HealthcareFacilities JOURNAL OF CANADIAN HEALTHCARE ENGINEERING SOCIETY
Volume 37 Issue 1
LEADING THE WAY
Chinook Regional Hospital first to use LEED-HC in Canada
Security at Horizon Health E-Health Information Sharing AHS: Fort McMurray Wildfire Response
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Compare power transfer switches for selective coordination applications. Then, select ASCO. www.EmersonNetworkPower.com/ASCO, (800) 800-ASCO (2726), ascoapu.com, firstname.lastname@example.org * Results reflect the opinions of more than 300 engineers polled in a recent Webcast exit survey. ASCO Power Switching & Controls Just another reason why Emerson Network Power is a global leader in maximizing availability, capacity and efficiency of critical infrastructure.
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CANADIAN HEALTHCARE FACILITIES Volume 37
Kevin Brown email@example.com PUBLISHER/ÉDITEUR
ASSOCIATE PUBLISHER/ Stephanie Philbin ÉDITRICE ASSOCIÉE firstname.lastname@example.org EDITOR/RÉDACTRICE Clare Tattersall email@example.com SENIOR DESIGNER/ CONCEPTEUR GRAPHIQUE SENIOR
Annette Carlucci firstname.lastname@example.org
PRODUCTION MANAGER/ Rachel Selbie DIRECTEUR DE email@example.com PRODUCTION PRODUCTION COORDINATOR/ COORDINATEUR PRODUCTION
DEPARTMENTS 6 8
Editor’s Note President’s Message
EMERGENCY PREPAREDNESS & RESPONSE 20 All Fired Up Alberta Health Services staff resilient in face of province’s most devastating inferno
10 Chapter Reports
MAINTENANCE & OPERATIONS HEALTHCARE DEVELOPMENT 12 Follow the Leader Chinook Regional Hospital’s new addition first LEED-HC registered project in Canada
CIRCULATION MANAGER/ Maria Siassini DIRECTEUR DE LA firstname.lastname@example.org DIFFUSION CANADIAN HEALTHCARE FACILITIES IS PUBLISHED BY UNDER THE PATRONAGE OF THE CANADIAN HEALTHCARE ENGINEERING SOCIETY. SCISS JOURNAL TRIMESTRIEL PUBLIE PAR SOUS LE PATRONAGE DE LA SOCIETE CANADIENNE D'INGENIERIE DES SERVICES DE SANTE.
CHES Canadian Healthcare Engineering Society
24 Simply the Best MSH recognizes plant maintenance team during National Healthcare Facilities and Engineering Week
16 Intelligent Infrastructure Mackenzie Vaughan Hospital to feature fully integrated ‘smart’ technology
26 Above and Beyond Fraser Health honours facilities maintenance teams for impressive accomplishments
SAFETY & SECURITY
18 Always on Guard Security an everyday priority at Horizon Health Network
28 Bridging the Divide E-health information sharing platform connects clinicians, improves access to patient data
Paula Miyake email@example.com
Société canadienne d'ingénierie des services de santé
PRESIDENT VICE-PRESIDENT PAST PRESIDENT TREASURER SECRETARY EXECUTIVE DIRECTOR
Mitch Weimer Preston Kostura Peter Whiteman Craig. B Doerksen Sarah Thorn Donna Dennison
Newfoundland & Labrador: Colin Marsh Maritime: Helen Comeau Ontario: Roger Holliss Manitoba: Reynold J. Peters Saskatchewan: Alan F. Krieger Alberta: Tom Howard British Columbia: Steve McEwan 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: firstname.lastname@example.org www.ches.org Canada Post Sales Product Agreement No. 40063056 ISSN # 1486-2530
Committed to service excellence
Structural Restoration Structural Engineering Building Science Parking Facility Design
Read Jones Christoffersen Ltd. Engineers 4 CANADIAN HEALTHCARE FACILITIES
Integrated Healthcare Communications OUR INTEGRATED HEALTHCARE COMMUNICATION SOLUTIONS INCREASE SAFETY, SECURITY AND EFFICIENCY
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A YEAR IN REVIEW THE END OF ONE YEAR and the beginning of the next is an ideal time to reflect on past achievements and establish new goals. With the Winter 2016/2017 issue of Canadian Healthcare Facilities straddling two years, we set out to include articles in this edition that follow this accomplishments equation. As you flip through the ensuing pages, you’ll read a variety of stories linked together by a common thread — each recognizes a great contribution (if not more) that has been made to a healthcare organization or the industry as a whole in the past year. To begin, we look at two hospital projects, one which opened its doors to the public in June, and the other which broke ground in October. In Follow the Leader, you’ll read about Chinook Regional Hospital’s new addition, which complements the existing building while creating a fresh, modern feel. More importantly, the hospital — one of two major healthcare facilities serving the communities of southern Alberta — is the first in the country to use the Leadership in Energy and Environmental Design for Healthcare (LEED-HC) rating system, and is targeting silver certification. Next, Intelligent Infrastructure details Mackenzie Vaughan Hospital, a 1.2 million square-foot complex that’s slated to be completed in 2020. Beyond its sheer size and hefty price tag estimated at $1.2 billion, Mackenzie Vaughan Hospital will be the first hospital in Canada to feature fully integrated ‘smart’ technology. We then turn our attention to security support personnel at the Horizon Health Network, who ensure the safety of staff, patients and visitors at 13 hospitals in New Brunswick. From here, you’ll read about how Alberta Health Services handled the Fort McMurray wildfire, one of the most damaging natural disasters in Canadian history. The focus of our Maintenance & Operations section is on the contributions that facilities maintenance staff have made at two separate healthcare organizations, Markham Stouffville Hospital and the Fraser Health Authority. To close, we return to Markham Stouffville Hospital where an electronic health information sharing platform was recently implemented to deliver better, faster and more coordinated patient care. Clare Tattersall email@example.com
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.
