automobiles.

Healthcare supply chains were no exception and were, in fact, exacerbated by

significant increases in demand. That reality was underscored by the scarcity of personal protective equipment (PPE).

IMPACT ON PATIENT CARE

Even outside of pandemic times, manufacturer supply disruptions have an ongoing impact on patient care. Changes to clinical protocols may be necessary due to product shortages, recalls or discontinuations, resulting in less-than-optimal workarounds.

Supply disruptions can also delay surgical procedures or prevent patients from beginning therapy on a preferred medication. Beyond this, disruptions burden hospital staff with additional work and reduce time available for frontline patient care.

One key example of a pre-COVID-19 supply chain disruption came in 2017, when Hurricane Maria caused extensive damage to a vital production facility in Puerto Rico, prompting a large-scale supply disruption

of IV mini-bags. Hospitals scrambled to find substitutions individually, while distributors and manufacturers were overwhelmed with inquiries. Mini-bags are ubiquitous throughout hospitals but despite having a DIN (drug identification number), which is the domain of pharmacy, they’re often ordered by materials management departments. That overlap in responsibility exacerbated the supply challenges. To deal with this issue, Mohawk Medbuy Corp. (MMC), a Burlington, Ont.-based supply chain and group purchasing organization for the healthcare sector, implemented its existing supply disruption support program to help hospital pharmacies navigate the backorder. However, the unique dynamics of the minibag crisis demonstrated more was needed.

MMC consulted extensively with member hospitals and vendors in shaping a program that would be embraced across the supply chain. The result was MitigAid, which launched in 2019. The new supply disruption management program was developed with a singular objective to help hospitals minimize the risk to patients in the event of a product backorder, discontinuation or recall.

THE POWER OF DATA

MMC maintains comprehensive spend data for hospitals that allows them to quickly assess the scale and scope of a disruption. The database is reviewed to determine what facilities are impacted and how much of the affected product each site uses.

Real-time updates are provided over the course of the disruption by the contracted suppliers to keep MMC and hospitals informed. In the event of an actual or pending product supply disruption, vendors

THE NEW SUPPLY DISRUPTION MANAGEMENT PROGRAM WAS DEVELOPED WITH A SINGULAR OBJECTIVE TO HELP HOSPITALS MINIMIZE THE RISK TO PATIENTS IN THE EVENT OF A PRODUCT BACKORDER, DISCONTINUATION OR RECALL.

are required to log into MMC’s online portal and submit a notification indicating what products are impacted, the start date of the disruption, estimated end date, suggested substitute products and other relevant information. Through MMC’s portal, hospitals have 24-7 visibility on the status.

FINDING SUITABLE SUBSTITUTES

Ensuring hospitals have immediate access to an alternative item is a top priority of MitigAid. Through years of information gathering, MMC has established a database of equivalent products for out-ofstock items. Potential substitutes are assessed by MMC’s clinical team of registered nurses and pharmacists to determine their suitability, reducing the workload of hospital clinicians.

Before advising member hospitals of a potential substitute item, MMC contacts the vendor to confirm they have the required supply and to pre-negotiate pricing. Throughout the process, MMC never recommends a particular substitute item over others or selects substitutes for member facilities. Each hospital always

determines what will work best for them and their patients’ needs.

DEALING WITH DRUG SHORTAGES

In 2023, Canadian hospitals were hit with 518 actual drug shortages caused by backorders, recalls and discontinuations. In many instances, there are therapeutic equivalents (generics) or alternate therapies available, but that still requires multiple steps. Hospital pharmacists need to determine what substitute drug is appropriate and to educate prescribers about the change. Pharmacy procurement staff must also confirm whether supply of a drug is available, coordinate the purchase and delivery to their facility and input the new product’s information in the hospital’s system.

For some very specialized, high-cost or sole source drugs, there may be no equivalent available. In such cases, the hospital will put in place conservation strategies for the backordered drug. But conservation can put doctors in the very difficult position of choosing which patients get the optimal drug for their therapy. In other cases, medications in short supply are rationed to people undergoing

treatment at less than the therapeutic dose or frequency.

DELAYED SURGERIES AND BACKLOGS

One area of healthcare that can be hit hard by supply shortages is the operating room (OR) — a precious resource of hospitals. For patients, a surgery is often a life-changing event that has been months or years in the making. A cancellation caused by shortages is significant for all

concerned. That was the case when a critical instrument used for an elective surgical procedure at one Canadian hospital went on backorder without notice.

