CHF Summer 2021 by MediaEdge

Canadian

HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY

Volume 41 Issue 2

Summer/Été 2021

SYSTEMS INTEGRATION

PM#40063056

Norwood redevelopment team looks to outside expertise for complicated project

A lesson in air duct leakage The impact of COVID-19 on CHES Commissioning puts hospitals to the test

* Results reflect the opinions of more than 300 engineers polled in a recent Webcast exit survey.

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

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

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CONTENTS

CANADIAN HEALTHCARE FACILITIES Volume 41

Issue 3

Clare Tattersall claret@mediaedge.ca EDITOR/RÉDACTRICE

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

Kevin Brown kevinb@mediaedge.ca

SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR

Annette Carlucci annettec@mediaedge.ca

GRAPHIC DESIGNER/ GRAPHISTE

Thuy Huynh roxyh@mediaedge.ca

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

DEPARTMENTS

INNOVATION & TECHNOLOGY

6 8

48 Strategic Alliances Systems integrator important part of Norwood redevelopment

Editor’s Note President’s Message

10 Chapter Reports 16 CHES Year in Review 24 SCISS Année Passée en Revue

FEATURE SERIES

50 Hospitals Under Siege Cybersecurity protects Canada’s health system from attacks 54 The Paper Chase Digitizing old engineering drawings frees up storage, saves valuable time and improves safety

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

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

PRESIDENT VICE-PRESIDENT PAST PRESIDENT TREASURER SECRETARY EXECUTIVE DIRECTOR

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

CHAPTER CHAIRS

36 The Air Up There Effects of ductwork leakage on HVAC systems

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

40 IAQ and COVID-19 The healthcare industry’s challenge to understand air filters 44 Commissioning for Patient Experience Understanding the key issues

FOUNDING MEMBERS

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

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

Chinook Regional Hospital Redevelopment and Expansion | Lethbridge

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EDITOR'S NOTE

LIVING IN LIMBO SUMMER IS IN FULL SWING and the country is in various stages of reopening. As a fully vaxxed citizen, I’ve enjoyed dining on a patio — something I hadn’t done in almost two years — and taking day trips to escape city living, though I remain cautious as my kids are too young to be vaccinated. With some provinces (surprisingly) ending pandemic rules and COVID cases once again ticking upwards, I’m concerned about the imminent fourth wave and what that will mean for society. After perhaps naively believing the last wave was behind us, our lives are thrown back into limbo. What fall will look like is unknown. Given the unpredictability of the virus, CHES had the foresight late last year to move the 2021 CHES National Conference to a virtual format. This is just one of many decisions the society’s national executive has made over the past 16 months in response to the pandemic. The same can be said for the chapters. In an effort to provide transparency, we sought to discover the thought process behind key decisions, as well as how CHES National and each chapter has been impacted by the pandemic. The information gleaned, which can be read beginning on page 16, also offers learning opportunities and aims to create a feeling of connectedness among CHES members across the country. From here, we turn to our feature series that’s based on the theme of this year’s CHES national conference, Enriching the Patient Experience by Optimizing the Environment. Our first two articles deal with air, specifically the effects of ductwork leakage on HVAC systems and the healthcare industry’s challenge to understand air filters. To close this section is an article on building commissioning, which authors Craig Doerksen and Bill Algeo will discuss in even greater detail during their session, How the Commissioning Process Ensures and Enhances the Patient Experience, at the 2021 CHES National (Virtual) Conference. Rounding out this issue, we explore innovation and technology. Topics include systems integration (as featured on the cover), cybersecurity and digitizing old engineering drawings. We are always looking for contributing writers. If interested in penning an article on a particular topic, please contact me.

Clare Tattersall claret@mediaedge.ca

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

6 CANADIAN HEALTHCARE FACILITIES

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

PRESIDENT'S MESSAGE

BUILDING ON SMALL SUCCESSES NOW THAT WE HAVE LIVED through more than 16 months of this pandemic, it’s worth taking time to reflect on what has transpired, including the good work and gains these last few months. After approximately three years of back and forth, CHES and the Canada Revenue Agency (CRA) have agreed on the appropriate CRA organizational category for CHES to be registered under. CHES and the CSA Group still have no formal contract in place regarding our membership’s access to CSA healthcare standards. However, both parties have agreed that until CSA plans to discontinue the current offering of unlimited access, there is no urgency to finalize this contract. The CSA’s qualified medical gas operator training course has been available online for some time. I am pleased to report a number of people have signed up and completed the new course. None too soon as well. COVID-19’s impact on the provision of safe and reliable medical gases has been far-reaching. I encourage you to take advantage of this qualified operator course as part of your ability to manage this pandemic. Financially, CHES remains on budget, albeit a modest one. We continue to manage the balance of investments versus holding cash to ensure we are properly covered operationally, but not at the determent of long-term stability. I have no doubt CHES will be fine. The 2021 CHES National (Virtual) Conference will take place Sept. 28-29. Given we had no experience in pulling off a virtual event a year ago, nor was this a consideration at the time, the planning committee has done extremely well. I’d like to thank Craig Doerksen and his team for taking a ‘blank sheet of paper’ and assembling our first-ever virtual conference, which is shaping up to be a noteworthy event. I strongly encourage everyone to attend since you can do so from anywhere. We’re just a little over a year out from the 2022 International Federation of Healthcare Engineering (IFHE) Congress, which will be held in tandem with our national conference. Jim McArthur and his international planning group are now ramping up their activity for what we expect to be CHES and IHFE’s first in-person conference in more than two years. It’s a difficult task to plan for an event when you’re not sure where the world will be with COVID in a year’s time, but I remain hopeful. All in all, it’s been a ‘fruitful’ few months given the foreboding environment we faced not long ago. We’re not done yet; however, the light at the end of the tunnel is shining even brighter than it was in spring.

Roger Holliss CHES National president

EARN CONTINUING EDUCATION CREDITS FROM CHES Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Summer 2021 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/FKKYQCJ to take the quiz. CHES members who pass the quiz will be able to claim one contact hour (0.1 CEU) on their CanHCC or CCHFM certificate renewals.

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CHAPTER REPORTS

CHAPITRE DU QUEBEC

QUEBEC CHAPTER

L’été a entraîné une diminution des cas de COVID dans la province et la possibilité de passer plus de temps à l’extérieur. C’est un soulagement après un hiver froid et lourd de restrictions en matière de santé publique. La section a choisi d’offrir un nouveau modèle de conférence qui permet aux participants de prendre le temps de discuter ou de faire des commentaires sur un sujet précis. Le format consiste en une petite présentation sur un sujet précis suivie d’une période de questions préparée par notre panel technique. Grâce aux outils virtuels, nous avons réussi à réduire les frais de participation et à mettre en relation un plus grand nombre de personnes. Récemment, nous avons tenu une conférence spécifiquement axée sur le thème des échangeurs de chaleur. Les hôpitaux du Québec en sont remplis, mais la détermination du meilleur entretien pour un fonctionnement optimal reste floue. La Conférence Nationale 2021 de la SCISS se tiendra cette année de façon virtuelle en raison de la pandémie. J’encourage tout le monde à participer à l’événement, qui aura lieu les 28 et 29 septembre, d’autant plus qu’il est axé sur l’enrichissement de l’expérience du patient. Pour vous tenir au courant, suivez-nous sur les médias sociaux et consultez régulièrement la page de la section québécoise du site web de la SCISS.

Summer has brought with it lower COVID cases in the province with the ability to spend more time outdoors. It is a relief after a cold winter heavy with public health restrictions. The chapter has opted to offer a new conference model that enables participants to take time to discuss or comment on a specific topic. The format consists of a small presentation on a certain subject followed by a question period prepared by our technical panel. Using virtual tools, we have succeeded in lowering the fees to participate and connect more people. Recently, we held a conference specifically geared to the topic of heat exchangers. Quebec’s hospitals are full of them but ensuring best maintenance for optimal operation remains unclear. The 2021 CHES National Conference will be held virtually this year due to the pandemic. I encourage everyone to take part in the event, Sept. 28-29, especially given its focus is enriching the patient experience. To keep up-to-date, follow us on social media and regularly check the Quebec chapter page of the CHES website.

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

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BRITISH COLUMBIA CHAPTER We had a successful week of education webinars from May 31-June 4, in place of our annual spring conference. It started off with a keynote address from Dr. Marietta Van Den Berg who provided insight about how to focus on ourselves and put our daily stresses aside, even for just a moment. This was followed with a session each day based around the theme, The Physical Environment: Creating Patient-focused Facilities. I’d like to thank Sarah Thorn and the conference planning committee for the time and work they put into this education event. I encourage everyone to visit the B.C. Chapter section on the CHES website to access the presentations, find out who won our daily draws and see our exhibitors and all they have to offer. With current health restrictions lifting, the chapter executive is looking forward to the possibility of hosting an in-person conference next year in Whistler. The chapter held its second Zoom annual general meeting on June 7, with 25 members present. With the current executive committee entering its last year of service, we will soon be looking for nominations for the positions of secretary, treasurer and vice-chair. An e-blast will be sent to CHES B.C. members providing nomination information and dates. CHES has been a stable and supporting organization in a year of challenges and changes to healthcare practices as a result of the pandemic. A huge thank you to all CHES members and leaders across Canada for sharing information and lessons learned. This support will take us forward as we face our future in healthcare service. —Norbert Fischer, British Columbia chapter chair

10 CANADIAN HEALTHCARE FACILITIES

CHAPTER REPORTS

MANITOBA CHAPTER

NEWFOUNDLAND & LABRADOR CHAPTER

With the chapter’s virtual conference now behind us, we are looking forward to next year’s in-person event, May 16-17, at the Victoria Inn Hotel and Convention Centre in Winnipeg. More information to follow as planning for 2022 proceeds. I’d like to thank everyone who attended this year’s virtual event as we managed to gain a few more members for CHES Manitoba. The chapter executive has decided to hold off on awarding this year’s Facilities Management Award of Excellence and Project Management Award of Excellence due to COVID. We plan to move forward with these awards in 2022, as we anticipate being able to host an in-person conference. Past chapter chair Tom Still retired at the end of June. Tom has been instrumental in helping move the chapter forward since becoming a member in 2007, and serving on the executive committee from 2010 until his retirement. In addition to this, Tom was the chapter representative on the CHES National professional development committee, Canadian Certified Healthcare Facility Manager (CCHFM) advisory committee and Red River College power engineering advisory committee, as well as the college’s student liaison. Tom’s leadership and attention to detail will be missed greatly. The chapter executive is still looking to fill the secretary position. I encourage all Manitoba members who have never served on the executive committee to consider joining. I’m excited to share that the CHES Manitoba-supported Red River College/Building Efficiency Technology Access Centre proposal to develop a building performance evaluation tool for assessing the design and performance of both existing and new long-term care facilities has been approved for funding. The chapter will continue to support the study by working with longterm care facilities to help develop the building performance evaluation. Once the study is complete, it will be made available to all CHES members across the country. The chapter plans to feature this work at the beginning of the study and at its conclusion in the CHES journal, Canadian Healthcare Facilities. I want to encourage all Manitoba chapter members to register for the 2021 CHES National (Virtual) Conference. You can do so online through the CHES website. This is a fantastic opportunity to attend the conference without having to travel.

It’s a different year to say the least. Not only are we still working through a worldwide pandemic but the weather has been all over the place — 30 C one day, 3 C with snow the next during the first week of June — water levels have been extremely low for the time of year and fewer icebergs paint our shorelines. The pandemic has required organizations to adapt processes and rethink approaches to the way they operate and do business. The chapter has cancelled all in-person conferences but is working toward more strategic electronic communications as a means of staying connected, which has been challenging, and updating members of the latest CHES news. The chapter exprienced an approximately 30 per cent decrease in membership between March 2020 and March 2021, triggered by COVID and supplemented by tough fiscal constraints placed on health authorities. The province depends significantly on revenues from the oil and gas industry, so the unexpected decline has delivered a major blow. Less revenue means tighter measures. This has made it challenging for members to have their memberships renewed. The executive team continues to meet virtually on a regular basis. We are sitting in a solid financial position. The chapter is committed to members’ professional growth. CHES Newfoundland and Labrador will sponsor each of our paid members to attend the 2021 CHES National (Virtual) Conference. This will provide education opportunities and allow members to reconnect with peers from across the country.