SAVE THE DATE! NATIONAL CONFERENCE CONGRÈS NATIONAL | 2017 | SEPTEMBER 17-19 SEPTEMBRE | SCOTIABANK CONVENTION CENTRE | NIAGARA FALLS
SCOTIABANK CONVENTION CENTRE| NIAGARA FALLS, ON SEPTEMBER 17-19, 2017 “QUALITY HEALTHCARE BY DESIGN: Putting People First” Niagara Falls showcases an impressive array of natural wonders, sights, and a�rac�ons that dis�nguish it as a world-class des�na�on. A block of rooms has been reserved at the Marrio� on the Falls Hotel, at the rate of $209 or $249 plus applicable taxes (single/double occupancy). The Marrio� is located on Fallsview Boulevard and features spectacular views of Niagara Falls along with an expansive oﬀering of well-appointed guest rooms and spacious suites. The CHES 2017 Educa�on Program is under development but will once again feature dual tracks with talks on relevant industry topics from high-proﬁle experts in the ﬁeld. Join us for the CHES President’s Recep�on and Gala Banquet again in 2017! The banquet will celebrate the accomplishments of our peers with the 2017 Awards presenta�ons, while enjoying great food and entertainment with friends.
Join us in NIAGARA FALLS in SEPTEMBER! Follow us on Twi�er! @CHES_SCISS 4 Cataraqui Street, Suite 310, Kingston, ON K7K 1Z7 Tel: 613-531-2661 www.ches.org | firstname.lastname@example.org
FORWARD MARCH 2016 WAS A BUSY and long year for many. I hope everyone had a chance to enjoy the holiday season and recharge. If your healthcare organization is anything like mine, it works on a fiscal year that ends March 31, which is just around the corner. Now is a time of great activity as staff try to complete projects and balance cash flow and budgets. This is also a busy time of year for most CHES chapters as they are deep into planning their spring conferences. It promises to be another great year of education sessions. 2016 was marked by tremendous achievements for CHES. The National conference in Vancouver was a resounding success, setting a new bar for future conferences. The Ontario chapter conference team is hard at work planning the 2017 CHES National Conference in Niagara Falls. By all accounts so far, it is shaping up to be an astounding event. As the year progresses, more details will be available on the CHES website. In the meantime, check out the newly developed chapter logos featuring regional themes for each chapter. I had the privilege of attending the Saskatchewan chapter conference in Saskatoon this past fall. The conference team put together a memorable education lineup that was second to none. I came away feeling excited and energized to get back to my day job. As always, there is considerable work going on behind the scenes to further CHES’s goals and objectives with its partner organizations. CHES continues to work diligently with the CSA Group to advocate for and develop some of the best healthcare facility standards in the world. We are also currently working with the Canadian College of Health Leaders. As you read this edition of Canadian Healthcare Facilities, remember the journal relies on information and articles submitted by our membership. Please take some time to submit your editorial pitches to the MediaEdge team. In 2017, let’s continue to network with and learn from our peers and colleagues in the healthcare industry. Education is a self-directed journey where we build on our past learnings to grow as people. CHES is a partner in this voyage and we hope to help you with education and tools, such as the Canadian Certified Healthcare Facility Manager (CCHFM) program, our webinar series, the Canadian Healthcare Construction Course (CanHCC) and, of course, our trade shows and education forums at our annual conferences. Education makes all the difference and CHES is proud to support your individual learning journey. Mitch Weimer President, CHES National
EARN CONTINUING EDUCATION CREDITS FROM CHES Members of the Canadian Healthcare Engineering Society can earn free continuing education units (CEU) by reading the Winter 2016/2017 issue of Canadian Healthcare Facilities and passing a quiz based on articles in the issue. Once you’ve read the issue from cover to cover, simply go online to www.surveymonkey.com/r/C8MZB6R to take the quiz. CHES members who pass the quiz will be able to claim one contact hour (0.1 CEU) on their CanHCC or CCHFM certificate renewals.
8 CANADIAN HEALTHCARE FACILITIES
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With less than a year to go until the 2017 CHES National Conference in Niagara Falls, progress continues. Official calls for abstracts have been released and we’ve received lots of quality submissions to date. Speakers are booked and sponsorships and booth sales are tracking well. Our planning committee will step up its efforts, with many more focused meetings at the start of 2017. The technical subcommittee had its final pre-public review meeting in October to finalize the public review document that will eventually be the 2017 medical gas standard. This same technical subcommittee already has consecutive all-day meetings booked for late winter to review and assess all feedback arising out of the public review. The CSA standard — Medical Gas Pipeline Systems - Part 1: Pipelines for Medical Gases, Medical Vacuum, Medical Support Gases and Anesthetic Gas Scavenging Systems — is still on track to be released in 2017. The Ontario chapter has accepted a sponsorship role with a provincial Ministry of Environment (MOE)/Ontario Centres of Excellence (OCE) initiative aimed at reducing/eliminating greenhouse gases linked to the release of anesthetic gas into the atmosphere. The current structure of this MOE/OCE grant is that approximately $10 million will be set aside for the design, installation and some operational costs of anesthetic gas scavenging systems within Ontario hospitals. At this point, a formal expression of interest is being completed, listing approximately 16 hospitals that are interested in being part of this grant application. An announcement should be made in early 2017, as to whether the expression of interest has been approved, which would then lead to formal applications for the grant money. This is a significant undertaking given that anesthetic gas emissions from hospital operating rooms are one of the leading contributors of greenhouse gases.
The chapter’s fall education day was a success. Held Nov. 22, at the Best Western Glengarry Hotel in Truro, N.S., it drew approximately 70 participants. Session topics included lockout/tag out procedures, energy efficiency and building automation systems, water damage restoration, advances in nurse call technology, roof inspections, and the importance of electrical maintenance and modernization. Planning for the 2017 CHES Maritime Chapter Spring Conference & Trade Show is underway. It will be held at the Delta Hotel in Halifax, May 14-16. The theme is, “Adjusting to Changing Times in Healthcare.” The chapter is able to balance its books while offering several financial incentives to members in the way of student bursaries, a contribution to the Canadian Certified Healthcare Facility Manager (CCHFM) exam fee, webinars, the fall education day and other rebates. The present bank balance is approximately $46,000.