In this instance, the instrument — an energy tissue sealing device — is essential for bariatric surgery. Also known as gastric bypass surgery, it’s a major procedure that involves making changes to the digestive system to help people lose weight. In many

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cases, the patients are contending with serious health issues due to their weight.

Given this hospital’s large catchment area, many patients travel significant distances for the procedure and undergo two weeks of unpleasant prep in advance. Bariatric surgeries are performed on Mondays and Wednesdays at this particular hospital. One Monday, as the OR was being set up for the first of three that day, it was discovered there were no energy tissue sealing devices due to a supply disruption that would ultimately continue for several weeks.

Because the hospital is a regional centre with no nearby facilities that could share the specific instruments, the surgeries had to be cancelled. It was a crushing disappointment for patients who had been counting on the procedure to give them a new lease on life. It also meant they’d have to go through the challenging pre-surgical prep all over again.

The supply disruption had implications for the hospital as well. An in-demand OR sat vacant on that first Monday. Surgeons and anesthesiologists scheduled to do the procedures were idle while the backlog of bariatric patients grew. From a financial perspective, the hospital receives a portion of its funding based on performing a predefined number of bariatric surgeries each year. That revenue was now at risk in the absence of a single instrument. Making up for the lost days in the OR would require overtime and extra resources.

While the pandemic highlighted supply chain challenges, shortages are an ongoing daily reality for hospitals. Processes and programs that mitigate their impact on patient care and staff resources and time are essential to keeping Canada’s healthcare system running. MMC’s supply disruption management program is doing just that.

Grant Beamish, Caitlin Gaudet and Aimee Gavin are part of the communications team at Mohawk Medbuy Corp. (MMC), a national, not-for-profit, shared services organization that supports hundreds of Canadian healthcare providers. MMC provides value-driven procurement solutions for medical/surgical supplies, pharmaceutical products, local sourcing, capital (equipment, furniture, fixtures and equipment, and redevelopment) and nutrition. The company consolidates the needs of its members and conducts large-scale procurements on their behalf rather than each facility going to market independently. By leveraging hospitals’ collective spend, MMC generates millions in savings each year that hospitals can reallocate to frontline care.

CARING FOR KIDS

Planning, design strategies for balancing security with welcoming open spaces in pediatric environments

By Sarah Walter & Nora Colman

Security and safety incidents are occurring in healthcare environments with increasing frequency and severity. Recent statistics show healthcare workers in the United States are five times more likely to experience violence than non-healthcare workers. Even more concerning is the prevalence of security incidents in maternity and pediatric environments. In 2022, pediatrics ranked third among the most dangerous units for healthcare workers with 84 per cent of staff experiencing violence at work, according to Children’s Hospital Association.

Pediatrics represents a more vulnerable patient population that faces a range of security and safety threats, such as abductions, elopement, domestic disputes, mental health and self-harm, and active shooter incidents. In the face of disease complexity, poor clinical outcomes or patient deaths, care providers are at higher risk for targeted aggression and anger. Hospitals are struggling to adapt to these growing threats while grappling with historic staffing shortages. The need for more inherently secure healthcare environments has never been greater.

On the other hand, patients, families and staff have come to expect a warm, welcoming hospital experience filled with hospitality-based features, including bright, open and spacious lobbies; lively cafes and dining areas that may be publicly accessible; family lounges and sibling play areas; family and community resource centres; and outdoor healing gardens and wellness trails. Healthcare facilities, particularly children’s hospitals, are increasingly seeking to expand their mission to better serve their communities through wellness and education programs, food pantries and healthy eating options, on-site childcare and other social services. Obvious and overt security measures like metal detectors, security fences and heavy patrolling presence can be intimidating and off-putting.

Bright, open lobbies convey a sense of warmth and welcome, reducing anxiety and fear for patients and their families and encouraging more active engagement in the visit.

Photo courtesy Peter Molick

As physical and psychosocial barriers to health and well-being are broken down, there is a need to think more holistically and creatively to ensure safeness in a pediatric environment without compromising the sense of warmth and welcome. Here are eight planning and design strategies to consider when enhancing safety and security on the hospital campus.

SPECIFY SECURITY PHILOSOPHY

Embracing a culture of safety and maintaining heightened risk awareness throughout planning and design leads to a more comprehensive, integrated and effective security plan. Too often, security planning is deferred to the end stages of design and strategies are limited to camera placement, card readers and security desks. Engaging a multi-disciplinary stakeholder team early in the planning and programming process encourages a more thorough, integrated and layered approach to security. Ideally, these conversations involve a variety of perspectives, including the hospital’s planning, design and construction team, security team, registration and front desk personnel,

frontline staff and clinicians, and even family advisory members.