—Reynold J. Peters, Manitoba chapter chair

Next year's joint International Federation of Hospital Engineering Congress and CHES National Conference will take place Sept. 17-21, in Toronto.

—Colin Marsh, Newfoundland & Labrador chapter chair

ONTARIO CHAPTER With in-person events still on hold, the Ontario chapter held its 2021 annually general meeting virtually on June 9, with 20 members present. All executive members in attendance provided their reports. Thank you to everyone who attended, Donna Dennison and events management for managing and recording this meeting. Although we had entertained the possibility of a fall chapter conference earlier in the year, we decided to postpone again due to the uncertainty of public gatherings. If things open up as anticipated, we will look at organizing a fall education day. While it’s now consecutive years with no major revenue for the chapter, we are still in reasonably good financial shape to continue weathering this storm. We continue to plan for the 2022 International Federation of Hospital Engineering (IFHE) Congress in Toronto. The subcommittees are busy with their various tasks and everything is coming together nicely for what should be an excellent conference. Many thanks to all who are volunteering their time on these committees. The 2021 CHES National (Virtual) Conference will take place Sept. 28-29. I encourage all CHES members to register for this event. I would also like to congratulate the other chapters who have organized virtual conferences for this year.

—Jim McArthur, Ontario chapter chair SUMMER/ÉTÉ 2021 11

MARITIME CHAPTER With the Atlantic bubble reopening, we are now planning for this year’s fall education day, which will be held at the Best Western Glengarry in Truro, N.S., in November. All Maritime CHES members and non-CHES frontline maintenance workers in healthcare and long-term care are welcome to register. The Maritime chapter offered members a discounted rate on the 2021 CHES National (Virtual) Conference to encourage participation. If registered by July 31, it only cost $62.50. The regular registration fee is $195, so that amounted to a savings of $132.50! The conference features a keynote presentation, two plenary sessions and a variety of educational programs. You can educate yourself on the latest technologies, procedures and services by attending the conference virtually from any location. The Maritime chapter’s next spring conference is scheduled to be held May 1-3, 2022, at the Delta hotel in Moncton, N.B. Planning is well underway. CHES Maritime is pleased to offer the Per Paasche bursary again this year. The $1,000 grant is open to all immediate family members (daughters, sons, grandchildren, nieces, nephews, spouse) of Maritime chapter members who are in good standing. The eligible person must be enrolled in a recognized educational program at a post-secondary education institution, such as a trade/vocational school, college or university. Although any career path is acceptable, preference is given to programs that could be supportive of a future career in healthcare facilities management, maintenance, operations and support. The chapter is able to balance its books while offering several financial incentives to its members in the way of student bursaries, contributions to Canadian Certified Healthcare Facility Manager (CCHFM) exam fees, webinars, the fall education day and other rebates. —Helen Comeau, Maritime chapter chair

ALBERTA CHAPTER This year, CHES Alberta held its annual general meeting virtually on April 30. I’d like to congratulate and thank the following for accepting roles on the chapter executive: Paul Teterenko (treasurer), David Attwood (secretary), James Prince (vice-chair) and Dan Ballantine (past chair). I’d also like to thank Liana Sousa for all the time and effort she put into helping CHES Alberta. You will be missed but not forgotten. I hope everyone is able to set some time aside this summer to allow for much needed rest and relaxation. It is well-deserved. The first few weeks were hot for us Albertans, and we spent much time trying to stay cool. (Anything over 25 C tends to slow us down a bit.) I am looking forward to the 2021 CHES National (Virtual) Conference, which will take place Sept. 28-29, and hope you are, too. It’s always a great opportunity to reconnect, meet new people and take advantage of some exceptional learning opportunities. —Mike Linn, Alberta chapter chair 12 CANADIAN HEALTHCARE FACILITIES

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SCISS ANNÉE PASSÉE EN REVUE

LA SOCIÉTÉ CANADIENNE d’Ingénierie des Soins de Santé (SCISS), comme la plupart des associations, a dû faire face à des changements rendus nécessaires par la COVID-19. Au cours des 16 derniers mois, tant le comité national que les sections individuelles ont régulièrement repensé et ajusté leurs approches quant à la manière de mener leurs activités et d’interagir dans ces circonstances exceptionnelles. La fluidité de la crise de santé publique a nécessité une certaine flexibilité, les décisions prises et les stratégies adoptées dépendant souvent de l’emplacement géographique et de leur situation pandémique respective. Dans un effort de transparence, de possibilités d’apprentissage et de création de liens, voici ce que la SCISS Nationale et chaque section ont dit sur l’adaptation pendant la pandémie. Les réponses ont été fournies par questionnaire par Roger Holliss (SCISS Nationale), Colin Marsh (Terre-Neuve et Labrador), Helen Comeau (Martimes), Jim McArthur (Ontario), Mohamed Merheb (Québec), Reynold Peters (Manitoba), Jim Allen (Saskatchewan), Mike Linn (Alberta) and Norbert Fischer (Colombie Britannique). 24 CANADIAN HEALTHCARE FACILITIES

SCISS NATIONALE Connectivité L’augmentation des réunions virtuelles par le biais de

Zoom est maintenant devenue le moyen par défaut pour traiter ne serait-ce qu’avec quelques personnes. Santé Financière Il y a plusieurs années, l’équipe de direction de la SCISS a eu la prévoyance de s’assurer que nous disposions de suffisamment d’actifs dans lesquels nous pourrions puiser en cas de ‘jours de pluie.’ Or, il pleut des cordes en ce moment. Nous avons modifié notre approche fiscale tout au long de nos budgets d’exploitation afin d’être un peu plus conservateurs, mais pas au détriment de notre mission qui est d’améliorer la capacité de nos membres à fournir des environnements de soins de santé efficaces et efficients. Nous continuons également à planifier le budget et les actifs sur trois ans, en privilégiant le conservatisme. Par conséquent, nous savons que nous pourrons facilement traverser les trois prochaines années, si nous continuons à gérer nos dépenses et nos actifs de manière responsable. Adhésion La SCISS a vu ses effectifs diminuer d’un peu plus de 12% entre mars 2020 et mars 2021, passant de 1,022 à 897 membres. L’association a perdu plus de membres associés (73)

SCISS ANNÉE PASSÉE EN REVUE

que de membres réguliers (62), ce qui représente environ 17% et 11% des pertes totales de membres, respectivement. La diminution globale peut être attribuée aux membres qui ont oublié de renouveler leur adhésion ou qui n’ont pas eu l’occasion de le faire; cependant, les données sont incomplètes. En outre, un certain nombre de personnes s’inscrivent souvent à la SCISS dans le cadre de leur inscription à divers événements en personne. Par conséquent, l’annulation de la Conférence Nationale 2020 de la SCISS, ainsi que des conférences provinciales de cette année et de l’année dernière, a entraîné la perte d’opportunités d’adhésion. La SCISS est engagée dans divers programmes de sensibilisation allant des rappels par courriel et des envois postaux au comité consultatif d’entreprise contactant directement les pairs. Les appels téléphoniques ont souvent le plus grand succès, mais ils prennent beaucoup de temps. 2020 Conférence Nationale de la SCISS Les doutes et les discussions subséquentes sur ce qu’il faut faire au sujet de la Conférence Nationale 2020 de la SCISS ont commencé en mars 2020. Il s’agissait de faire preuve de diligence raisonnable quant à nos options, y compris toute obligation contractuelle déjà en place. Même le moment de l’annulation potentielle a dû être pris en compte, car tout le monde dans le monde de la conférence a appris les nuances juridiques du terme ‘force majeure.’ La décision d’annuler a été prise en avril 2020, par une très petite poignée de personnes clés, puis rapidement diffusée aux personnes concernées peu après. Le temps de préparation limité pour assembler un équivalent virtuel, le manque total d’expérience sur la façon d’accueillir un événement virtuel et l’impact de la première vague de COVID, dans laquelle nous étions encore, ont rendu la décision de renoncer à tout événement 2020 réellement facile. 2021 Conférence Nationale de la SCISS L’incapacité de générer une prévision stable et fiable pour septembre 2021 du point de vue du COVID signifiait que la SCISS ne pouvait pas justifier les coûts initiaux élevés nécessaires pour s’engager dans un événement en personne. La réduction des effectifs a été envisagée, mais immédiatement rejetée. Les engagements contractuels initiaux en matière d’hôtels et de conférences concernant les minimums garantis présentaient un risque financier beaucoup trop élevé étant donné la difficulté d’estimer les recettes compensatoires provenant de la participation des délégués et du soutien des commanditaires. Un événement hybride n’était pas non plus envisageable, car il est beaucoup plus coûteux qu’un événement virtuel ou en personne. La décision de passer à un événement virtuel a été prise fin 2020. C’est historiquement tard, mais nous avons gardé l’espoir d’un événement en personne aussi longtemps qu’il était raisonnablement possible. En même temps, nous avons reconnu que nous devions être décisifs pour donner suffisamment de temps au comité de planification de la conférence pour se réunir et commencer la courbe d’apprentissage abrupte sur la façon d’organiser et d’accueillir une conférence virtuelle.

2022 Congrès de l’IFHE La SCISS ne prévoit pas pour l’instant de réduire ou d’accueillir un autre type d’événement pour le congrès conjoint de l’International Federation of Healthcare Engineering et la Conférence Nationale de la SCISS en 2022. L’approche de la SCISS aujourd’hui est de présenter le Canada, nos processus et nos approches en matière de soins de santé au monde entier en personne, bien que cela doive être fait d’une manière fiscalement responsable. Quant à savoir si cette conférence nécessitera des modifications à notre offre traditionnelle, elle est continuellement scrutée puisque cela dépend de l’état d’avancement du monde avec la COVID. Cependant, comme c’était le cas pour la conférence nationale de 2021, un événement hybride ne sera probablement pas organisé. L’inconvénient financier est aggravé par le fait que nous pensons que la participation en personne diminuerait probablement lors d’un événement hybride, ce qui entraînerait une baisse des revenus puisque le parrainage en pâtirait également. Valeur Ajoutée Pour améliorer l’expérience des membres existants, la SCISS a augmenté le nombre de ses webinaires sans frais supplémentaires. Cette situation va se poursuivre dans un avenir prévisible. Nous avons également créé une échelle de tarifs unique pour la Conférence Nationale de la SCISS de 2021. Un groupe de cinq personnes bénéficie d’une réduction de $45 par inscription. La réduction passe à $70 par personne avec l’inscription d’un groupe de 10 personnes. La structure tarifaire a également été modifiée pour les commanditaires afin de refléter le passage à un format d’événement virtuel.