—Roger Holliss, Ontario chapter chair
—Helen Comeau, Maritime chapter chair
MANITOBA CHAPTER The Manitoba chapter is well on its way to completing planning for its 2017 Education Day. To be held April 27, it will take place again at the Canad Inns Destination Centre Polo Park in Winnipeg. This year’s focus is, “Confronting Building Operations Challenges Head On.” Sessions will cover a broad range of topics, from computerized maintenance management systems to roofing, plumbing, and electrical and fire systems. The day will end with a lessons learned roundtable. —Reynold J. Peters, Manitoba chapter chair
BRITISH COLUMBIA CHAPTER
Planning for the Clarence White Conference & Trade Show is well underway. The organizing committee has been struck and, after a brief break at Christmas, is working hard to finalize the plans. The 2017 event will take place April 10-11, at the Sheraton Red Deer Hotel. Registration will begin in January, for both vendors and delegates. As this is the first spring conference for the chapter, we expect a busy and exciting two days. If you are interested in volunteering, please contact me or anyone on the chapter executive. 2017 is an election year for the Alberta chapter. The first call for nominations has been sent; however, there will be further opportunities to put forth nominations for treasurer, secretary and vice-chair. Elections will be held during the chapter’s annual general meeting April 11, following the conference. The chapter plans to host the Canadian Healthcare Construction Course (CanHCC) this fall. The date has not yet been finalized. More details to follow.
I’d like to extend a special thank you to the sponsors, vendors and delegates that supported the 2016 CHES National Conference in Vancouver. It was a successful and rewarding event. The chapter executive and planning committee has launched into planning the 2017 conference and trade show. It will be held May 28-30, at the Penticton Trade and Convention Centre. The call for education abstracts has been posted. The trade show is already sold-out and only a few sponsorship opportunities are still available. The planning committee is comprised of Norbert Fischer (conference chair), Steve McEwan (chapter chair), Wendy MacNicoll and Linda Williams (conference coordinators), Rick Molnar, (education/planning committee), Sarah Thorn, Mitch Weimer, Mark Swain, Ken Van Aalst and Arthur Buse. In 2016, the B.C. chapter approved approximately $30,000 in membership grants to support CHES National webinars, the online medical gas course, attendance at the 2016 CHES National Conference, college bursary top-ups and several education grants. The education committee has recently revised the terms and conditions of the chapter’s education grants. They are now posted on the CHES website.
—Tom Howard, Alberta chapter chair
—Steve McEwan, British Columbia chapter chair
10 CANADIAN HEALTHCARE FACILITIES
The 2016 Saskatchewan Chapter Annual General Meeting, Conference & Trade Show is now in the rear-view mirror. By almost every metric, it was our best event yet. Highlights included 38 trade booths and sponsorships for almost all available opportunities. I am at a loss for words to describe the support shown by our vendor community — it went above and beyond. A sincere thank you to all. While the event is now behind us, we still appreciate feedback on the venue layout and timing as it was a unique approach. Planning for the 2017 chapter conference is well underway, with Candace Hahn serving as conference chair. It will be held at the Delta Regina Hotel, Oct. 1-3. The focus will likely be building envelopes, specifically targeting remediation in occupied facilities. This is a hot topic given the healthcare industry’s aging infrastructure. The floor plan and registration forms will soon be posted to the Saskatchewan chapter section of the CHES National website. The date and location for the 2019 CHES National Conference have been booked. It will take place Sept. 22-24, at TCU Place in downtown Saskatoon. Detailed conference planning has not yet begun but will soon. The chapter is in the process of setting up an account to accept payment by credit card for all transactions. This should make things much easier for everyone in the future.
Stop the Spread Willoughby’s Infection Control Sink is specifically designed to minimize splashing and A reduce the spread of infectious disease. C
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The Newfoundland & Labrador chapter is in the process of developing a nominating committee comprised of the chapter chair and two active chapter members. The chapter will seek nominations for all positions in early 2017. At present, the chapter is actively looking for a replacement for its vice-chair as well as a new treasurer. The chapter is constantly seeking new membership. Currently, there are 41 active members. We recently recruited another member and we’re in the process of signing up two corporate members. The chapter is sitting in a solid financial position with more than $40,000 in the bank. All expenses incurred from sending four members to the 2016 CHES National Conference in Vancouver have been paid in full. We are in the process of planning another successful professional development day. It is tentatively booked for May 7-8, at the Capital Hotel in St. John’s, Nfld. However, this is subject to change. Over the course of the coming months, we will be looking for members to sit on a planning committee for the 2018 CHES National Conference. The venue is booked. The conference will be held at the new St. John’s Convention Centre. We are currently looking for someone to join the chapter executive to liaise with CHES National on the conference. —Colin Marsh, Newfoundland & Labrador chapter chair
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—Alan F. Krieger, Saskatchewan chapter chair
NEWFOUNDLAND & LABRADOR CHAPTER
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FOLLOW THE LEADER Chinook Regional Hospitalâ€™s new addition first LEED-HC registered project in Canada By Gerrett Lim
ealthcare facilities require specialized building types to perform the practical functions that are needed for patient care. They must be built to allow for around the clock operations, energy and water use intensity, and chemical use, as well as satisfy infection control and formidable regulatory requirements, and respect for patient privacy. In addition, research has demonstrated that the healthcare environment has a large impact on patient recovery. A facility that promotes stress reduction and safety, provides a high-quality indoor environment and a strong connection to the outdoors has shown to result in faster healing, shorter hospital stays and fewer return visits. 12 CANADIAN HEALTHCARE FACILITIES
In recognition of these specialized needs, the U.S. Green Building Council (USGBC) developed the Leadership in Energy and Environmental Design for Healthcare (LEED-HC) rating system. Officially launched in 2011, LEED-HC is intended for hospitals that operate 24-7 and provide in-patient medical treatment, including acute and longterm care. The development of this rating system is a large step forward in encouraging the building of sustainable healthcare facilities and recognizing its positive effect on human health. The LEED-HC rating system creates new healthcare-specific credits and modifies existing LEED for New Construction (LEED-NC) points. For instance, indoor environmental quality credits have been adjusted to align with
the need for infection control to protect patients from contaminants, and there are strict code regulations on ventilation with green building strategies. Overall, six prerequisites and 25 credits were modified, and three prerequisites and 15 credits were added to the rating system. LEED-HC is more challenging than LEED-NC in terms of scope and requirements, recognizing the greater need to create a healthy environment for the most vulnerable. It is also the first LEED rating system to include a prerequisite for integrated planning and design. Despite these challenges, healthcare facilities are well-positioned to implement sustainable design practices since they are typically owner-occupied and designed to be long-lasting, durable buildings.