It’s important to develop a security philosophy early in the design process. The most effective security plan takes an integrated approach that layers design strategies, physical security measures, technology, and training and protocols.

ESTABLISH CAMPUS BOUNDARIES

Security measures begin well before arriving at the hospital’s front door. Best practice considers the entire hospital campus, including edges, parking structures and lots, walkways and paths, and all building entrances. Factor in the urban or suburban context of the campus as boundaries and functional zones are defined on-site.

It is necessary to determine how porous the campus will be, as well as the accessibility of campus amenities to different populations. Perhaps the community is welcome to enjoy the hospital’s gardens and walking trails, but indoor and outdoor dining areas are secure and only usable by screened visitors. When

defining campus boundaries, consider leveraging topography or garden walls to create a visually appealing campus edge. Security fences may be softened by layering landscape design elements, such as privacy trees, shrubs and other garden elements.

SEPARATE VEHICULAR FLOWS

Clearly mapping and separating vehicular traffic so that the public is guided to visitor parking areas and public entrances will limit unauthorized access of service yards, loading docks, staff entrances and ambulance dropoffs. A variety of subtle and more overt cues can be leveraged to reinforce the distinction between public and non-public parts of campus. These include signage, lighting, vegetation, hardscaping, narrowing of drives and security gates.

PLAN FOR AFTER-HOURS

Hospital staff regularly change shifts in the middle of the night, so the path walked from the building to the parking area and vice versa is critically important. With the reduced num-

LEFT: Roof gardens allow for clearly defined and inherently secured outdoor therapy and play areas with excellent vistas and views for patients and families. RIGHT: Bright lighting and external glass stairwells that are well-lit enhance visibility and discourage security threats that may otherwise occur in isolated, poorly lit parking garages. Photos courtesy Jonathan Hillyer

ber of security personnel on campus at night, lighting and well-maintained landscaping becomes critically important to maintaining staff safety. Parking facilities are among the most dangerous areas of any campus. Technologic enhancements like parking deck automation, licence plate readers and artificial intelligence threat detection can enhance security in these high-risk areas.

SECURE OUTDOOR PLAY AREAS

Pediatric environments often feature outdoor play areas that may be enjoyed by patients, their siblings and sometimes visitors from the community. Establish a clear perimeter with controlled access and visibility. In more urban settings, elevating play areas to rooftops can be an excellent strategy to maximize safety, privacy and access control, while also optimizing vistas and views for patients and families.

MINIMIZE BUILDING ENTRY POINTS

It is common for hospital campuses that have grown over time to have multiple public

entrances; however, having too many opportunities for public entry increases the likelihood of unauthorized access of secure or sensitive areas. Where possible, limit the number of building entrances, separate public and back-of-house entries, strive to have eyes on all public points of building access, and provide the ability to lockdown all entrances from a remote location.

DEFINE LEVEL OF OPENNESS DESIRED

In planning public spaces, it is essential to understand the healthcare facility’s philosophy on security and accessibility, particularly when the children’s hospital is located within or shares a campus with an adult hospital. Many children’s hospitals require guests to check-in at a centralized security desk for a cursory background screening before accessing hospital patient care areas and inpatient floors. But some institutions decide to fully restrict access to all lobbies and amenities, including play areas, resource centres, dining and mediation spaces. Planning the spatial sequencing of lobby elements to support the hospital’s security philoso-

phy sets the foundation for a safe and successful lobby design. Work with the security stakeholder team to determine which program elements require security screening prior to access and those that will be freely usable. Include public elevators, waiting areas, cafes and dining areas, gift shops, outdoor gardens and play areas, public toilets, conference centres and education spaces, and outpatient services in the conversation.

PRIORITIZE SITUATIONAL AWARENESS

Certain departments within the hospital, namely the emergency department and inpatient units, are considered higher risk for escalating aggression, violence and other security concerns. Prioritize anti-abduction and anti-elopement risks by ensuring staff can monitor and control access through all department entry/exit points. Care team stations that offer visibility into the patient room provide a layer of situational awareness so that staff are alerted to escalating situations inside. Desk designs should minimize staff isolation or entrapment, and they should be standardized from unit to unit with consistently located duress stations. Receiving bad news especially about a child is often a trigger for aggression and violence. Delivering difficult news in an intentionally designed consultation space can create a safer, more controlled process for providers and staff.