CHAPITRE DU TERRE-NEUVE ET LABRADOR Connectivité L’exécutif de la section est resté connecté par le biais de Microsoft Teams et continue à tenir des réunions sur une base régulière. Cependant, la connectivité avec les membres a été difficile et les médias sociaux ne nous ont pas aidés à cet égard. Nous travaillons actuellement à l’élaboration de méthodes de communication électronique plus stratégiques afin de rester en contact et de tenir nos membres informés des dernières nouvelles de la SCISS. Santé Financière La section est en bonne santé financière. Adhésion La pandémie n’a fait qu’ajouter à une situation déjà bien sombre. Avant la COVID, nous connaissions une lente diminution du nombre de nos membres, qui serait le résultat de contraintes fiscales plus strictes imposées aux autorités sanitaires. La province dépend fortement des revenus de l’industrie pétrolière et gazière, qui ont considérablement diminué depuis la COVID. Les soins de santé étant le principal prélèvement sur le budget provincial, les dépenses ont été réduites. Cela a restreint les fonds alloués par les employeurs pour payer l’adhésion et la participation aux comités. Rien que l’année dernière, les effectifs ont diminué d’un peu plus SUMMER/ÉTÉ 2021 25

SCISS ANNÉE PASSÉE EN REVUE

de 32% entre mars 2020 et mars 2021. Le déclin des effectifs était encore plus important avant la pandémie. Entre mars 2019 et mars 2020, il a plongé de près de 36%. La section prépare une stratégie de communication pour maintenir activement les membres existants dans la boucle et leur rappeler ce que la SCISS a à offrir afin d’éviter de nouvelles pertes. Nous nous demandons quelle pourrait être la meilleure approche pour faire revenir les anciens membres. 2021 Conférence Provinciale L’annulation a été motivée par l’état de la pandémie dans la province et par le respect des directives de santé publique. Le personnel a également été extrêmement occupé à mettre en place des centres d’écouvillonnage et de dépistage dans chaque région de l’autorité sanitaire, de sorte que nous avons estimé qu’il serait difficile pour la plupart d’entre eux de participer de toute façon. Le temps nous a empêchés d’organiser un autre type d’événement, comme une conférence virtuelle, avec un minimum de personnes pour aider à la planification. Nous sommes une petite section dont la majorité des membres se trouvent dans la plus grande région de l’autorité sanitaire et sont les plus impliqués dans la mise en œuvre des plans d’action COVID. 2022 Conférence Provinciale Nous espérons revenir à notre événement en personne. Valeur Ajoutée La section parraine la participation de tous les membres actifs à la Conférence Nationale (Virtuelle) de 2021 de la SCISS.

CHAPITRE DES MARITIMES Connectivité Avec la suspension indéfinie de la bulle atlantique à la fin novembre, qui a restreint les déplacements entre les provinces maritimes, l’exécutif de la section s’est appuyé sur des réunions virtuelles pour rester en contact. En ce qui concerne nos membres, les informations fournies par notre envoi de courriel ont maintenu la connectivité. Nous n’avons pas adopté les médias sociaux pour communiquer avec les membres. Santé Financière La section est dans la même situation financière qu’avant la pandémie. Adhésion Nous avons connu une baisse de près de 11% des adhésions entre mars 2020 et mars 2021, passant de 130 à 116, étant donné que tout le monde a été tellement concentré sur les questions de pandémie au sein de leurs installations. 2021 Conférence Nationale de la SCISS Malheureusement, en raison de la pandémie, la Conférence Nationale de la SCISS a été annulée en 2020, puis est passée à un format virtuel pour 2021. Ces deux années, la section des Maritimes devait accueillir l’événement à Halifax. (Voir SCISS Nationale pour plus de détails sur le raisonnement et le processus d’annulation). Journée de Formation d’Automne Nous prévoyons actuellement d’organiser une journée de formation en novembre. Elle se tiendra en personne au Glengarry Best Western à Truro, en Nouvelle-Écosse. 26 CANADIAN HEALTHCARE FACILITIES

2022 Conférence Provinciale La planification de la conférence

du printemps prochain va bon train. Elle se tiendra du 1 au 3 mai à l’hôtel Delta de Moncton, N.B. Valeur Ajoutée La section des Maritimes offre aux membres un rabais important sur la Conférence Nationale (Virtuelle) de 2021 de la SCISS. Ceux qui s’inscrivent avant le 31 juillet ne paieront que $62.50. Cela représente moins d’un tiers des frais d’inscription habituels de $195.

CHAPITRE DE L’ONTARIO Connectivité L’exécutif de la section a

toujours communiqué par courriel et a mené la plupart des réunions de l’exécutif par Zoom, donc peu de choses ont changé à cet égard. La plus grande adaptation a été la tenue virtuelle de notre assemblée générale annuelle en 2020 et 2021. Elle a toujours été tenue en personne lors de la conférence de notre section, mais, bien sûr, elle a été annulée les deux années en raison de la pandémie. Santé Financière La section est en bonne situation financière grâce aux anciens dirigeants qui ont fait preuve de prudence en mettant de l’argent de côté pour les mauvais jours. En ce moment, c’est la mousson. Nos finances actuelles nous permettront de poursuivre nos activités dans un avenir prévisible et nous nous remettrons de ce contretemps dès que nous pourrons à nouveau organiser des conférences en personne. Ceci étant dit, en raison de l’annulation de nos conférences de chapitre 2020 et 2021, nous avons perdu notre principale source de revenus pour ces deux années. La section de l’Ontario accueillera également la Conférence Nationale de la SCISS de 2022, en même temps que le congrès de l’International Federation of Healthcare Engineering (IFHE), mais la rentabilité demeure incertaine. Compte tenu de ces facteurs, nous sommes attentifs à nos fonds existants et prudents en matière de dépenses, bien que nous ayons accepté de parrainer un candidat admissible par le biais de la bourse pour jeunes professionnels de la SCISS. Le candidat qui n’est pas actuellement membre, mais qui travaille dans un établissement de santé depuis moins de cinq ans bénéficie d’une inscription gratuite à la Conférence Nationale (Virtuelle) de la SCISS de 2021, ainsi que d’une adhésion pour le reste de l’année fiscale en cours. Adhésion Nous avons perdu seulement 12 membres entre mars 2020 et mars 2021, ce qui représente une baisse de près de quatre pour cent. Certains n’ont pas encore renouvelé leur adhésion et nous les contactons. Il est possible que les membres ne voient pas l’intérêt des conférences en personne. Cependant, si vous considérez les nombreux avantages de l’adhésion, y compris les offres de webinaires, qui ont augmenté sans coût supplémentaire, et l’accès gratuit aux normes de soins de santé de la CSA, cela vaut bien le prix de faire partie de la SCISS. Nous recherchons activement de nouveaux membres

SCISS ANNÉE PASSÉE EN REVUE

et avons contacté les associations de soins de longue durée pour encourager leurs établissements à s’inscrire en tant que membres de la SCISS. Nous avons connu un certain succès avec cet exercice. 2021 Conférence Provinciale Il est devenu évident au début du mois de janvier que l’événement en personne qui devait avoir lieu à Niagara Falls en mai ne serait pas possible. Nous l’avions provisoirement reprogrammé pour le début du mois d’octobre. Toutefois, le temps passant et la pandémie s’aggravant, nous avons dû prendre la décision de mettre fin à toute conférence en personne. Un événement hybride n’a jamais été envisagé. En ce qui concerne l’événement virtuel, nous ne voulions pas entrer en concurrence avec la SCISS Nationale pour les commanditaires et les participants. Nous encourageons plutôt nos membres à s’inscrire à la conférence nationale. Journée de Formation d’Automne Si l’Ontario continue sur la voie de la réouverture et que nous sommes autorisés à accueillir 30 à 40 personnes à l’intérieur, nous pourrions proposer un événement éducatif d’une journée en novembre ou décembre. 2023 Conférence Provinciale Avec le Congrès de l’IFHE qui aura lieu l’année prochaine à Toronto, notre prochaine conférence de section aura lieu en mai 2023, à Windsor. Nous espérons que la vie reprendra son cours normal et que la conférence se déroulera uniquement en personne.

CHAPITRE DU QUÉBEC Connectivité Les réunions virtuelles ont aidé

les membres de l’exécutif de la section à rester en contact les uns avec les autres et se sont avérées plus faciles à gérer puisque nous pouvons organiser des ‘réunions’ à tout moment. La technologie a également permis de rester en contact avec les membres et de toucher davantage de personnes, compte tenu de la taille de la province. Pour ces raisons, nous continuerons à utiliser des outils virtuels. Les médias sociaux se sont également révélés être un outil puissant. La page LinkedIn da SCISS Nationale a été particulièrement utile pour diffuser des informations afin de maintenir nos membres à jour. Santé Financière Bien que la section soit jeune, elle est en bonne santé financière. Nous n’avons pas de dettes et nous disposons d’une trésorerie positive en ce qui concerne les événements prévus. Ces fonds seront utilisés pour augmenter nos offres et attirer plus de membres. Adhésion Bien qu’il s’agisse d’une petite section, l’adhésion est restée stable non seulement pendant la pandémie, mais aussi au cours des deux dernières années. Le fait de pouvoir offrir des possibilités d’apprentissage axées sur la lutte contre la COVID a permis de mieux faire connaître la SCISS dans la province, en particulier dans le secteur des soins de santé. La SCISS s’est avérée extrêmement utile au fil des ans, car les membres de tout le pays communiquent entre eux sur divers sujets. Le domaine des soins de santé présente de nombreux défis et la

meilleure façon de les surmonter est de les affronter en groupe, c’est pourquoi nous nous efforçons d’établir un rapport officiel avec les autorités de santé publique. Cela nous aidera à établir une ligne directe avec tous les hôpitaux de la province. Formation Comme la section est encore jeune et que nous devons augmenter le nombre de nos membres, nous n’avons pas de conférence ou de journée dédiée à la formation. Au lieu de cela, nous avons choisi d’organiser plusieurs petits événements sur des sujets sensibles liés aux soins de santé. Ainsi, les membres bénéficient d’une expérience plus concrète. Une conférence à l’échelle de la province sera envisagée une fois que nous aurons recruté assez de membres. Valeur aAoutée Nous offrons des tarifs très compétitifs à nos membres pour participer aux événements.

CHAPITRE DU MANITOBA Connectivité L’exécutif de la section est resté

connecté grâce à l’utilisation de Microsoft Teams, lorsque cela était nécessaire. Les médias sociaux ne sont pas utilisés actuellement pour diffuser des informations aux membres. Santé Financière La section est en bonne santé financière. Adhésion La section du Manitoba n’a connu aucune baisse d’adhésion entre mars 2020 et mars 2021. Elle a conservé ses 72 membres. Il s’agit d’une bonne nouvelle, compte tenu de nos efforts de recrutement considérables. Avant la pandémie, de mars 2019 à mars 2020, nos effectifs ont augmenté de près de 24%. 2021 Conférence Provinciale En novembre 2020, le chapitre a opté pour une conférence virtuelle, au lieu d’un événement présentiel. Étant donné qu’il s’agissait d’une première pour nous, ce fut un grand défi à bien des égards et cela a nécessité un marketing créatif pour inciter les gens à participer. La conférence s’est déroulée sur quatre jours, les 27 et 28 avril de même que les 4 et 5 mai. Les sessions de formation de chaque jour tournaient autour du thème, Construction et Rénovation dans les Établissements de Santé, et se déroulaient entre 11 heures 30 et 13 heure. Au dire de tous, ce fut un succès et nous avons gagné 15 nouveaux membres. 2022 Conférence Provinciale Nous prévoyons de tenir notre prochaine conférence de section en personne, si cela est autorisé.

CHAPITRE DE LA SASKATCHEWAN Connectivité Les réunions de l’exécutif se sont tenues

virtuellement, lorsque cela était possible, mais la section a eu du mal à rester active et un travail minimal a été effectué. De nombreux membres ont été accaparés par le travail de soutien aux soins de santé pendant cette période sans précédent, avec peu de temps à consacrer. Nous n’avons pas utilisé les médias sociaux pour maintenir la connectivité, bien qu’il s’agisse probablement d’un bon forum pour y parvenir. SUMMER/ÉTÉ 2021 27

SCISS ANNÉE PASSÉE EN REVUE

Santé Financière La section a des avoirs financiers importants.