A CANADIAN FIRST
In late 2015, Chinook Regional Hospital in Lethbridge, Alta., opened its new addition — a five-storey, 205,000-squarefoot wing that includes expansions to several departments. What’s more, the addition is the first healthcare project in Canada to register with the LEED-HC rating system. Although the requirement was for a LEED-NC silver rating, there were multiple benefits for certifying with the LEED-HC rating system instead, such as the ability to factor in the intensive use of energy and water that could be difficult with LEED-NC. LEED-HC also has more stringent criteria centred on health
and comfort that raises the bar for quality patient care. Chinook Regional Hospital is targeting LEED-HC silver certification. It will earn points by reducing energy use by 26 per cent, lighting power density by 30 per cent and potable water use by 42 per cent; optimizing daylighting and providing a high-performance building envelope; installing efficient mechanical and electrical equipment, including heat recovery for the ventilation system and automatic lighting controls; and using healthy and locally sourced materials, which included specifying bio-based resin flooring instead of the typical PVC-based flooring.
Working with the existing facility posed some challenges to earning LEED credits. The project required the use of the hospital’s existing plant as the primary provider of chilled water, reducing opportunities for cooling savings. Although an additional chiller and cooling tower was included in the project, it is only intended for backup use. Other challenges included construction within an operating facility where careful planning was required to ensure patient, staff and public safety and infection control. To mitigate this risk, construction areas were sealed off to reduce the spread of dust and highefficiency filtration was applied to air-handling equipment. It was important that low-emitting WINTER/HIVER 2016/2017 13
HEALTHCARE DEVELOPMENT volatile organic compounds (VOCs) were used during construction to reduce toxic contamination that could inhibit patient recovery. MODEL EXAMPLE
The project employed an energy strategy that involved an extensive monitoring program capable of identifying the amount of energy and water being used. In order to provide a baseline and estimate the project’s energy use, an energy simulation model was created. Calibrated with reallife occupancy and weather data, the simulated data will be compared to monitored data to ensure building systems are being used efficiently. This program was intended to provide hospital operations staff with data they can use to make informed decisions when adjusting the building systems. THE GRAND DESIGN
Balanced with the practical concerns of a healthcare building, the design promotes environmental quality and social benefits while minimizing operational costs. The addition’s narrow floorplate maximizes daylight through light scoops along the central spine, clerestory windows, glass floors and glazing into the various departments. By maximizing daylight, the addition not only benefits occupant wellness but helps to reduce lighting energy use through a decreased need for artificial lighting. A landscaped courtyard and roof terrace provides on-site respite gardens that promote healing and a connection to nature, enhancing the circadian rhythm. The narrow floorplate also informs a simple logical layout, with the central corridor acting as its spine, allowing ease of wayfinding. Lit artwork panels direct people to department entrances, performing double duty as wayfinding elements and visual appeal. Art has the ability to transform the healthcare experience by helping occupants feel comfortable, familiar and reassured. Lean strategies were integrated early in the design process to improve and optimize outcomes through the delivery of an efficient and effective workflow, with shorter distances for most tasks and better sightlines for improved supervision and safety. As a result, many program components benefitted, including a 30 per cent increase in floor space for the day procedures unit by streamlining the design. The new addition connects to all six floors of the existing hospital, making access between the buildings seamless. To accommodate the rapid cycle of innovation and change seen in healthcare environments, spaces were designed to be flexible enough to allow for changes in equipment, function or workflow. NEXT IN LINE
Following the footsteps of Chinook Regional Hospital, five other healthcare projects in Canada have registered for LEED-HC, including the Haida Gwaii Hospital and Health Centre in northern British Columbia. Currently, there are only 38 LEED-HC certified projects in the world — two of which are platinum certified — and approximately 350 are registered. The modest number of certified projects is an indication of the challenge offered by this rating system. But through this challenge, healthcare facilities have the opportunity to provide a healing environment that produces the greatest positive outcomes for patients, while adhering to sustainable building practices. Gerrett Lim, P. Eng, is a sustainable building and LEED technical advisor at Perkins+Will, an interdisciplinary, research-based design firm with roots in Canada for more than 30 years. The firm is known for design excellence and innovation, and is recognized as one of the industry’s leading sustainable practices. 14 CANADIAN HEALTHCARE FACILITIES
• • • • • • • • • • • •
Dr William Rutala:
Ozonated water Laminar Flow Self-flushing Motion activated Programmable Wireless data-logging Wheelchair accessible Cleans even without soap Prevents bacterial growth and biofilm Drain & trap free of CPOs and other pathogens Future data integration with hand hygiene monitoring programs Exceeds CSA Z317.1-16 requirements UV Compatible Coating
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“Prevent all infectious transmission associated with the environment in 5 years via research/technology/automation/competency.” APIC 2016 Plenary Presentation
Untitled-5 1 7 X4.625.indd 1 Sink AD 2016
2016-11-23 16-07-06 3:35 9:44PM PM
CHES Canadian Healthcare Engineering Society
Société canadienne d'ingénierie des services de santé
CALL FOR NOMINATIONS FOR AWARDS
CALL FOR NOMINATIONS FOR AWARDS 2016 2016 Hans Burgers Award
For Outstanding Contribution to 2017 Hans Burgers Award Healthcare Engineering
Wayne McLellan Award of Excellence In Healthcare Facilities Management
For Outstanding Contribution to Healthcare Engineering DEADLINE: April 2017 DEADLINE: April 30, 30, 2016
2017 Wayne McLellan Award of Excellence In Healthcare Facilities Management DEADLINE: DEADLINE: April 30, 2016 April 30, 2017
Tonominate: nominate:Please use the nomination form posted on theTo nominate: To nominate: Please use the nomination form posted on the To Please use the nomination form posted on use theand nomination form posted on Please CHES website refer to the Terms CHES website refer to the Terms of Reference. the CHES website andand refer to the Terms of of Reference. the CHES website and refer to the Terms of Reference. Reference. Purpose: To recognize hospitals or long-term care facilities that Purpose: The award shall be presented to a resident of Canada Purpose have demonstrated outstanding success in completion of a major asPurpose a mark of recognition of outstanding achievement in the field To recognize hospitals or long-term The award shall of behealthcare presentedengineering. to a resident of capital project, energy efficiencycare program, environmental facilities that have demonstrated outstanding Canada as a mark of recognition of outstanding stewardship program, or team success in completion of a major capitalbuilding exercise. achievement in the field of healthcare Award sponsored by project, energy efficiency program, engineering. environmental stewardship program, or by Award sponsored team building exercise. Award sponsored by Award sponsored by
For Nomination Forms, Terms of Reference, criteria, and past winners www.ches.org / About CHES / Awards For Nomination Forms, TermsNational of Reference, and past winners Send nominations to: CHES Officecriteria, email@example.com Fax: 613-531-0626 www.ches.org / About CHES / Awards Send nominations to; CHES National Office firstname.lastname@example.org
WINTER/HIVER 2016/2017 15
INTELLIGENT INFRASTRUCTURE Mackenzie Vaughan Hospital to feature fully integrated ‘smart’ technology By Catalina Guran
ackenzie Health marked the largest milestone to date for the Mackenzie Vaughan Hospital project with the beginning of construction in October 2016. Mackenzie Vaughan Hospital will be the first new hospital to be built in Ontario’s York Region in the last 30 years. As part of Mackenzie Health’s twosite hospital model, Mackenzie Vaughan 16 CANADIAN HEALTHCARE FACILITIES
Hospital and Mackenzie Richmond Hill Hospital will provide its growing communities with increased access to cutting-edge healthcare, closer to home. Upon completion in 2020, Mackenzie Vaughan Hospital will provide a state-ofthe-art emergency department, modern surgical services, advanced diagnostic imaging, ambulatory clinics and intensive
care beds. Other specialized services will include medicine, birthing (obstetrics), pediatrics, mental health and the York Region District Stroke Centre. The hospital will have approximately 350 beds on opening day, with capacity to expand to 550. The majority of patient rooms will be private — a best practice in infection prevention and control.