Sarah Walter is managing director of the Charleston, S.C., office for Page Southerland Page, an architecture and engineering firm specializing in the programming, planning and design of healthcare facilities. As a registered architect and senior medical planner, Sarah’s experience includes strategic facility planning, campus transformation and the programming, planning and design of healthcare facilities. Nora Colman, MD, is an assistant professor in pediatrics in the division of pediatric critical care medicine at Children’s Healthcare of Atlanta. Nora has extensive experience in leading initiatives where simulation has been used as vehicle to meet system-wide quality goals. She is passionate about the role of simulation to proactively identify latent safety threats in new healthcare design.

A UNIFIED SOLUTION

Consolidating physical security helps create safer work environment, stem cyberattacks

By Karl Vancl

Hospital security is inherently complex. In these busy environments, staff, patients and visitors come and go 24 hours a day, 365 days a year. There’s expensive equipment and potent medications to safeguard. Many areas and buildings require heightened security, such as maternity wards, psychiatric units, pharmacies and equipment storage rooms. Yet, in an emergency, hospital staff also need to be able to access these areas without delay.

These facilities are a critical environment where emotions run high. Often conflicts arise between visitors and staff, nurses and doctors or even patients and their loved ones. People from all walks of life pass

through the door every day and hospitals must prepare for a range of threats.

A unified security system may be a source of untapped data that can improve hospital safety, operations and compliance.

A UNIFIED PLATFORM

In a unified security and operational platform, all components use shared core building blocks, such as maps, schedules, users and privileges. Events and data from the connected systems are aggregated and shared in a single user interface. The result is a security solution that not only looks like a single system but also preserves the ability to bring

applications and sensors from multiple providers on to the unified platform.

With fewer systems to manage, maintenance costs are reduced and staff require less training because there’s only one piece of software to learn and operate.

A unified system simplifies reporting, too. Since data from video surveillance, access control, connected sensors and even parking management systems are managed in one place, it’s quicker to retrieve the information needed.

OPERATIONS AND PATIENT EXPERIENCE

Analysis of data from security systems may provide actionable insights on operations

and help teams work more efficiently. They can generate reports on incidents and use the data to analyze the issue to proactively find a solution.

Some ways a unified security system can improve efficiency in hospitals is through incident analysis, visitor management insights, crowd management, emergency response planning, predictive analysis for preventive measures and environment safety monitoring.

By analyzing data from security incidents, hospitals can identify patterns or trends. This information guides the allocation of resources and development of preventive strategies.

Data on visitor flow and behaviour helps hospitals optimize staffing, improve the layout of entry points and enhance the visitor experience while maintaining security.

Insight on foot traffic patterns assists in managing crowds, ensuring smooth and safe movement within the facility.

By reviewing how staff and visitors respond during drills or actual emergencies, hospitals can refine their emergency response plans and evacuation protocols.

Advanced analytics may be applied to predict potential security risks, enabling proactive measures to mitigate them before they materialize.

Enhanced safety monitoring can be achieved by using security cameras and sensors to monitor environmental safety within the hospital, such as indoor temperature and humidity awareness for infection control.

EFFICIENT COMPLIANCE MONITORING

Hospitals are highly regulated environments. Each province and territory has its own rules governing the protection of personal health information along with national privacy legislation that requires hospitals to control and secure access to personal data.

These facilities must ensure records are properly managed from creation to destruction. This entails policies and procedures around data management and reporting. Hospitals need to protect sensitive data from cyber threats and make sure all staff and outside partners follow the correct policies. To assist, modern unified solutions include the option to program standard operating

THE RESULT IS A SECURITY SOLUTION THAT NOT ONLY LOOKS LIKE A SINGLE SYSTEM BUT ALSO PRESERVES THE ABILITY TO BRING APPLICATIONS AND SENSORS FROM MULTIPLE PROVIDERS ON TO THE UNIFIED PLATFORM.

procedures (SOPs) for specific events. These SOPs guide staff through the correct actions to remain compliant.

Likewise, a unified system brings data from all systems within a single software application, making it easier to create a comprehensive audit trail and generate compliance reports as required. Monthly reports tallying data on the number and type of security incidents, time to resolution, status of incidents and exposure for the hospital can be quickly accessed.

CYBERSECURITY AND UNIFICATION

Cybersecurity is another important aspect to consider. A unified system makes it easier for information technology (IT) teams to protect networks, encrypt data and keep devices safe.

A unified system can also be configured to run automatic security audits regularly to protect against unauthorized access and cyberattacks. It can notify the IT team when it’s time to update and patch security devices or change passwords. This reduces the risk of a cybersecurity breach from those looking to exploit vulnerabilities in devices, such as security cameras, access control systems or other endpoints. Regular data backups and a robust recovery plan are crucial for data integrity. These features may also be configured within a unified system.