CHAPITRE DE LA COLOMBIE-BRITANNIQUE

Nous étions en bonne forme avant la conférence annuelle très réussie de 2019, et nous avons eu peu de dépenses depuis. Adhésion La section a perdu cinq membres, soit environ 16%, passant de 35 à 30 entre mars 2020 et mars 2021. Nous avons constaté une baisse constante depuis que nous avons accueilli la Conférence Nationale de la SCISS 2019 à Saskatoon. Les membres renouvellent généralement leur adhésion à l’occasion de notre conférence annuelle. Étant donné que nous n’avons pas organisé d’événement depuis la période précédant la pandémie, cela a très probablement contribué à la baisse de nos effectifs. Nous n’avons pas encore développé de stratégie pour augmenter activement le nombre de nos membres. Pour cette raison, il est important que les membres existants soutiennent l’organisation en s’impliquant. 2021 Conférence Provinciale Après l’annulation de la conférence provinciale de l’an dernier, qui devait se tenir en octobre, l’exécutif de la section envisage de tenir une journée virtuelle de l’éducation cet automne. Bien qu’aucune date n’ait été fixée, nous avons contacté quelques orateurs potentiels pour évaluer leur intérêt. 2022 Conférence Provinciale Nous espérons revenir à un format de conférence en personne. Valeur Ajoutée L’équipe de direction envisage de soutenir la participation à la Conférence Nationale (Virtuelle) de la SCISS en 2021.

Connectivité Nous nous sommes réunis régulièrement pour nos réunions de direction et en tant que comité de planification de conférence. À une occasion, nous avons eu l’opportunité de nous rencontrer en face à face, car les déplacements non essentiels étaient autorisés à ce moment-là; sinon, les réunions se sont déroulées par le biais d’appels vidéo. Les médias sociaux ont joué un rôle limité pour rester en contact avec les membres. Nous avons eu quelques communications via le compte LinkedIn de la SCISS Nationale, mais nous comprenons que les membres des sections peuvent passer un temps limité sur cette plateforme de médias sociaux. La plupart de nos communications se font par le biais de courriels et de bulletins électroniques. Santé Financière La section est en bonne santé financière. Adhésion Nous avons enregistré une réduction de 15% de nos effectifs entre mars 2020 et mars 2021, passant de 234 à un peu moins de 200 membres. Nous pensons que cela est dû en grande partie au fait que nous n’avons pas été en mesure de nous réunir en personne dans le cadre d’une conférence, tant au niveau provincial que national, depuis le début de la pandémie. Dans le but d’accroître la visibilité de la SCISS, nous avons ouvert gratuitement le forum virtuel sur l’éducation d’une semaine aux non-membres, ainsi qu’à tous les membres de la SCISS au Canada. 2021 Conférence Provinciale En novembre 2020, nous avons commencé à discuter de l’annulation de l’événement en personne. Deux mois plus tard, nous avons décidé de déplacer notre conférence annuelle en ligne, de l’alléger et d’en modifier le format pour en faire un forum éducatif d’une semaine, avec un webinaire par jour, sur le thème, L’Environnement Physique: Créer des Installations Axées sur le Patient. La première journée a également été marquée par la présence de la Dre Marietta Van Den Berg comme oratrice principale. 2022 Conférence Provinciale Pour l’instant, nous prévoyons une conférence en face à face à Whistler. Les membres ont fait part de leur impatience de se rencontrer à nouveau en personne. Valeur Ajoutée La section a payé les dépenses liées au forum éducatif virtuel de cette année en guise de remerciement à tous les fournisseurs et exposants qui nous soutiennent et qui luttent contre la pandémie. Nous continuons à offrir gratuitement des bourses d’études, des subventions à l’éducation et la série de webinaires nationaux de la SCISS aux membres de la section de la Colombie-Britannique, ainsi que des tirages de prix pour la participation aux forums sur l’éducation. Nous couvrons les frais de tous les membres de la C.B. qui souhaitent assister à la Conférence Nationale (Virtuelle) de 2021 de la SCISS grâce à nos bourses de formation.

CHAPITRE DE L’ALBERTA Connectivité L’exécutif de la section s’est appuyé sur

des réunions virtuelles pour rester connecté. Santé Financière La section est en bonne santé

financière. Adhésion Nous avons perdu 45 membres entre

mars 2020 et mars 2021, soit une baisse de 28%. Nous avons attribué cette situation à un manque de contacts en face à face dû à l’annulation de notre conférence annuelle ces deux années, à une connaissance limitée de la SCISS et à des personnes qui ont du mal à comprendre la valeur de l’adhésion. 2021 Conférence Provinciale La décision d’annuler la conférence a été prise par l’exécutif de la section au début de 2021, étant donné que les rassemblements en personne et les déplacements non essentiels ont été restreints. La réduction de la taille de l’événement a été initialement envisagée, mais les ordres de santé publique ont limité cette option. Un événement virtuel n’a pas été perçu comme apportant une valeur ajoutée et nous nous attendions à une participation limitée étant donné que tant de personnes ont été fortement impliquées dans la pandémie. Sur le plan logistique, cela aurait également été un défi. 2022 Conférence Provinciale La section prévoit le retour d’un événement en personne. 28 CANADIAN HEALTHCARE FACILITIES

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tueSDAY SepteMBer 28, 2021 10:00-10:05 (CT) Introduction/Welcome 10:05-10:50 (CT) trACK 1: Concurrent tracks 1A, 1B, 1C Track 1A: Building an Improved patient experience Jerald Peters, Architect, AAA, AIBC, MAA, OAA, SAA, FRAIC, LEED AP, Principal, ft3 Architecture Landscape Interior Design, Winnipeg MB At the end of the session, participants will be able to: • Identify the issues related to patient experience that arise most often in our design experience. • Explore the opportunities to change how we design things for improved patient outcomes. • Challenge operational procedures with balancing LEAN processes and patient experience. Track 1B:

Track 1C:

Lessons in relation to o2 from CoVID-19: What did we Learn from the Very High Load Demands? TBA new Construction/renovation and IAQ: Build or Fix it right ... the First time! David Muise, OHST, National Practice Leader, Indoor Environmental Quality, Pinchin LeBlanc

The phasing, sourcing and protection of building materials can have a significant impact on final occupancy conditions in a building. When executed poorly these issues can result in scheduling delays, rework and concerned occupants. Not to mention the potential for cost overruns. At the end of the session, participants will be able to: • Share lessons learned from new construction and renovation projects gone wrong. 10:50-11:00 (CT) transition/Break

11:00-11:50 (CT) trACK 2: KeYnote ADDreSS the Success-energy equation: How to regain Focus, recharge Your Life and really Get Sh!t Done Michelle Cederberg, BA, MA, Certified Exercise Physiologist, Certified Professional Co-Active Life Coach, Author, Live Out Loud, Inc., Calgary AB In an age of disengagement, distraction and fatigue exacerbated by the ongoing pandemic, how we work and live has been tested. We’re busy, stretched and stressed, and as we navigate the constant change and uncertainty of it all, it can feel difficult to stay focused, and do our best work. In this thought-provoking session, Michelle Cederberg shares research from her new book The Success-Energy Equation that will help you regain focus, recharge your life, and move forward with confidence and positivity, even during these challenging times. In this high-energy keynote you will: • Get clear on your own definition of success; what really matters to you in work and life, and what drives you to do what you do — even as we ride out COVID-19. • Look at typical barriers that get in the way of success, and how you can effectively navigate them. • Discover four science-backed variables that contribute to higher levels of goal success and overall well-being and how to make them work for you. • Embrace a simple but powerful habit you must do daily to ensure on-going success with everything you do that’s important to you. Full of hilarious stories, anecdotes, and innovative strategies, you’ll leave this session with a renewed sense that it’s possible to break free from stress and drive your own success, through the pandemic and beyond. That’s successenergy, and it’s a formula worth calculating. 11:50-12:00 (CT) transition/Break

NAtIONAL CONFereNCe 2021 congrès national | September 28-29 2021 septembre | www.ches.org

12:00-12:45 (CT) trACK 3: Concurrent tracks: 3A, 3B, 3C Track 3A: Improving project Delivery in operating Hospitals: Lessons Learned

14:15-15:00 (CT) trACK 5: Concurrent tracks: 5A, 5B, 5C Track 5A: patient experience: How the Commissioning process ensures and enhances the patient experience Craig Doerksen, CCHFM, CFM, CEM, MFM, P.Eng, Shared Health: Health Sciences Centre Winnipeg, Winnipeg MB

TBA At the end of the session, participants will be able to: • Discuss challenges in managing projects in aging hospital facilities while maintaining full operations.

Bill Algeo, Shared Health: Health Sciences Centre Winnipeg, Winnipeg MB

• Review challenges in balancing competing priorities amongst project stakeholders, including project management team, funders, clinical user groups, and contractors.

At the end of the session, participants will be able to:

• Present a robust and dynamic framework for effective and efficient management of redevelopment projects in complex healthcare environments.

• Develop the process scope for commissioning — which systems and elements.

• Discuss processes and tools to manage, monitor and report on project performance. Track 3B:

Critical power upgrades: Building an electrical Substation for the Future

• Understand that commissioning is a process involving the entire project length.

• Discover how to implement a wide sweeping process to enhance the patient experience. • Hear project examples of success (and challenges). Track 5B:

Phillip Chow, Senior Project Manager/Engineer, H.H. Angus & Associates Ltd., Toronto ON At the end of the session, participants will be able to: • Identify innovative design features for the construction of an outdoor electrical substation and planning opportunities that can promote future operability. • Describe how a complicated electrical infrastructure renewal project can be undertaken. • List risk mitigation strategies to ensure critical hospital operations are not impacted.

Steve Dering, MSc, MIFSM, Grad IOSH, ICAC-BE, Direct Access, Cheshire UK At the end of the session, participants will be able to: • Identify barriers common to healthcare premises and action to mitigate impact. • Identify suitable management procedures or minor changes that increase accessibility. • State where to find accessibility solutions. Track 5C:

• Detail infrastructure that can support future campus development, including the development of an on-site microgrid. Track 3C:

HVAC performance optimization for Improved Health outcomes TBA

At the end of the session, participants will be able to: • Understand how CSA Z317.2 and the suite of CSA health care facility standards work cooperatively together. • Learn about the key changes in the fifth edition of CSA Z317.2 and the rationale for the updates. • Understand when HVAC systems should be upgraded based on the intended function of the space after the renovation. • Answer attendee questions on issues and concerns with using CSA Z317.2. 12:45-13:15 (CT) transition/Lunch Break

At the end of this session, participants will be able to: • Better understand contracts and legal rights thereunder.

CSA Z8002.19: AHS’s Journey from Assessment to Implementation Paul Perschon, M. A Leadership B.BA, Alberta Health Services, Calgary AB

At the end of the session, participants will be able to: • Determine the value of the CSA standard for operations. • Understand the evaluation of current state — assessment versus audit — what’s the difference? • Understand engagement strategy — how to involve both frontline and management. • Evaluate the operationalization of plan — areas of focus (COMP, SOPs, inventory management, training and safety). Challenges, benefits, and opportunities of work done to date.

WeDneSDAY SepteMBer 29, 2021 10:00-10:45 (CT) trACK 6: Concurrent Sessions 6A, 6B, 6C TRACK 6A: Leveraging Strategic partnerships to enhance Healthcare through Innovation

13:15-14:00 (CT) trACK 4: plenary Session project Contract Language: Contract Litigation — Shared Liability/responsibility TBA

Designing and retrofitting Health Facilities for Accessibility

Michael Pringle, Senior Business Consultant, P.Eng, Honeywell, Toronto ON David Diamond, Eastern Health, St. John’s, NL At the end of the session, participants will be able to: • Identify opportunities for strategic partnerships and collaboration within your organization.

• Better understand contract clauses like force majeure.

• Identify potential facility and technology solutions that may be applicable within your organization.

14:00-14:15 (CT) transition/Break

• Understand the process to engage in a strategic private partnership. TRACK 6B:

environmental Controls for Hospitals and the Impact on patient Safety Don MacDonald, Northern Regional Manager, Phoenix Controls, Kincardine ON

NAtIONAL CONFereNCe 2021 congrès national | September 28-29 2021 septembre | www.ches.org

PROGRAM -continued At the end of the session, participants will be able to: • Identify the impact of the environment and how it is becoming more of a target of study and interest to manage the infection risk.