Mackenzie Vaughan Hospital will be the first hospital in Canada to feature fully integrated ‘smart’ technology systems and medical devices that can speak directly to one another to maximize information exchange. To achieve this, Mackenzie Health is re-visioning its care delivery model. A connected health strategy, utilizing unified communications and the Internet of Healthcare Things (IOHT), will enable intuitive, patient-centred, highly-efficient, quality healthcare. The smart hospital vision will be applied at Mackenzie Vaughan Hospital as well as the existing Mackenzie Richmond Hill Hospital, for a seamless care experience. PUTTING PATIENTS FIRST
Mackenzie Vaughan Hospital is being designed through the eyes of the patient. It will be connected to nature, enabled by smart technology, and have generous drop-off areas and dedicated entrances for emergency and labouring patients, respectively. Filled with daylight and warm, natural materials, the double-height ceiling main lobby (named the Vic De Zen Family Welcome Centre) will be a relaxed, welcoming environment for patients, visitors and staff. The welcome desk, registration area and main public elevators will be visible upon entering the hospital, making wayfinding simple and clear. Patients will have the option of using an information kiosk or smartphone application to schedule and register for appointments and find their way within the hospital. A feature stair will be set against a large, multi-storey glazed wall overlooking the main courtyard. Visitors will also have orienting views to the outside at each public elevator lobby throughout the facility — a key component of intuitive wayfinding. In-patient rooms will be efficiently organized with communication stations nearby, ensuring staff are readily accessible to patients while respecting patient privacy. Electronic status boards will be displayed in patient care areas and automatically include details on infection prevention and control, as
well as patient information, including allergies and falls risk. Patient rooms will also feature natural wood accent materials to bring a sense of home and warmth, and ample space for family and visitors. A proven aid in recovery, large windows will provide expansive views to the outside. Through an integrated bedside solution, patients, physicians and staff will have access to medical and non-medical information and services at the patient’s bedside. This includes an electronic medical record portal for staff that will display medications, allergies, vital signs, diagnostic reports and images; video conference capabilities for remote consulting or speaking with family; real-time translation services; patient entertainment; meal selection; and room controls for temperature and lights.
Compugen will be working with Mackenzie Health to provide infrastructure and services for the devices, network, security and technology management of the new hospital. Under the smart hospital vision, Mackenzie Health plans to develop its own wired and wireless electronic health platform enabled by secured networks. The smart system will include unified communications (audio/video) between providers and patients, and access to patient portals, community provider portals and home health tools, such as integrated private and secure patient electronic records. AUTOMATING NON-CLINICAL SERVICES
MANAGED ICAT SERVICES
Through a partnership between the Mackenzie Innovation Institute and Sodexo Canada, Mackenzie Health will undertake a technology development project that promises to establish new healthcare industry standards for the delivery of non-clinical support services. Key aspects of this partnership include improving how the various IT systems that manage support service delivery communicate with each other and interface with Mackenzie Health’s electronic medical record system to enable smart patient scheduling. The goal is to get as close as possible to ‘one-touch point’ service fulfillment. In the future, a single entry by a physician or nurse using the hospital’s patient flow software will trigger multiple service directives that are time-stamped, scheduled and seamlessly delivered on time without any further involvement by the clinician. Services undergoing transformation include call centre operations, environmental services, patient transport, biomedical and physical plant maintenance, central equipment distribution, security and patient food services.
In 2016, Mackenzie Health announced Compugen Inc. as the preferred provider of managed information, communication and automation technology (ICAT) services for the Mackenzie Vaughan Hospital project.
Catalina Guran is a communications and public affairs consultant at Mackenzie Health, a regional healthcare provider serving more than 500,000 people across Ontario’s York Region and beyond.
Seventy-five smart workflows are being developed to improve the way staff work, to ultimately allow caregivers more time with patients. One example currently under development focuses on code blue (cardiac arrest) response. Through integrated technology, the vital signs monitor will send a silent alert directly to the critical care response team. The team members will be wearing smart real-time location services (RTLS) badges that will automatically override the elevators once they are in proximity, saving valuable time. At the same time the alert is triggered, the bed will automatically return to a flat position to allow for resuscitation, and the IV pump will stop dispensing narcotics that may cause respiratory depression. A summary of the patient’s medical record will appear on the room display for caregivers’ easy reference. Once the response team has arrived, the alerts will stop automatically.