Not all software providers have the same commitment to cybersecurity. This needs to be a priority when selecting security technology partners. Look for manufacturers that have cybersecurity measures built in by design. Likewise, the networks connecting physical security devices should be secure and the system should encrypt sensitive data both in transit and at rest, including strong access measures.

COST-EFFECTIVE MIGRATION

Years ago, switching security systems

required a complete rip-and-replace of all devices and wiring because the old proprietary systems were incompatible with each other. Today, systems are designed to work with a wide variety of devices from many different manufacturers.

Choosing an open-architecture security software solution can save hospitals millions of dollars if they’re able to reuse some existing hardware. For example, many hospitals keep select cameras, access control hardware and audio components like intercoms after moving to a unified solution. This flexibility enables them to be more agile when adapting to changes in technology, regulatory requirements or security requirements.

Likewise, a unified system can often integrate with other hospital systems, such as patient management systems, to provide a more comprehensive view of operations. This may lead to additional cost savings for the healthcare facility through better coordinated service delivery.

ENHANCING HEALTHCARE

Protecting patients and staff while mitigating workplace violence and stressful conditions is already challenging. Constantly changing government regulations make it even harder to remain compliant.

A unified solution can unlock opportunities to enhance operations, safety and staffing so medical teams are able to better focus on patients. Reducing the number of systems in use makes it more intuitive to manage and monitor what’s going on, especially in a fastpaced workplace. The result is improved patient care, which is fundamental for patient recovery and comfort.

Karl Vancl is director of enterprise sales for Canada at Genetec. He leads a team of sales professionals dedicated to guiding clients in enhancing their security and operational frameworks. With more than 20 years of experience in the security software industry,

WEATHERING THE

PERFECT STORM

How to mitigate risks associated with workplace electrical safety

By Paul Lupinacci

Healthcare facilities are facing a possible ‘perfect storm’ when it comes to electrical safety.

Three trends are converging to make managing the risk of electrical incidents increasingly difficult for their leaders: budget constraints, expanding electrical infrastructure and a changing labour force. And because electrical accidents may endanger staff and public safety, facilities leaders need to pay attention.

Facilities management budgets have not always kept pace with infrastructure maintenance requirements, making it harder for facilities teams to meet the workload of maintaining their vast infrastructure.

Couple this with the fact that healthcare facilities depend on an ever-increasing array of electrical equipment, some of it highly spe-

cialized, sophisticated and often critical to patient care. From solar panels and electric vehicle chargers to support the move to renewable energy, to the increase use of connected medical equipment, there is no doubt electrical infrastructure is becoming more prevalent and critical to healthcare operations.

All of this is happening at the same time labour market challenges — an aging workforce, skilled trades shortage and greater reliance on external contractors — are working against facilities managers. At present, a sizeable proportion of facilities staff are nearing retirement age. This means facilities teams will no longer be able to rely on the experience and know-how of mature electricians who have been servicing the infrastructure for years, making it more difficult to

maintain the equipment. Replacing those electricians is proving to be difficult due to the general skilled trade shortage in Canada. And whether it’s budget savings, the need to maintain specialized equipment or difficulty replacing skilled trades, more external contractors are being used to maintain and service electrical infrastructure. This means technicians that may not be familiar with a facility are working on equipment, potentially introducing safety risk.

While these trends may seem daunting, healthcare facilities managers are a resourceful and talented group. Further, these leaders have traditionally been passionately commited to the safety of staff and the public.

In order to be confident their facilities are managing the risks of electrical incidents, it’s important for facilities leaders to understand

the danger is not only from the potential malfunction of electical equipment but also from the act of servicing the electrical infrastructure.

As far as equipment malfunction is concerned, facilities leaders are accustomed to relying on CSA standard Z32, Electrical Safety and Essential Electrical Systems in Health Care Facilities, which primarily covers essential electrical equipment and systems in healthcare facilities. However, there is another CSA standard, Z462, also known as Workplace Electrical Safety, which deals mainly with how electrical service and maintenance work is performed. This standard includes specifications for items such as electrical labelling of equipment; the need for regular incident energy (arc flash) studies; the creation of job safety plans (or assessments) before commencing any electrical maintenance or service tasks; safe work procedures for persons working on electrical equipment; and personal protective equipment (PPE) for electrical workers and maintenance personnel.

While performing this work represents safety risks to electricians, any accidents that may result may also impact electrical

infrastructure and possibly present risks to all staff and patients.