• Identify concepts that can be helpful with clinical and operational staff conversations about the benefits of smart hospitals and IoT technologies. • Identify cost-effective and innovative approaches that can be used to create smart healthcare facilities that reduce and/or implementation construction costs. TRACK 8C:

• Describe the environment with respect to being a critical component to aseptic design in any procedure room in control of the airborne environment, including airflow direction, speed, temperature, humidity and air change rates, as well as microbial and particle contamination. • Share the results from a third party that tests a proposed engineering control solution that may improve outcomes by reducing the risk of wound site infections through improved environmental contamination control, which optimizes procedure rooms and allows ICUs to be more safely used as procedure rooms when needed. • Introduce the concept of addressing the environmental risk by correlating the relationship between the airborne environmental parameters and the potential for elevated contamination risk. In ORs, procedure rooms and ICUs, a more wholistic approach to analyzing and controlling environmental parameters is necessary to point to or even predict, in near real time, the increase in risk of microbial contamination inside and outside aseptic zones. TRACK 6C:

Impact of CoVID-19 on Long-term Care: Starting the Conversation TBA

new Standard CSA Z8003: Design research and post-occupancy evaluation Robin Snell, Chair Z8003 Cliff Harvey, Vice Chair Z8003

12:45-13:15 (CT) transition/Break 13:15-14:00 (CT) trACK 9: Concurrent Session 9A, 9B, 9C TRACK 9A:

the new Waterford Hub Complex: A Different Approach to Health, LtC, education and Communities Services Bryan Darrell, P.Eng., Senior Director, NS Department of Infrastructure Renewal, NS Lands, Halifax NS

At the end of the session, participants will be able to: • Do more with less. • Practice sustainability. • Practice collaboration. TRACK 9B:

11:50-11:00 (CT) transition/Break

Heliport operations Safety Jeff Young, CPP, CHPA, National Director, Healthcare, GardaWorld, Burnaby BC

11:00-11:50 (CT) trACK 7: plenary Session CHeS president’s Welcome, Award presentations

At the end of the session, participants will be able to:

11:50-12:00 (CT) transition/Break

• Describe strategies to mitigate these identified risks.

12:00-12:45 (CT) trACK 8: Concurrent Session 8A, 8B, 8C

• Define operational procedures and applicable training to support heliport safety.

TRACK 8A:

Wayfinding: Accessible Design for the Built environment

• Define the fire and emergency response protocols.

Allison Moz, Wayfinding Partner, eyecandy SIGNS INC., Halifax NS

TRACK 9C:

TBA At the end of the session, participants will be able to: • Provide an overview of accessibility in Canada. • Explain the role of wayfinding in healthcare. • List the tools needed for a functional wayfinding system that can be updated as the building continues to evolve. • Illustrate the principles behind accessible wayfinding in the built environment with case studies from hospitals across Canada. TRACK 8B:

• Identify heliport safety risk issues.

Creating Smart Hospitals: enhancing patient experiences, reducing Staff Workloads and Improving operating results using Iot Jerry Folsom, Director, Smart Hospitals and Healthcare Solutions, North America , Siemens Smart Infrastructure, Siemens Canada Limited, Oakville ON

At the end of the session, participants will be able to: • Identify opportunities that exist to improve patient experiences and operating results. • List technologies that can be used to enhance clinical and operational staff experiences. • Describe how the Internet of Things (IoT) and other technologies can be used to create smart hospitals.

Building Healthcare resiliency from Design to operations Nicholas Gabriele, CFPS, Vice President, Global Serviceline Leader Healthcare and Emergency Management, RPA, a Jensen Hughes Company Dan Walsh, Director, Security Risk Management, Hillard Heintze, a Jensen Hughes Company

At the end of the session, participants will be able to: • Translate the results of a threat and hazard assessment into more robust building designs, enhanced security measures, security technology investments and improved emergency response capabilities of hospital personnel. • Be familiarized with threat and hazard vulnerability assessment as part of resiliency and emergency preparedness. • Be informed on staff training programs in resiliency and emergency preparedness. 14:00-14:15 (CT) transition/Break 14:15-15:00 (CT) trACK 10: plenary Session Hotstove Lounge: International roundtable on Climate Impact and resiliency Design TBA

NAtIONAL CONFereNCe 2021 congrès national | September 28-29 2021 septembre | www.ches.org

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

41st ANNUAL CONFERENCE OF THE

CANADIAN HEALTHCARE ENGINEERING SOCIETY September 28 - 29, 2021

The AIRE-GUARDIAN® SHIELD anteroom features a new self-closing, sliding door and is deployable in minutes. This innovative solution installs with virtually no dust, is adaptable for any job, and is budget-friendly. Manage negative pressure by adding a PRED750 Portable Air Scrubber and an RPM-RT Series differential pressure monitor.

Chicago Faucets touchless HyTronic Patient Care faucets are an effective tool for infection control and improved hygiene. They are designed and tested to limit the growth of waterborne pathogens. A Complete Solution For High Risk Patient Care Areas. With HyTronic Patient Care faucets you can install a complete system that helps reduce the spread of infection, provides protection against scalding, and prevents the crossflow of dangerous bacteria within the plumbing system.

Caster Town was founded in 1977, from commercial to industrial casters and wheels, our large in-stock selection will allow us to fit your application. We always make sure that we have the inventory on hand to supply your need, and if we don’t have it on hand we will find it. Contact us or come to one of our stores and let us find for you the right wheel or caster that will make your world an easy place. You can find a selection of our products in our online catalogue.

Regardless of Building Automation Brand you have in your Health Care facility, Yorkland Controls can assist with intelligent multiparameter IAQ and live data People Counting sensor technologies. Easily integrate and control ventilation based on CFM per person rather than inaccurate and delayed CO2 levels, optimizing ventilation and reducing energy usage. SUMMER/ÉTÉ 2021 35

THE AIR UP THERE Effects of ductwork leakage on HVAC systems By Josh Lewis

roperly designed and operated HVAC systems are critical to ach ieve com for t , adequate indoor air quality and energy efficiency in healthcare facilities. These systems are governed primarily by American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) standard 170, Ventilation of Health Care Facilities, which sets out temperature and humidity levels that must be maintained; minimum outdoor air and total air changes per hour; filtration levels; whether recirculated air can be used; and room pressure relationships to adjacent areas. The standard has evolved as ongoi ng resea rch has shown it’s necessary that HVAC systems effectively filter, dilute, purify and humidify air to reduce the risk of healthcare acquired infections (HAIs). As a result, healthcare facilities often

36 CANADIAN HEALTHCARE FACILITIES

have some of the largest HVAC systems, which consume a high amount of energy per square metre compared to most commercial buildings. Since no price can be put on the health and safety of patients and staff, energy ef f iciency has historically taken a backseat to the minimum design and operational requirements of HVAC systems. (If the standard is not followed, there is potential increased risk of HAIs and legal liability.) But now, with Canada’s commitment to reduce greenhouse gases to achieve net-zero emissions by 2050, solutions must be found to address these compet i ng pr ior it ies a nd t hen systematically implemented. THE X-FACTOR

There are many factors that determine both the operating state and energy efficiency of an HVAC system. They

include the necessary fan speed and power to move the air through the system; the heating and cooling energy input to achieve the desired temperature; and the effort needed to humidify or dehumidify the air to maintain the space conditions required by standard 170. Many of these factors can be optimized through commonly used strategies, such as variable frequency drives (VFDs), parallel fans, high-efficiency boiler and chiller systems, heat recovery equipment and building automation, as well as tuning the systems to operate at the optimal level. This is primarily achieved with testing and air balancing by professional service providers. There is another factor that can greatly impact the operation and efficiency of these systems — ductwork leakage. Most people easily recognize the waste produced by leakage in other types of systems like a steady drip com-

FEATURE SERIES

ing from a garden hose around the connection to the water tap or a compressed air line that is whistling loudly due to a defect. A leak in a compressed air line or in ductwork are essentially two versions of the same issue; the major difference is that ductwork systems operate at a much lower pressure. This in no way implies that duct leakage can be ignored. In fact, quite the opposite is true. DUCTWORK LEAKS

When testing and balancing HVAC systems, the goal is to obtain the building code mandated amount of supply, return and exhaust air flowing to and from occupied areas of the facility. That is accomplished by taking airflow readings at the registers, diffusers and ventilation hoods. Adjustments are then made to various system components like the fans, dampers and controls to achieve the desired outcome. But what about air leaking out of or into the ductwork between the air handling units and occupied areas? Any leakage into utility areas, such as mechanical rooms, ventilation shafts or ceiling spaces, wastes a portion of the system’s capacity, resulting in higher energy consumption. It can also reduce the total volume of air that is delivered to occupied areas, causing non-compliance with standard 170, and increase the risk of cross contamination of air streams that service different areas of the facility. According to ASHRAE’s duct design manual, three-quarters of commercial duct systems leak 10 to 25 per cent of their total airf low. Lawrence Berkley National Laboratory has also studied this issue and determined that, on average, 10 to 20 per cent of air provided to supply fans does not reach occupied spaces in a building. A quantitative way of estimating ductwork leakage for an HVAC system is to review testing and air balancing reports and compare the total system airflow at the air handling unit to that measured at discharge points. The difference between these numbers is primarily ductwork leakage. A qualitative method is to inspect unoccupied spaces, such as above ceilings and in mechanical rooms, and listen for air

Pressurize and spray technology overview.

noises and feel the temperature. These areas can often be hotter in winter and cooler in summer than the desired building set-point when ductwork leakage is significant. SAVE ON ENERGY

From an energy efficiency perspective, a simple example illustrates the benefits of addressing ductwork leakage. The base case assumption is the HVAC system is balanced and providing the required amount of air to the occupied spaces. The fan is running at a fixed speed of 100 per cent, with 25 per cent ductwork leakage. If the leakage is lowered to five per cent or less, then in most cases the fan speed can be reduced to 80 per cent from 100 per cent f ixed running speed using a VFD, while still meeting airflow requirements. This reduction in fan speed will have an immediate and permanent effect on the energy usage of the system, lowering the fan electrical consumption by up to 50 per cent, while also avoiding up to 20 per cent of heating and cooling energy usage, depending on the percentage of outdoor air

being introduced. But what if that same system is running at 100 per cent fan speed with 25 per cent ductwork leakage and is not meeting airflow requirements? Addressing leaky ducts can help a facility achieve current ASHR AE requirements without undertaking an expensive and invasive project to replace the entire HVAC system. The issue of cross contamination of air due to ductwork leakage also cannot be ig nored when per for m ing a n assessment, especially in the healthcare sector. An example of the energy efficiency and cross contamination benefits of fixing ductwork can be found in a case study from the University of Ottawa Heart Institute. Hospital monitors detected that a radioactive isotope created in one of the institute’s laboratories had somehow migrated to an adjacent wing of the building. This issue was determined to be occurring due to ductwork leakage at a rate of approximately 800 cubic feet per minute (CFM). After implementing a solution to fix the duct leakage, the isotope contamSUMMER/ÉTÉ 2021 37

FEATURE SERIES

ination issue was resolved and due to the extremely low level of ductwork leakage that remained in the system (approximately 10 CFM), it was also discovered that the ventilation fan could be permanently slowed down while maintaining a higher airf low rate than was originally possible, saving both energy usage and wear and tear on the mechanical components. SEALING SOLUTIONS

From an execution perspective, there are two primary ways to seal ductwork to minimize leakage. The traditional method is to apply sealants (primarily mastic, tape and caulking) to the exterior during construction or renovation. While theoretically effective, real world results quickly uncover f laws with this method, including variability in the caution and care taken by the installers, lack of access to certain areas of the ductwork to apply sealants (especially if the ductwork is insulated and/or there is asbestos in the space), and the inability to know where all possible holes may

be along the joints, seals and folded edges of the ductwork. In addition, exterior sealant products used in more modern buildings are typically waterbased due to health and safety concerns. This causes them to dry out and crack earlier in their service life, compared to those products used in older buildings that were oil-based and retained more f lexibility and adhesiveness over their lifetime. The newest way to seal ductwork can be described as ‘from the inside,’ through the utilization of pressurize and spray technology. This method eliminates guesswork and makes for a quicker and less invasive installation. As well, it uses a computer-controlled system to produce results that are monitored in real-time during the sealing process, which provides a straightforward path to achieve guaranteed leakage rate targets. Pressurize and spray technology is quickly becoming the standard way to seal ductwork for both new construction and retrofit projects in not only the healthcare sector but also in

commercial and institutional building sectors. STAY ON TARGET

Ductwork leakage is a serious issue that needs to be addressed. Existing facilities should investigate their current duct systems, set a leakage target and then utilize the most appropriate sealing method to fix any problems. For new construction, the leakage target should be clearly defined in the specifications, along with a requirement to test and validate the ductwork systems as they are built and commissioned in order to hold the contractor accountable, regardless of whether they use traditional or new technology to achieve their deliverables. Josh Lewis is the engineering manager at Nerva Energy Group Inc. Nerva Energy provides award-winning energy advisory and speciality contractor services, deploying cutting-edge technologies to enable high-performance green buildings. Josh can be reached at 289-856-9717 ext. 103 or josh@nervaenergy.com.