WINTER/HIVER 2016/2017 17
ALWAYS ON GUARD Security an everyday priority at Horizon Health Network By Terry Fallis
o two workdays are the same for Jeff Whyte, regional lead of security, safety and parking, and emergency management coordinator at Horizon Health Network. With 12 hospitals, more than 100 medical facilities, clinics and offices, and over 12,400 employees, security is a concern every moment of every day for the New Brunswick health authority. “Managing security, safety and parking for a large healthcare network is a massive undertaking,” says Whyte. “We are a support service.” Support is a consistent theme across the full spectrum of services provided by security within the healthcare industry. This includes (but is not limited to) maintaining public order, site safety and security; providing support and assistance to patients, visitors 18 CANADIAN HEALTHCARE FACILITIES
and staff; responding to emergency codes; and managing parking services. “Driven by our patient and family-centred care model, the safety and security of patients, their families and our staff is of paramount importance and cannot be overemphasized,” says Whyte. “It’s ingrained in everything we do, day in and day out.” Horizon employs the use of both a hybrid and contracted security service model, with a total of 26 proprietary staff and more than 120 contracted security personnel. “Because of the vast size of our organization, we rely on our contracted security service providers, currently the Canadian Corps of Commissionaires,” says Whyte. At most Horizon sites, the commissionaires provide a full slate of security services, including patient monitoring, and assisting with parking services, traffic control and
patrols, as well as incident response, investigation and reporting. “Ensuring the safety and security of patients and staff across Horizon is complex and diverse, but a very rewarding challenge,” says Peter Kramers, CEO of Commissionaires, New Brunswick and P.E.I. division. “We share with Horizon a strong commitment to training and that’s an important component of our long-standing partnership.” Because the healthcare security landscape is ever-evolving, Whyte agrees on-going training is critical to stay on top of security concerns. “Our contract with the commissionaires stipulates all security staff must receive continuous education and training so they are equipped to respond to the broad range of situations that arise,” he notes.
SAFETY & SECURITY
In February 2016, Horizon introduced a workplace violence prevention program, which includes various levels of training, with an advanced level specifically focused on the effective and appropriate response of code white team members. Code white is one of the more sensitive and potentially dangerous situations that can arise within a Horizon facility. It activates a response to a situation in which there is an immediate threat of violence, and Horizon’s highly trained teams respond instantly and efficiently. As part of the workplace violence prevention program rollout, all code white team responders, including both proprietary and contract, are specifically trained to respond to these situations. Security team members also respond to medical emergency situations under a code blue (unresponsive person not breathing) or stat medical assistance (immediate medical assistance required) alert. The team is trained to provide support and assistance to medical personnel to ensure they can do what they do best — save lives.
“THE TRAINING WE OFFER TO ALL STAFF IS THROUGH A MULTITUDE OF MEDIUMS, FROM E-LEARNING MODULES TO ADVANCE LEVEL IN-CLASS TRAINING.” “I believe that for our teams to be successful, both training and a proactive approach to security function must go hand-in-hand,” says Whyte. “The training we offer to all staff is through a multitude of mediums, from e-learning modules to advance level in-class training.” Training is not limited to security personnel; it’s also provided to other staff, both clinical and non-clinical. This helps promote a sense of responsibility for security among all employees and also breaks down any barriers between the security team and the broader employee population. In a patient and familycentred care model, every employee must share in the collective obligation to protect and promote the security of others within Horizon.
The health authority is committed to fostering a culture of safety for its patients, public and staff. An example of this is evident in work recently done by the Women and Children’s Health Program in introducing the infant and child abduction prevention program. Whyte explains that although infrastructure and security systems can do everything from locking doors to activating audible alarms, systems are only one part of prevention. “Technology cannot replace the experience, training and sensitivity of our staff. We must continue to educate and inform our patient and public populations,” he says. “When we continue to focus on prevention and response, then and only then will we become successful.” Terry Fallis is a freelance writer.
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WINTER/HIVER 2016/2017 19
EMERGENCY PREPAREDNESS & RESPONSE
ALL FIRED UP Alberta Health Services staff resilient in face of provinceâ€™s most devastating inferno By Sara Warr & Jason Morton
20 CANADIAN HEALTHCARE FACILITIES
ay 2, 2016, began like any other day. Patients at the Northern Lights Regional Health Centre (NLRHC) in Fort McMurray, Alta., were attended to by their healthcare teams. Encroaching wildfires in the area had begun to cast a shadow over the healthcare facility — some neighbourhoods had already been evacuated, as well as patients of the Fort McMurray Recovery Centre south of the city — but nobody expected what was to come. That Monday morning, hospital leadership gathered to discuss emergency planning, just in case. They had been receiving regular updates on the blaze and wanted to be prepared for the worst. Even so, everything felt fairly normal. “We all went home at the end of the day,” recalls Monique Janes, director of patient care. “Then, on (May 3), things started to change.” By noon Tuesday, the blaze had escalated, threatening new areas of the city. With more neighbourhoods being placed under mandatory evacuations, and staff and patients hearing news over the radio, it was difficult for many to keep their minds on work. “I was feeling it myself, being a mother with my kids in school,” says Janes. “I made a call to my husband and said, ‘You’ve got to get the kids out of school. Look after them. I can’t leave the hospital. I have too much to do.’” An Alberta Health Services (AHS) zonewide Emergency Operations Centre (EOC) had already been set up, in constant communication with the municipality’s EOC. “We anticipated the situation could change very quickly and we wanted to get ahead in our decision-making,” explains David Matear, senior operating director at the health centre. “The event accelerated so fast,” he continues. “Just getting the word out about the current status, as opposed to the status 10 minutes ago, was a challenge. We were
given as much information as (possible), given the situation.” Meanwhile, AHS’ North Zone EOC was working a few steps ahead of on-the-ground staff to ensure care would continue after evacuation. Around 5 p.m., the hospital began to evacuate — a wall of fire visible in the nearby ravine. “We were trying to keep people calm,” explains Janes. “When we got the mandatory evacuation, we were ready. We did it floor by floor.” Most patients began boarding buses and ambulances. One ventilated intensive care unit (ICU) patient required an air ambulance. Patients remained amazingly composed and understanding during the whole ordeal. “Not one person complained or cried,” says Pam Lund, emergency department and ICU manager. “There was no panic whatsoever. (Patients) trusted our staff and knew we were going to get them to where it was safe.” Physicians and staff from all departments helped wherever they could. For instance, nutrition and food services packed up food and water for the trip to, at the time, an unknown destination. “So many people came together,” recalls Janes. “We had facilities maintenance staff and protective services guys loading crash carts and equipment — everything that we would need to run an emergency department. We even got the cat and bird from the continuing care unit.” Lund was in one of the first ambulances to leave, along with some of the equipment. Other ambulances and buses followed. Protective services staff stayed behind to help sweep the building several times to ensure no one was left behind. Matear was the last to leave the site, amidst thick black smoke. In total, 73 acute care patients and 32 continuing care clients were safely evacuated in less than two hours. Upon arrival at Suncor Energy’s Firebag site north of Fort McMurray, physicians and staff worked around the clock to ensure WINTER/HIVER 2016/2017 21