St. Thomas Elgin General Hospital (STEGH) in southwestern Ontario recognized compliance with both standards is necessary to ensure complete electrical safety for the facility. While there was a general understanding of the requirements of Z32, there was a need to implement processes and systems to meet the requirements of Z462.

Daniel Neaves, director of facilities management at STEGH, is particularly interested in electrical safety as he began his career as a licenced electrician. Neaves decided 2022 was the perfect time to address this for two reasons. First, an updated incident energy analysis (or arc flash study) was to be performed. (Z462 requires this study be completed at least every five years.) Second, the facility was migrating to a new work management system.

As part of the work management system project, STEGH also implemented e-WorkSafe, a mobile application and cloud platform purpose-built for workplace electrical safety. The system allows staff or contract electricians to create Z462-compliant job safety

assessments before performing any electrical tasks. It also stores the arc flash data for all electrical equipment and uses it as part of the Z462 calculations to determine the appropriate arc flash boundary, PPE and other parameters to ensure work is performed safely.

Another important requirement for Neaves was that information about the electrical infrastructure be easily accessed by staff and contractors using mobile devices. Information such as single-line diagrams are especially important to contractors who may not be familiar with a facility.

As a result of this project and the updated arc flash analysis, the risks associated with electrical service and maintenance tasks has been reduced and STEGH has digital, documented job safety plans for every task in the event an audit is required.

Paul Lupinacci, P.Eng., is chief operating officer of e-WorkSafe Inc., a Canadian software company focused on workplace electrical safety. Paul earned a bachelor of applied science in mechanical engineering from University of Toronto, and a master of business administration from the Schulich School of Business at York University.

A WATCHFUL EYE

Leveraging surveillance technology for efficient healthcare facility management

By Paul Baratta

There is a lot going on today in Canadian healthcare settings. The complexity arises from various interconnected factors and trends, all of which are a main driver for efficient facility management. For example, workplace violence in healthcare is still at an epidemic level, with statistics showing 73 per cent of staff report at least one physical or verbal abuse incident. Also, emergency rooms have become the great unknown. Patients are being dropped off by ambulance or car and they walk right

into the hospital, sometimes undetected. Many hospitals are having difficulty keeping track of who is coming into the building. There could be patients with psychological needs and those that are being kept for longer periods in emergency rooms and hallways, and some may be accompanied by family or friends. With high patient demand and volume, staffing shortages, budget constraints and resource allocation problems, aging infrastructure, administrative burdens, cyberattacks and more, healthcare settings

have had to rapidly adapt with a multi-faceted approach.

These challenges and fluctuations are not unique to Canada. Some outcomes have led hospitals to have ‘patient watchers’ — security officers are watching patients and they are wearing body cameras to monitor and document everything. The data from these cameras can be stored on any device like a digital video recorder, even within the electronic medical record system or a video management system.

It is evident surveillance is becoming paramount to healthcare settings. The technology has evolved rapidly over the years and is now an indispensable tool in achieving efficient facility management.

ENHANCED SECURITY

One of the most critical aspects of healthcare facility management is ensuring the safety and security of patients, staff and assets. Surveillance technology plays a vital role in achieving this by providing real-time monitoring of the premises. High-resolution cameras strategically placed throughout the facility can deter potential threats, thefts and provide valuable evidence in case of incidents. Hospitals have had success with licence plate recognition that allows them to monitor vehicles, identify plates and take pictures of people pulling up in front of emergency rooms, dumping a patient or illegally parking.

ACCESS CONTROL

Surveillance technology can be integrated with access control systems to manage and monitor who enters and exits the facility. This not only enhances security but also helps in tracking staff attendance and ensuring only authorized personnel have access to sensitive areas. Also, intercoms are used more in unmanned entrances, loading docks and parking garages for emergency calls where a person can hit a button, be seen by a security guard and talk to relay they need help. The security guard can also respond via the intercom to deliver a message. This can be done anytime of the day and works especially well for urgent deliveries like blood and organ donations. Access control systems can also be integrated with asset tracking to restrict access to certain areas or assets. Only authorized personnel with the necessary permissions can access specific assets, reducing the risk of theft or misuse.

PATIENT MONITORING

Surveillance cameras equipped with advanced features like facial recognition can be used for patient monitoring while respecting their privacy. This technology can assist in tracking patient movements within a busy facility, ensuring they receive timely care, and helping healthcare professionals respond

promptly to emergencies. Some hospitals are using surveillance analytics for patient elopement. So, if there’s a patient watch situation, instead of assigning a security guard to a patient watch, video and audio solution analytics are used to better watch multiple patients. Acoustic analytics or sound intelligence has been very successful in monitoring behaviour and is useful for providing a proactive response. This kind of efficiency allows one security officer to observe up to four to six patients. And if a patient starts to go beyond the door/entrance area, cross detection analytics can provide an alert that they are trying to leave.