MAINTAINING BUILDING ENVELOPE INTEGRITY WITHIN THE HEALTHCARE ENVIRONMENT When it comes to building health, keeping a building dry and leak free is paramount. Water intrusion in a medical facility can lead to millions of dollars in lost revenue and potentially compromising patient outcome. The key to a “healthy” building is addressing the entire building envelope, eliminating the unseen gaps, cracks and holes in roofs, walls, windows, connections and doors that let in water, humidity, insects, dust and the problems they bring.

THE BUILDING SCIENCE OF AIR LEAKAGE The best first step to improving healthcare building performance and indoor air quality (IAQ) is to stop air leakage. “Air leakage” is any breach in the building envelope that disrupts continuity between connections, allowing unintended infiltration/exfiltration to occur in a conditioned (heated or cooled) space.

Part of Tremco Construction Products Group

DIAGNOSTIC TECHNIQUES So how do you begin to address air leakage? A professional building envelope assessment consisting of a visual inspection and tests such as a simple smoke pencil can help pinpoint the sources.

When this happens, HVAC systems struggle, resulting in uncontrollable hot and

Another common diagnostic tool, Infrared Thermography, measures and maps surface

cold spots, wasted energy and skyrocketing costs. Health and safety issues can

temperatures, which may reveal surface heat patterns that signify heat loss/gain.

also arise with the airborne spread of dirt, pests and even viruses.

Blower door testing is also popular. This test can determine the air leakage rate and reveal how much energy is being lost to air leaks. After identifying where leaks are located, the next step is to seal those pathways and enjoy benefits such as: → Reduced heat loss → Less dust, mold, and pollutants → Reduced noise and odours → Less condensation, mold, and mildew → Improved building envelope and building performance

IT BEGINS WITH THE BUILDING ENVELOPE Maintaining the integrity of the building envelope is essential to providing a safe, comfortable, and healthy environment. Quite simply, better indoor air quality paired with better building performance yields healthier buildings with happier occupants. For more information or to schedule an air leakage assessment, contact STEVE TRATT, our National Sales Manager, at 519.217.6336

38 CANADIAN HEALTHCARE FACILITIES

SPONSORED CONTENT

SPONSORED CONTENT The restoration industry in Canada is one of the most diverse in the world with contractors ranging in scope, scale, and training from single person owner/operators to complex multi billion-dollar global firms. The most impor tant factors in selecting a contractor in the healthcare sector should be: experience, knowledge of regulations, training and specialized equipment. Experience in this sector is critical. As you know, to protect our most vulnerable, adherence to policies and procedures in a healthcare facility is critical. What would normally be a simple lapse could have dire consequences. For these reasons especially it is critical that any restoration contractor provide a list of references and experience in similar facilities before they are retained. Unqualified contractors can result in incalculable damages to a facility and its community. It should be a requirement that your contractor is intimately familiar with all relevant government regulations, specifically CAN/CSA Z317 as well as being able to complete a detailed ICRA for all portions of the work. Not only should the firm be familiar with these standards, but also consider key project personnel. Do the project management team and key field supervisors have appropriate training and experience in healthcare related restorations? Do the individual workers have this training? Are these individuals comfortable participating in a multi-disciplinary IPAC team to complete the work?

Restoration in healthcare facilities also requires specialized, dedicated equipment. Any equipment used in a healthcare project should be thoroughly cleaned, wrapped and inspected prior to it arriving on site. The risk of cross contamination, especially from restoration related equipment (air filtration devices, air movers and dehumidifiers) is substantial if they have been relocated from another project without these critical steps. Having a trusted partner, who is experienced, trained, and has the right resources should be a critical part of any BCP in a healthcare facility. Without this partner small floods, fires or environmental issues could drastically impact the operations of the facility and its community.

UVC Germicidal for Air Handler Unit Coils üImprove Indoor Air Quality üExtend HVAC System Life üSave Energy Now, more than ever, indoor air quality is an issue of vital importance for Healthcare facilities. UV germicidal UVC light systems reduce the risk of airborne infectious disease and have been proven to inactivate the SARS-COV-2 virus. This virus, like all viruses, bacteria, and mold has no defense against UVC light. The very short 254 nm wavelength of UVC light is able to penetrate the cell walls of microorganisms and disrupt their DNA which inactivates them. Every healthcare building can benefit from germicidal UVC disinfection; reducing biofilm on coils, resulting in significant energy and maintenance savings. www.chemaqua.com | 1-877-902-6095

Rep. Terry Runka | 905-327-6492 SUMMER/ÉTÉ 2021 39

IAQ AND COVID-19 The healthcare industry’s challenge to understand air filters By Mark Davidson

OVID-19 has impacted virtually every aspect of society. In fact, it would be difficult to find anyone who has not experienced the effects of the pandemic in one capacity or another. While it may be hard to imagine a silver lining, those in the business of providing clean air are encouraged by a renewed focus on indoor environmental quality. Poor air quality has been the root cause of many illnesses long before coronavirus became a household word. By its very nature, the healthcare industry must be prepared to adjust to the changing landscape in order to provide the level of care people have

40 CANADIAN HEALTHCARE FACILITIES

come to expect. Part of that adjustment is understanding the performance attributes of a technical air filter. VIRUS SPREAD

COVID-19 can spread through the air via large respiratory droplets or smaller airborne aerosols. Early in the pandemic, it was accepted that large respiratory droplets (defined as greater than five microns in size) expelled by an infected person were responsible for the majority of infections other than person-toperson direct contact. Large respiratory droplets are too heav y to remain suspended in the air and if a person were

too close, the droplets could settle on mucous membranes or be inhaled directly. This is the reasoning behind six-foot social distancing — it gives these large droplets time and space to settle out of the air. However, with time, a group of scientists began to wonder if smaller droplets, known as aerosols, were playing a larger role in spreading the infection than originally thought. Unlike larger respiratory droplets, aerosols (five microns down to sub-micron in size) are small enough to remain suspended in the air for longer periods of time. The aerosols can then be inhaled when a person

FEATURE SERIES

moves into the infected space. They can also drift through the air outside the six-foot social distance zone, leading to inhalation. As such, the World Health Organization and U.S. Centers for Disease Control and Prevention added an additional caution against the virus spreading via aerosols, which are the particles air filters must be designed to capture and remove, not the virus itself. MITIGATING THE RISK OF TRANSMISSION

The main function of an HVAC system is to supply conditioned air throughout a facility. That seemingly simple task

grows in complexity as considerations like humidity, air quality and energy usage is addressed with additional system components. One consideration is selecting the proper air filter based upon the intended use of the facility or specific area. For healthcare facilities, air filters must meet certain performance standards based upon the function occurring in a given space. For example, air filters protecting operating rooms have a higher performance standard than those in administrative areas. In Canada, healthcare facilities must follow CSA standard Z317.2-19, Special Requirements for Heating, Ventilation

and Air-Conditioning (HVAC) Systems in Health Care Facilities. The performance of air filters is classified based on ASHRAE standard 52.2, Method of Test ing Genera l Vent i lat ion A irCleaning Devices for Removal Efficiency by Particle Size. This standard developed a means of classifying filter performance by establishing a minimum efficiency reporting value, known as MERV, based on a filter’s ability to remove certain size particles. MERV ranks particle capture efficiency on a scale of 1-16. The higher the number, the more effective the filter is at removing particles. SUMMER/ÉTÉ 2021 41

FEATURE SERIES

The particle capture efficiency of an air filter is primarily determined by the media. This is the term given to a nonwoven fabric constructed of f ibres arranged in a random, non-repeating pattern in a 3-D structure. There are several benef its gained from using nonwoven fabrics in air filters as opposed to woven ones. For the most important performance attribute, particle capture efficiency, the random fibres create a layered and torturous path that air must navigate. Dirt particles carried within the air inevitably encounter pores too small to fit through or crash directly into the fibres themselves and are captured. AIR FILTER MEDIA

42 CANADIAN HEALTHCARE FACILITIES

The main function of an HVAC system is to supply conditioned air throughout a facility. That seemingly simple task grows in complexity as considerations like humidity, air quality and energy usage is addressed with additional system components.

Some air filters use a nonwoven media constructed with far fewer and larger diameter fibres. This dramatically improves airflow but with far fewer fibres, the particle capture efficiency is not nearly as high so dirt particles are less likely to encounter fibres and be captured. An air filter constructed with this media would carry a lower MERV value. To make up for the loss in particle capture efficiency, this type of media can be infused with an electrostatic charge creating an effect analogous to a magnet, known as an electret. The charge greatly enhances the media’s efficiency because the charge attracts pa r t ic le s t o t he r e l at ive ly l a r g e diameter fibres in the media. Without the charge, many particles would other wise easily pass through the media; however, with it, the filter is able to capture these particles and carry a much higher MERV value. As dirt particles begin to accumulate on the outside of the charged fibres, the particles begin to produce an effect much like insulation, which lowers the attractive force that pulls particles to the fibre. As the insulation ef fect g rows, d irt part icles beg in slipping past in greater numbers as they are no longer attracted to the fibre by the electrostatic force. There is an inverse relationship between increasing insulation and particle capture efficiency. If it were possible to visibly display the MERV value of an installed f ilter undergoing this process, the value would continuously

drop as time passed and more dirt would accumulate on the fibres. Members of the ASHRAE standard 52.2 committee were aware of the particle capture eff iciency drop-off phenomenon. Appendix J was added to the standard so consumers would understand the actual MERV value over the life of the filter as it accumulates dirt during use, not just when brand-new. The Appendix J conditioning step addresses the electrostatic charge from the media. The result of the second test is listed as a filter’s MERV-A value, which is the particle capture efficiency without the benefit of an electret. For example, an initial MERV test conducted on an air filter with an electret may result in a published value of MERV 14. However, the same filter tested under Appendix J procedures may perform as a MERV 12. Putting the two test results together would result in the filter being labelled as a MERV 14/MERV-A-12A. This indicates that once the electret is no longer effective, the filter performs as if it is a MERV 12. A filter constructed with finer fibres and without the value of an electret could perform as a MERV 14 under ASHRAE standard 52.2. The Appendix J procedures would be conducted but since there is no electret to begin with, that air filter still performs as a MERV 14. The labelling therefore would show the filter as a MERV 14/MERV-A-14A,

indicating the f ilter performs as a MERV 14 before and after the influence of any present electret has dissipated. A consumer who determined a MERV 14 is required for a particular application would have more information on which to base their decision. When considering mitigating the risk from COVID-19, the size of the droplet and aerosol become a primary concern. The value of MERV-A becomes clear when reviewing the full ASHRAE 52.2 standard with Appendix J test report for a specific air filter. In Canada, through CSA Z317.2-19, healthcare facilities must use air filtration products that are MERV-A rated. MERV values are derived by averaging the particle capture efficiency percentage on particle sizes from calibrated test dirt that range between 0.3-10 microns. This range is divided into 12 separate groups. For example, particles between 0.3-0.4 micron are the first group, 0.5-0.55 micron the second group, and so on. Those 12 groups are further divided into three ranges known as E1, E2 and E3. E1 consists of the four particle ranges from 0.3-1.0 micron; E2 is from 1.0-3.0 microns; and E3 includes the remaining four ranges from 3.0-10 microns. The particle capture efficiency of the three ranges is then matched against a chart, and a MERV value is assigned where the filter data meets all the requirements of that particular MERV. For example, in