EMERGENCY PREPAREDNESS & RESPONSE SOCIAL MEDIA COLUMN Sponsored by MediaEdge
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22 CANADIAN HEALTHCARE FACILITIES
patients received the care they needed. From all reports, kindness and compassion abounded. “I’m so proud of our hospital and what we accomplished,” says Janes of the experience. “Our staff were fearless and selfless,” adds Lund. That selflessness continued in the weeks to come, with AHS staff from all over the province pulling together to support evacuees, including displaced staff and patients. Reception centres in Edmonton, Calgary and elsewhere across the province had AHS staff present to assist. Meanwhile, on the ground in Fort McMurray, AHS continued to provide emergency services to first responders and restoration workers who remained in the city. On May 14, a temporary Urgent Care Centre (UCC) opened. Comprised of Portable Isolation Containment Systems (PICS) units — a series of portable, interconnected modular shelters — it allowed AHS to provide staff with clean air and water, and significant space to work. “It was a huge task to accomplish what we did,” says Sam Primerano, EMS fleet operations team lead. “Everyone worked together and we were able to get (the UCC) up in two and a half days, which, I think, is unprecedented for something that large.” Additional supports, such as addiction and mental health, physical and occupational therapy, and public health services, were also available through temporary trailers at the Syncrude Sports and Wellness Centre at Keyano College. With the UCC open and able to provide care, AHS focused its attention on reopening the NLRHC. Beginning May 21, more than 500 vendors and AHS staff worked around the clock to see this through to fruition. Gordon Dancey, an AHS facility maintenance and engineering employee, was among those who lent a hand, despite losing his home to the wildfire. “I didn’t hesitate. I wanted to help out any way I could,” says Dancey. “It was also sort of therapy (for me), to keep me busy, give me purpose and come to terms with everything I had lost.” The NLRHC reopened in phases, starting with the emergency department, lab and diagnostic imaging on June 1.
“The biggest issue was the smoke caused by the fire. It was obvious when you walked into the hospital,” says David Ponich, AHS North Zone director of facility maintenance and engineering. “Smoke made its way into the building, leaving behind a strong smell and some residue, which compromised some of the hospital infrastructure and equipment.” Every ceiling tile in the facility (nearly 8,200) had to be removed and replaced because of the smoke and residue. Special measures were taken to clean the ventilation system, including the installation of a temporary charcoal filter. The water systems were continuously flushed, and both air and water quality was tested regularly to ensure they met the health authority’s high health and safety standards. Carpets, linens, curtains and towels were also cleaned or replaced. Several walls were re-painted. Hundreds of pieces of medical and lab equipment were cleaned, tested and verified to ensure they weren’t compromised. A team of electricians and plumbers went through each room to ensure plumbing and electrical systems were functioning properly. “The safety and health of staff and patients was our primary concern for all our cleanup work,” says Ponich. “We only opened a unit or department after it had been extensively inspected and approved by (provincial) Infection Prevention and Control (and) Workplace Health and Safety (personnel).” When looking back on the entire experience, Matear says he feels pride more than anything else. “It’s hard to mention just one area (I’m proud of),” he explains. “The physicians and staff at the hospital, AHS leadership at all levels, staff from elsewhere in the province who came to our aid and helped with the recovery effort — they all pulled together to do what was required, then eagerly asked what else they could do. I can’t say enough about our community and Albertans as a whole. The amount of kindness we’ve been shown has been unbelievable.” Sara Warr and Jason Morton are senior communication advisors with Alberta Health Services.
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MAINTENANCE & OPERATIONS
SIMPLY THE BEST MSH recognizes plant maintenance team during National Healthcare Facilities and Engineering Week By Tamara Wright
arkham Stouffville Hospital (MSH) is a two-site hospital that offers a wide range of services to almost 400,000 residents in surrounding communities. Delivering excellent patient care is a top priority for the hospital’s 450 physicians, 17 midwives and 2,100 staff. While the clinical team delivers direct care to patients, departments behind the scenes also contribute to the quality of patient care, comfort and safety. One such department is plant maintenance. The team fully understands that properly maintaining the facility systems and equipment is essential to ensuring reliability and optimizing performance, while preventing unscheduled interruptions and downtime.
A JOB WELL DONE
As the facility more than doubled its footprint in 2013 — MSH now stands at 710,000 square feet — it was imperative that the hospital retain an experienced and welltrained team to tackle the increasingly complex tasks related to its cutting-edge building automation system, state-of-the-art reverse osmosis system, variable fan drive, and domestic hot and cold water systems. The team strives not to fall into a cycle of reactive maintenance. To avoid this, plant maintenance keeps a general record of maintenance activities that have been appropriately planned and successfully carried out. A facility of this size and complexity needs a suitable strategic framework in order to fully meet its demands. In addition to having the right people, the plant maintenance team uses a time-based management strategy to keep the building functional, equipment operational and, most importantly, patients safe. This robust and straightforward approach ensures the hospital is predictive and proactive in how it maintains its 24 CANADIAN HEALTHCARE FACILITIES
physical assets. It also works hand in hand with the facility’s existing preventive maintenance programs. It’s often said preventive maintenance is only as effective as the professionals that perform it. MSH’s plant maintenance department currently consists of 18 individuals that, as part of their everyday role, demonstrate their commitment to safe operational practices. Part of this commitment is their constant attention to detail and consideration of how preventive maintenance of various systems and equipment will aid the organization in meeting larger operational goals. These maintenance professionals attribute their successful track record of keeping on top of operational issues to the team’s brief daily meetings, during which they brainstorm and discuss the challenges of managing the safety of current projects, and use of tangible performance measures. Apart from the traditional measures such as graphs, key performance indicators and spreadsheets, which are used to assess the quality and timeliness of work being done, the hospital has adopted a more personal approach.
highlighted the plant maintenance staff, gave the hospital community the chance to get to know the team better and shined a light on the role the department plays in patient care. Physicians, staff and volunteers were invited to tour the hospital’s 10 mechanical rooms and other restricted areas of the building. For many, it was their first look at what’s involved in maintaining the facility’s intricate systems. Staff was also encouraged to attend the ‘MSH mechanics’ showcase.’ Here, staff had an opportunity to speak with the mechanics about how to optimize their workspace and equipment, as well as any maintenancerelated issues they might be experiencing at home. The showcase was well-received and attended by hundreds of hospital employees. The week-long recognition events culminated in a vendor fair. Many of MSH’s major plant maintenance suppliers were invited to meet and greet the senior leadership team, plant maintenance professionals, as well as other hospital staff. The vendors (at their various booths) discussed the latest technologies in their respective fields and demonstrated how their company’s products, equipment and services contribute to keeping the hospital operational.