There is also wayfinding or real-time positioning apps being used to track patients and staff. These real-time location system badges are attached to the recipient or wherever location data is required, including hallways and rooms, even external spaces. The devices then emit a unique space ID, which is received by a tag located within the space, and video surveillance can be used to attract them.

ASSET TRACKING

Efficient facility management involves track-

ing and managing assets like medical equipment, pharmaceuticals and supplies. Surveillance tracking of assets within hospitals requires the use of technology, including radio frequency identification (RFID), cameras, software and access control systems, to monitor and manage the movement and usage of assets. This approach improves operational efficiency, reduces costs, and enhances patient care and safety.

RFID technology is commonly used for asset tracking. Each asset, such as medical equipment or supplies, is tagged with a RFID tag containing a unique identifier. RFID readers installed throughout the hospital can detect these tags and track the location of assets in real-time. This information can be integrated into a central monitoring system, allowing hospital staff and facility managers to locate assets efficiently.

Surveillance cameras, whether traditional closed-circuit television cameras or more advanced Internet protocol cameras, can be used to monitor the movement of assets within a hospital. Cameras placed strategically in storage areas, corridors and key locations can capture footage of assets being

OPPOSITE PAGE: Surveillance technology plays a vital role in achieving safety on-site by providing real-time monitoring of the premises. ABOVE: Surveillance cameras can be used for patient monitoring while respecting their privacy. Photos courtesy Axis Communications

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moved or used. This visual information can complement RFID data and provide a more comprehensive view of asset tracking.

Hospitals will use specialized asset management software that integrates data from RFID systems, surveillance cameras and other tracking technologies. This software can provide a centralized dashboard where staff can view the location, status and maintenance history of assets. Alerts can be set up to notify staff of any unauthorized movements or maintenance requirements.

COMPLIANCE AND DOCUMENTATION

Surveillance technology can aid in compliance with healthcare regulations by providing a comprehensive record of activities within the facility. This documentation can be invaluable in audits and investigations, helping healthcare facilities maintain their accreditation.

ANALYTICS AND MAINTENANCE

Advanced surveillance systems often incorporate analytics capabilities. Machine learning algorithms can analyze video feeds to predict maintenance needs for equipment and infrastructure. This proactive approach can reduce downtime and improve overall facility efficiency.

STAFF TRAINING AND EVALUATION

Surveillance footage can be a valuable tool for staff training and evaluation. It can be used to identify areas where staff might need additional training and to assess their performance in critical situations.

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Incorporating tailored and validated end-toend surveillance technology into healthcare facility management, including a video management system or a camera station, as well as connected devices, is not only a smart investment but also a critical step toward achieving day and night operational efficiency, ensuring security and providing the best possible care to patients. By harnessing the power of surveillance technology, healthcare facilities in Canada and beyond can thrive in an increasingly complex and demanding environment.

Paul Baratta is the segment development manager for healthcare for Axis Communications. In this capacity, Paul is responsible for developing strategies and building channel relationships to expand Axis’ presence in healthcare markets.

HIDDEN HAZARDS

Lessons learned from an operating room event

By Gordon Howie

In the complex landscape of healthcare, fostering a culture of empowerment, building trust and implementing robust incident command structures are essential to ensure patient safety and resilience in the face of unforeseen events. A poignant example of this unfolded in October 2022, at Mayo Clinic Health System in Menomonie, Wis. An incident in the operating room tested the organization’s commitment to these principles and underscored the need for comprehensive evaluation of such significant events.

Mayo Clinic Health System is one of five system hospitals and one of four critical

access hospitals (CAHs) within the northwest Wisconsin region. In the United States, CAHs are designated by the federal government. They are intended to reduce financial vulnerability in rural areas and keep access to services like emergency care, care for short-term illness, and resources for rehabilitation or services after hospitalization within these communities. Among other requirements, CAHs can have no more than 25 beds and must be at least 57 kilometres from any other hospital.

On Oct. 19, 2022, surgical personnel encountered an unexpected challenge as

they prepared operating rooms for scheduled procedures. Small, dark particles on surgical lights and various surfaces raised concerns. Described as resembling pepper but smearing when rubbed, the material’s ferrous nature led to assumptions that it was not bioburden. In a decisive move, the surgical team invoked ‘stop the line’ protocols, initiating a series of tasks that would prove critical in averting potential disasters.