order to achieve a MERV 14 value, the filter must capture 90 per cent or more of all particles in the E3 range of 3.0-10.0 microns, 90 per cent or more in the E2 range of 1.0-3.0 microns, and 75 per cent or more of all particles in the E1 range of 0.3-1.0 micron. However, assume an air filter relied on an electrostatic charge to achieve the designated values. Now consider that charge was removed and the filter tested again. The particle capture efficiency percentages will be lower. On one such actual test, after the Appendix J conditioning test was applied to the air filter, the particle capture efficiency dropped to the equivalent of a MERV 12. According to the MERV chart, it means in the E3 range of 3.0-10.0 microns, the efficiency would remain unchanged at 90 per cent or more. However, in the E2 range of 1.0-3.0 microns, it falls to 80 per cent or more. In the critical E1 range of 0.3-1.0 micron, the sizes aren’t considered in the chart because the average is less than 50 per cent. When looking closely at actual test data on two air filters (one rated a MERV 14/MERV-A-14A, and the other a MERV 14/MERV-A-12A), the performance difference is obvious for the particle sizes that mimic the size of the aerosols suspected of being more involved than originally thought in spreading COVID infections. The MERV 14/MERV-A-14A air filter potentially captures 45 per cent more particles in the 0.5-1.0 micron range and 15 per cent more in the 1.02.5 microns range when compared to a MERV 14/ MERV-A-12A. When the reality that a single HVAC system rated to deliver an airflow of 100,000 cubic feet per minute into a facilit y is considered, the percentage disparity between the two styles of air filters makes a sig nif icant d if ference in mitigating risk. Mark Davidson is the manager of technical marketing at Camfil USA, a leading manufacturer of premium clean air solutions. He’s also the air filtration technology leader and is responsible for participating in ASHRAE committees, including 170 for healthcare facilities. He can be reached at mark.davidson@camfil.com.

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

National Healthcare Facilities and Engineering Week October 17 - 23, 2021 Recognize yourself, your department and your staff during Healthcare Engineering Week. Make sure everybody knows the vital role played by CHES members in maintaining a safe, secure and functioning environment for your institution. *2021 Challenge* CHES members are challenged to celebrate NHFEW by creating a short video and posting it on LinkedIn or Twitter using #NHFEW. CHES will then like and share it on LinkedIn (@CHES National Office) and Twitter (@CHES_SCISS).

Visit the CHES website www.ches.org/resources/ for downloadable material to help you with plans to celebrate!

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COMMISSIONING FOR PATIENT EXPERIENCE Understanding the key issues By Craig B. Doerksen & Bill Algeo

atients and their care providers rely on properly operating buildings and systems (electrical, medical gas, nurse call and HVAC, for instance). While not always thought of as key to the patient experience, commissioning all building elements is essential to providing safe and reliable care.

BUILDING COMMISSIONING

Commissioning ensures goals established at the beginning of a project are delivered collectively by the various building systems. 44 CANADIAN HEALTHCARE FACILITIES

Building elements are integrated across systems, operate across technological platforms and require proper training, operations and maintenance to perform. And it is not just the systems but the entire building functioning together. Commissioning cannot just be addressed during the final days before occupancy or even just through the construction phase. It is an entire project process that starts at goal setting and carries through all design stages, construction, quality inspections and system demonstrations (which is often the lim-

ited time pigeonholed for commissioning) to building readiness, occupancy and post-occupancy. PROJECT CHECKLIST

The most familiar commissioning activities deal with building life safety and life support systems, such as fire alarm, HVAC with smoke control and medical gas systems, to ensure safe and reliable operations, and compliance with codes as well as building and occupancy permits. However, these systems do not stand-

FEATURE SERIES

alone. Intertied with them are emergency power systems, building automation systems, central plant systems, elevators, data networks and uninterruptible power source systems, to name a few. Factor in card access, patient anti-wandering, and infant protection and nurse call systems and it becomes apparent that very few building systems operate alone. As an example of this interconnectedness, consider an automatic power assist door. Commissioning involves the door operator, card access, fire alarm, power, remote release intercom and door function when building HVAC and smoke pressurization systems are operating. And let’s not forget all building elements require a commissioning process. For instance, flooring is not just a choice between grades and look. Its anti-slip qualities are essential for safety and properly installed coved bases help contain moisture. Post-occupancy cleaning, care and maintenance methods must also be included in the commissioning plan. SYSTEMS READINESS

Commissioning starts by ensuring project goals are properly detailed in design and then correctly supplied, installed and operated by the users. This influences each step of the commissioning process. Before project tender, all building elements require detailed review. This can be done with constructed mock-ups or simulated with today’s software like Revit, building information modelling or custom systems. Biomedical_CHF_Winter_2017_FINAL.pdf 1 For example, in the patient space, it must be confirmed that earlier design choices enhance the patient experience. Are lights positioned so they don’t shine in patients’

eyes? Can patients reach the controls? And will lights flicker when dimmed? Once in construction and the building and systems begin to take shape, there are basically three steps to ensure systems are ready. The first in the on-site commissioning process is to ensure the right building elements and products have been purchased and installed. As a building or system is the sum of its parts, one incorrect part or incorrectly working part will hamper tot a l bu i ld i ng per for ma nce, l i ke installing a swing versus a spring check valve. The next one involves confirming each building system operates independently. Inspections may follow other contracted processes, such as fire alarm verification and elevator inspections. Commissioning must also oversee tools like thermal scans to ensure building envelope integrity. In this step, any interconnected system conditions are simulated. Finally, performance tests where real interconnected conditions, not simulated, are completed. If a relay on the elevator high sump pit alarm is to trigger both a building automation system alarm as well as shut down the elevator, for example, performance testing will confirm this by filling the pit with water while pumps are turned off, not by tripping or shorting the sensor. SCENARIO-BASED TESTING

Scenarios need to take into consideration all the established project goals, which have been independently confirmed in commis2017-10-23 4:45 PM sioning. The next step is to ensure the collective systems perform in normal conditions, expected conditions like a power outage or fire alarm, and extended stresses, such as

extreme heat/cold or a lengthy power outage. This leads to total integrated building commissioning that involves monitoring across all systems, testing multiple scenarios and numerous condition impacts on systems. TOTAL INTEGRATION

While the 2015 National Building Code outlines integrated systems testing of fire protection systems, total integrated building commissioning involves all systems and scenarios. Many projects also require a life safety test for occupancy, so by the time the previous commissioning steps have been completed there will be no surprises in this test. Even when this exhaustive work has been done, commissioning must be addressed across all seasons and weather conditions where building envelopes and HVAC act differently. These can affect building pressurization, hot and cold zones, airborne isolation room performance and pressurization, for instance. Soon after commissioning and occupancy, the process of recommissioning elements must begin along with recalibration. This ensures system performance and parameters are being maintained, as well as safeguards reliable healthcare delivery for patients. Craig B. Doerksen, P.Eng, is divisional director of facility management at Health Sciences Centre (HSC) Winnipeg, a Shared Health facility. Bill Algeo is a building technologist at HSC Winnipeg. They are together hosting the session, How the Commissioning Process Ensures and Enhances the Patient Experience, at the 2021 CHES National (Virtual) Conference.

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SUPPORTING PATIENT NETWORKS WITH DIGITAL SIGNAGE

How digital signage can improve the hospital experience for all Better patient experiences result in stronger healthcare outcomes. However, enhancing these experiences means making the healthcare journey as efficient and stress-free as possible for both patients and their support networks. “Anything you do to improve a hospital visit for visitors has a positive impact on the people they’re escorting or coming to see,” says Scot Martin, CEO of youRhere. “For us, that means using interactive digital communications to provide the directions, hospital updates, and personalized information they need during this otherwise busy and stressful time.” POINTING THE WAY Digital signage has a critical role to play in helping patients’ loved ones, care providers, and other supporters. This is particularly true when it comes to showing them the way. “Many hospitals have been built in stages. They have wings and additions that have been added over the years, which can make them confusing places to navigate for the majority of people who haven't memorized their layout,” says Martin. “In that respect, interactive digital displays can provide clear and concise directions that cut through the confusion.” When it comes to hospital directions, “clear and concise” counts. That’s why youRhere employs professionallytrained graphic designers who have experience designing user interfaces for healthcare environments. The result is interactive displays with userfriendly maps and information sources that can assist anyone who walks into a hospital. “We try and make those directions as easy to follow as possible by doing things like showing multiple levels on the same screen or enabling people to download step-by-step directions onto their mobile device,” adds Martin. “Being able to provide personalized directions goes a long way towards lowering a visitor’s stress levels and getting them to their loved one that much quicker,” he continues.

A FOCUS ON ACCESSIBILITY Interactive maps and directories are only effective if they can be used by anyone, regardless of their preferred language or physical disabilities. “Accessibility is a vital consideration for interactive digital signs," explains Martin. "We need to make sure that the sign is just as accessible to a person who is two meters tall as it is to someone in a wheelchair.” For example, youRhere's digital interfaces include buttons that adjust

the height of on-screen menus. They can also feature headphone jacks and braille keyboards for the visually impaired. Language is also an important part of promoting accessibility. This is especially true in many Canadian hospitals that serve a broad range of communities and demographics who may struggle with following directions or receiving information outside their first language. “For many Canadians, especially new arrivals, the ability to search for what

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they're looking for in their mother language is a huge benefit. That’s why an interactive or digital sign in multiple languages is far more effective and helpful to patients than putting up a bunch of physical English signs and indicators,” notes Martin. PROMOTING SAFETY Anxieties around airborne infections are at an all-time high, and these will likely linger well beyond the current pandemic. As expectations for hospital hygiene climb, it helps to use digital signage to showcase everything being done to keep hospital staff, patients, and visitors safe (e.g., new protocols, cleaning technologies, real-time indoor air quality (IAQ), hygiene initiatives, etc.). At the same time, digital signage can also be used to remind all hospital users of their role in mitigating the risks of infection (e.g., wearing masks, washing hands, safe distancing, etc.) and making the facility as safe as possible. “Rather than one static image on a poster, digital displays allow a hospital to communicate multiple types of information that contributes to a safer overall environment,” says Martin, offering, “You could have a rotating

‘playlist’ on your screen that includes health and safety protocols, information about a new fundraising campaign, updates about a blood donor drive, or even messages thanking staff and volunteers for their work.” TRANSPORTATION CONNECTIONS Few people plan for their initial trip to the hospital, let alone consider how they will get back. Moreover, family and friends who visit regularly may need support in finding the most effective travel option. Whatever the case, digital signage can display up-to-the-moment transit information or connect users to travel alternatives such as rideshares, taxis, nearby public transport, and other options. Similarly, details regarding on-site parking (e.g., availability, maps, parking services) can also help first and repeating visitors find their way to and from home with fewer headaches. CREATURE COMFORTS Visiting a hospital as a non-patient can be overwhelming. Any efforts to make visitors feel welcome and less overwhelmed throughout the journey go a long way towards ensuring guests

don’t carry that stress into their visit. "If you have someone that’s going to be at the hospital for any period of time, you want them to feel at home and make their subsequent visits less stressful,” adds Martin. “So providing information on hospital amenities such as gift shops, guests services, food and beverage options, the location of the nearest pharmacy to prescriptions filled, or what amenities are available near the hospital will help them find what they need to get comfortable.” IT TAKES A COMMUNITY T h e goa l i s t h e s a m e i n a n y environment: ensure occupants and visitors have access to the information they need to get to where they're going and access to supports that will e n r i c h t h e i r e x p e r i e n ce . T h i s philosophy applies as much to malls and office buildings as it does for hospitals, where there is further motivation to assist patients by making visits easier for their care network. “Getting a patient to their appointment is job one. But beyond that, there's a lot of other things you can do for the patient and the people helping them that benefit everyone,” adds Martin.

Scot Martin is CEO of youRhere, a leading provider of interactive digital signage solutions for commercial, retail, healthcare, and educational properties across Canada. For more information, visit www.youRhere.ca.

STRATEGIC ALLIANCES Systems integrator important part of Norwood redevelopment By John Karman

rojects with many complex IT systems are rarely hiccup-free. Often the main issue is that no single person is responsible for the integration of the various systems, resulting in long drawn out commissioning processes, disconnects among the various trades and sometimes last minute changes that are expensive. If someone is in charge, they’re gener-

48 CANADIAN HEALTHCARE FACILITIES

ally one of the suppliers that knows their system but is not well-versed in others. This is particularly true for stipulated sum or construction management procured projects, though not the case for the CapitalCare Norwood redevelopment in Edmonton. The project is a combination of new construction and renovation of the existing Angus McGugan Pavilion. Once complete, the facility will house 350

continuing and post-acute care beds and include out-patient services geared to better serving an aging population. EXPANDING CARE IN EDMONTON

In Canada, large and complex facilities with extensive healthcare technology systems are often procured using a public-private partnerships model. This means ownership and operation of these

INNOVATION & TECHNOLOGY

THE SYSTEMS INTEGRATOR ALSO TAKES AN ACTIVE ROLE IN SCHEDULING ALL INSTALLATION, TESTING AND COMMISSIONING ACTIVITIES WITH THE OVERALL CONSTRUCTION AND OCCUPANCY SCHEDULE.

Rendering courtesy Dialog

systems rests with the consortium, which then hires a specialist to direct the systems integration. The method of delivery for Norwood is construction management. With this type of procurement, the construction manager is hired to manage the work for the client and there are separate tenders for the various trades like the mechanical and electrical contractors. Norwood is a particularly complex project that has a combined total of 26 different healthcare technology systems, building management systems and communication systems, some of which have been custom designed for the facility. Further complicating matters is not all departments use these systems in the same manner. Given this, the project team decided an independent systems integrator was

needed. They developed a robust set of specifications, linking the role to each electrical system, as well as elevators, building automation systems, door hardware and other components. A cash allowance was then included in the electrical contractor’s tender price to cover the systems integration scope of work. SMP Engineering was awarded the electrical design contract and is responsible for the systems integration design and creating use cases as part of the design process. Details were developed through a series of in-depth workshops. A responsibility matrix outlines the duties of each team member, including clinical users, Alberta Health Services (AHS) IT department, constructors, designers and AHS equipment planners. Following this, a request for proposal was issued to five firms to bid on the systems integration component of the work. After a lengthy selection process in which several parties participated, the contract was given to Johnson Controls. THE PERFECT PARTNER

A systems integrator is responsible for a wide variety of issues related to the implementation of the design, including a review of all shop drawings and conducting a gap analysis of IT, healthcare technology systems and building infrastructure systems on the project to ensure integration is addressed and the individual systems can communicate with each other. The systems integrator also takes an active role in scheduling all installation, testing and commissioning activities with the overall construction and occupancy schedule. Key to this is

the coordination of all systems with AHS’ IT department to ensure compatibility with its network. A fundamental role of the integration specialist is to facilitate the use case study workshops with clinical as well as facility management and engineering staff to finalize details and ensure system programming and integration allows for their needs. The workshops also provide an opportunity for each system to be preconfigured and programmed appropriately to avoid major reprogramming during the commissioning process. Further, the systems integrator must direct and witness all testing at subsystem and systems levels prior to calling for full third-party commissioning. SUCCESSFUL TEAMWORK

The first use case studies with Norwood clinical, facility management and engineering, and IT staff have now been completed. Detailed discussions have unearthed some unexpected potential for improving facility operational efficiencies. The final commissioning of the systems is still some time away with the project anticipated to be completed in 2022, but all parties involved feel the process will produce successful results. John Karman is a senior projects director with SMP Engineering, a Western Canadian consulting firm that specializes in healthcare facility design. John is responsible for leading the electrical team on highly complex and large projects for healthcare, laboratory and educational facilities, as well as master planning. SUMMER/ÉTÉ 2021 49

INNOVATION & TECHNOLOGY

HOSPITALS UNDER SIEGE Cybersecurity protects Canada’s health system from attacks By Nasir Mundh & Yves Renaud

ith more Canadians working from home, a spike in the volume of business being conducted online and the number of connected devices in buildings growing at an ever-increasing rate, organizations have seen a rise in cybersecurity-related issues. Healthcare facilities are no exception to these incidents. A 2020 global report showed Canada’s healthcare sector experienced the most dramatic increase compared to other countries, with a 250 per cent uptick in attacks. This is especially concerning during a time when hospitals are oper50 CANADIAN HEALTHCARE FACILITIES

ating at full capacity and cannot afford any downtime. As healthcare facilities adopt and deploy new technologies, how can they effectively manage the cybersecurity aspect of operations and protect themselves and their data? Although no system will ever be foolproof, there are key considerations every hospital administrator, facility manager, IoT (Internet of Things) engineer and software developer should keep in mind to minimize any damage and protect patients. Only then can hospitals identify and adopt best practices to effec-

tively manage threats and mitigate cybersecurity risks. DIGITAL FACILITY ECOSYSTEM

Cybersecurity for healthcare facilities is subject to extremely stringent standards and protocols. And rightfully so. Hospitals are a critical institution — when it comes to public health and saving patient lives, tampering with digital devices is simply unacceptable. The very nature of the work these cyber systems and software manage are integral to a hospital’s success and positive patient outcomes.

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INNOVATION & TECHNOLOGY

It is no surprise the primary concern for any healthcare facility moving to a digitally connected ecosystem is cybersecur it y. The ecosystem’s capability to make decisions based on data means any disruption or manipulation of that data could have serious repercussions; hence, the necessity to act quickly when there’s a data threat. This is exactly what happened when IT systems for Ireland’s health service had to be taken off line as a precaution due to a cyber security threat. This affected outpatient appointments and posed a potential risk to Ireland's COV I D -19 vaccinat ion prog ram. With so much on the line, the ability to identify risk and act fast in this type of situation is crucial. INCREASED THREAT AMID COVID

52 CANADIAN HEALTHCARE FACILITIES

Since the onset of the pandemic, 32 per cent of Canadians have made the transition to remote work, according to Statistics Canada. Businesses were forced to adapt quickly to connect their employees to physical assets on- site. W h i le work i ng remotely offers advantages, it relies on systems like WiFi connections, non-hardened work devices and collaboration apps that could be more vulnerable to cyberattacks. Hackers see these points of vulnerabi l it y as a n oppor t un it y to t a ke advantage of hospitals and the data t hey’re col lect ing. Last year, t he world saw a 45 per cent spike in the volume of cyberattack s target ing hea lt hca re orga n i zat ions, w it h Canada taking the number one spot for the most dramatic increase. Superhospita ls and med ica l research facilities are no longer just a convenient target for the average hacker looking to make a quick dollar through a ransomware attack. While hackers can make money from patient data through blackmail or by selling data records to the highest bidder, attacks against hospitals are becoming more sophisticated as the people e n g a g i n g i n t he m h av e g r e a t e r resou rces. Cyber cr i m i na l s have grown increasingly savvy during the pandemic and are targeting businesses using a variety of methods.

On 14 May, the Health Service Executive, which runs Ireland's healthcare system, suffered a major ransomware cyberattack that caused all of its IT systems nationwide to be shut down.

Some attacks have also become more prominent like the crippling of digital infrastructure. PROTECTING AND MANAGING DATA

Canadian healthcare facilities are more vulnerable now than ever to cyberattacks, so it’s time for healthcare organizations to start thinking realistically about the risks to and vulnerabilities of their healthcare network and how to best protect their facility. There are three key elements that must be addressed to ensure a cybersecure digitized healthcare facility. The f irst is the use of appropriate t e c h no l o g y w h i l e i m p l e me nt i n g cybersecure products, software and network architecture. A hospital’s digital solutions provider should follow a series of standards like ISA/ IAC 62443 that specify security capabilities for control system components. Next is to have a comprehensive set of processes and procedures to follow when using technology and t hat reg u lates c ybersecur it y best practices. Healthcare facilities must also work together with their vendors and partners to share knowledge of

cybersecurity risks and mitigation strategies, as well as regulatory compliance. Finally, it is important that people in the facility are trained and have ownership of keeping the hospital cyber secure. Good cybersecurity begins with the user. When hospital staff know and are kept up-to-date on best practices, the risks of an attack or data breach decline significantly. In a world where hospitals are becoming more digitally connected, advances in technology are pushing the limits of what they can do. But the risk posed by cyberattacks on the Canadian healthcare industry cannot be ignored. Vigilance is absolutely necessary to building more resilient security systems. All patients and visitors expect hospitals to be safe, clean and eff icient. Secure must now be added to that list. Nasir Mundh is senior director, commercial cybersecurity solutions and services group, at Schneider Electric, a multinational company that provides energy and automation digital solutions for efficiency and sustainability. Yves Renaud is the company’s healthcare marketing director.

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THE PAPER CHASE Digitizing old engineering drawings frees up storage, saves valuable time and improves safety By Tyler Welker

aving instant access to engineering drawings that contain critical building information is essential for the safe and efficient operation of a facility. This may seem like common knowledge; however, the storage and accessibility of these drawings is often neglected. Many facilities still default to storing hard copy draw ings in a d istant archives room and rely on the knowledge of a few key team members. Although this may currently be enough to get by, the approach poses many potential issues for the foreseeable future, especially as most staff now work remotely due to the pandemic, some of which will soon retire. Hard copy drawings are also only worth the paper they are printed on. They are vulnerable to being lost, ripped, folded, crumpled and spilled on. Often stored for countless years in rolls, boxes, hanging racks and drawers in an archives room, they are left to deteriorate and become hard to read over time. What’s more, these rooms are susceptible to accidents like fires and f loods. An entire drawings archive room can be damaged beyond repair if a sprinkler is activated in that location. As engineers and architects will attest, these drawings are invaluable and the price to replace them is far more. Implementing a digital image backup ensures they are always top quality and protected. CASE IN POINT

Hospitals are continuously undergoing renovations to accommodate growing communities and provide state-of-the-art 54 CANADIAN HEALTHCARE FACILITIES

patient care. The process has become increasingly difficult to manage as most contain a mix of old and new systems. Depending on the age of the facility, some hospitals have undertaken hundreds of projects over the years, varying in type and size from the installation of new ventilation systems to lighting efficiency retrofits to door security lock upgrades. Each project has its own set of drawings that are added to the ever-expanding archives room. These drawings often need to be referenced for the planning of new projects, repairs or replacement work, and any general maintenance requests. Facility managers are tasked with tracking down the right drawings, which generally becomes a job in and of itself. This can add countless hours to a project and hinder the overall efficiency of the maintenance department. It can also cause unnecessary communication issues, especially between staff on opposite shifts. Digitizing all drawings enables staff to instantly access important building

information. It also helps current facility managers share knowledge acquired about the facility with the next generation coming into the field. The most critical need for digitized engineering drawings is the added safety it provides in the event of an emergency. Every second counts when there’s a fire, f lood, security breach or gas leak. Being able to quickly and easily locate emergency exit plans, power distribution systems, shut-off valves and other life-saving information is imperative. Events such as these can result in tremendous damage, causing entire departments to be shut down that subsequently puts patients in those areas in danger. Tyler Welker is a drawing specialist guru at DCM Inc., a leading drawing management company that provides the ultimate solution to preserve and modernize engineering drawings. Tyler can be reached at tylerw@drawingspecialists.com.

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