The first pivotal step in managing the issue was the establishment of a hospital incident command system (HICS). This structured approach ensured consistent communication, centralized decision-mak-

ing and consolidated information — crucial elements when facing unforeseen challenges. The HICS included the incident commander, operations officer, public information officer, safety officer, planning officer and logistics officer, along with medical and technical experts. The incident prompted a cascade of tasks. Staff contacted patients, rescheduled cases and coordinated efforts with another Mayo Clinic facility in Eau Claire, Wis.

But challenges continued to mount. Coordination of patient care was complicated by the need to relocate labour and delivery services due to the unavailability of operating rooms for emergent procedures.

The facilities operations team delved into troubleshooting the problem, with infection prevention staff seeking to identify potential exposure risks. Turnaround times for laboratory analysis were delayed; however, the team suspected issues with recent optimizations in water treatment for steam humidification. It was thought residue in steam humidification piping had been dormant had broken up and dispersed through the air handling systems since humidification takes place after final filtering.

Although not conclusive, changes were implemented based on system design considerations, including duct inspections, filter evaluations and consultations with water treatment experts. Following extensive work, the environment underwent a thorough sterile cleaning. It was then monitored for 24 hours before resuming operations.

Despite positive visual inspections and particulate count readings, the problem recurred on Oct. 25. The immediate reestablishment of HICS reflected a commitment to transparency and decisive action. However, questions arose about the persistence of the problem despite reported improvements. The facilities operations team, in particular, quickly convened leadership meetings to develop a comprehensive plan so that a methodical and thoughtful plan could be implemented.

The team strategized next steps, opting for a comprehensive inspection of every inch of ductwork serving the operating rooms. This revealed residue from a previous water leak during construction. Inspection also identified dampers that were installed backwards and construction debris left above ceilings. Corrective actions included cleaning, steri-

lizing affected areas, reinstalling dampers correctly and monitoring air quality for 48 hours before safely resuming procedures.

Evaluation of this event uncovered significant vulnerabilities, such as conflicts of interest in mechanical commissioning and the absence of routine inspections during construction. As-built conditions deviating from design intent underscored the necessity of third-party commissioning and routine construction reviews.

Post-incident debriefing also emphasized the critical importance of continuous empowerment, fostering a culture of intervention and maintaining robust incident command structures. A mature incident command model must include mitigation, preparedness, response and recovery. Transparent communication with patients yielded successful outcomes and the trust remained intact. Business continuity plans and downtime procedures proved vital, with lessons learned in staff orientation, logistics and mobilization.

This incident serves as a reminder to avoid hasty decisions and the need for thorough confidence before system turnover to clinical departments. All identified deficiencies had been rectified and effectiveness rigorously evaluated before allowing procedures to resume, with no reported issues in the past year. This sequence of events stands as a testament to the resilience of healthcare professionals when empowered, the significance of trust in crisis situations and the necessity of continual improvement in the face of unexpected challenges.

It is also important to remember these types of events are highly stressful for all involved. Pointed questions will be asked and it will be uncomfortable. However, these crucial conversations are necessary in order to ensure patient safety is first and foremost.

Gordon (Gordy) Howie serves as regional chair of facilities and support services for Mayo Clinic Health System in northwest Wisconsin. His primary responsibility is leadership of facilities, safety, compliance and construction for five hospitals totalling 2.3 million square feet. Gordy is also the current president of the American Society for Health Care Engineering. He can be reached at howie.gordon@mayo.edu.

The Mayo Clinic Health System in Menomonie, Wis., is one of five system hospitals and one of four critical access hospitals within the state's northwest region. On Oct. 19, 2022, surgical personnel encountered an unexpected challenge as they prepared operating rooms for scheduled procedures.

We are pleased to announce that now monitors 50 plus hospitals Ontario region.

We are pleased to announce that now monitors 100 plus hospitals Ontario region.

Labour Canada has fully “acknowledged” the scope of work provided in the semiannual inspection program. In addition, the written documentation contributes greatly to the hospital accreditation programs.

Labour Canada has “acknowledged” the scope work provided in the semiannual inspection program. In addition, the written documentation contributes greatly to the hospital accreditation programs.

Further we are always pooling the knowledge resources of Infection Control and Engineering Groups like CHES, the ventilation inspection program is in a evolution to meet future healthcare needs for patients and staff.

Further we are always pooling the knowledge resources Infection Control and Engineering Groups like CHES, the v inspection program is in evolution to meet future healthcare patients and staff.

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and inspection of the hospital building audit this year. Some of u have already taken advantage f our new software program which in conjunction with our patented robotics, allows us to minimize ceiling access requirements.

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