During 2016’s National Healthcare Facilities and Engineering Week, Oct. 16-22, MSH
Tamara Wright is a facilities and support services associate at Markham Stouffville Hospital.
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MAINTENANCE & OPERATIONS
ABOVE AND BEYOND Fraser Health honours facilities maintenance teams for impressive accomplishments By Mitch Weimer Photos courtesy Lindsey Donovan Photography.
very day, Fraser Health employees, physicians and volunteers go above and beyond their daily duties to improve patient care and services across the B.C. health authorityâ€™s facilities and communities. Each year, the healthcare organization recognizes those who have achieved extraordinary results. In September 2016, Fraser Health honoured 19 individuals and teams in five categories with Above and Beyond Awards at a special ceremony at Surrey City Hall. Among the recipients were two facilities maintenance teams. CHAMPIONS OF CHANGE
26 CANADIAN HEALTHCARE FACILITIES
Fraser Healthâ€™s ceiling lift program team received an Innovator Award, which recognizes those with the vision and creativity to champion changes that improve services, advance practices and conserve resources. Occupational health studies have shown using ceiling lifts to move patients keeps employees from countless injuries. The team responsible for repairing these lifts in Fraser Health facilities has also achieved significant savings by finding innovative ways to maintain and refurbish them. The ceiling lift program team maintains more than 3,000 lifts, most nearing 15 years old and installed by one vendor. With repair costs escalating and challenges mounting, the team began to question the value of the vendor managed service. When the 10-year-old lifts were declared obsolete and vendor service halted, the team knew it had to act. The well-built and trusty old lifts were being replaced by another smaller product that appeared to be less robust. Two team technicians, head machinist Les Cleveland and facilities maintenance and operations department supervisor Alan Kelly, believed they could do better. So, in 2010, they launched an initiative to train in-house employees in lift repair. The team not only saved labour costs but saved money on parts, sourcing $180 batteries for $16, and manufacturing
TOP TO BOTTOM: Dennis Fuchs and Kevin Woykin; Bruce Kinch; and Alan Kelly and Les Cleveland.
MAINTENANCE & OPERATIONS
$300 lift covers for $11. Since the project’s inception, more than 570 lifts have been repaired and their lifespan extended from 10 to 15-plus years, enabling the health authority to defer $9 million in capital investment. The program has since been adopted by other health authorities that now regularly send their lifts to Fraser Health for repair. SERVICE DELIVERY EXCELLENCE
A second team within the facilities maintenance and operations department was singled out with a Service Delivery Excellence Award. This award is presented to individuals and teams, both clinical and non-clinical, that go to great lengths to exceed service expectations and encourage others to follow their lead. Within Fraser Health, thousands of employees work behind the scenes to ensure Class1_QP_CHF_Summer_2016_FINAL.pdf crucial services never fail. Among them are
the technicians who provide support to medical device reprocessing (MDR) and operating room departments at Fraser Health sites. This regional maintenance program, which uses a quality management system, is unique to Fraser Health — at one time it was the only ISO 9001 certified MDR program in North America. The health authority’s MDR maintenance team has personnel who are cross-trained in multiple modalities. Led by technical coordinator Stefan Manea, the team elevates its service delivery every year. With 11 site-based MDR departments, Fraser Health has a lot of ground to cover. The MDR maintenance team has site-based technicians at the largest sites but still must deal with travel to smaller sites as well as after-hours emergencies, vacation and sickness. The three technicians who provide regional support and go above and beyond their duties 1are Dennis 2016-07-11 10:56 AM Columbian Hospital, Fuchs at Royal
Bruce Kinch at Ridge Meadows Hospital and Kevin Woykin at Peace Arch Hospital. These technicians have always made themselves available during times of crisis to ensure complex sterilization and disinfection equipment runs smoothly, preventing surgical delays and cancellations. They solve high-pressure problems around the clock, including on weekends and holidays, often saving money in the process. Among their efforts, they’ve repaired decommissioned surgical device sterilization machines so they can go back into service. They have also found ways to refurbish water filtration membranes, saving up to $5,000 per unit in replacement costs. Mitch Weimer is the facilities maintenance and operations director for the Fraser Health Authority in B.C. He is a 26-year healthcare industry veteran and the current president of CHES National.
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BRIDGING THE DIVIDE E-health information sharing platform connects clinicians, improves access to patient data By Leela Holliman
he number of healthcare professionals a person may see over their lifetime seems limitless. One survey suggests it could range from 18 to 30 different providers. When a patient is seated in front of a clinician, whether in a hospital emergency department, urgent care centre or community practice, their health information may be scattered across dozens of facilities. This can present a challenge for a physician who needs that information to fully understand the patient’s medical condition and offer the most effective and timely care. Because patients rarely travel with their health records, clinical staff may have to 28 CANADIAN HEALTHCARE FACILITIES
spend time phoning other institutions to obtain a patient’s latest lab results, medical images or medication history. More than just an inconvenience, the lack of this data may significantly compromise a patient’s care, resulting in requests for duplicate or possibly unnecessary tests or treatment that may conflict with the patient’s current care. CONNECTING DATA
Recognizing this concern, Markham Stouffville Hospital (MSH) recently implemented an electronic health information sharing platform, known as ConnectingGTA (cGTA). Part of eHealth Ontario’s larger ConnectingOntario initiative, cGTA inte-
grates electronic health records through a centralized database linking participating healthcare organizations across the Greater Toronto Area and eventually Ontario. By seamlessly and securely linking through the organization’s hospital information system (HIS), clinicians have ready access to a provincial patient data repository. Such access allows them to view information critical to patients and their care. The system also benefits patients who may be struggling with their immediate medical concerns. For example, in an emergency situation, a patient may not have access to a list of their prescription medicines
Canadian Healthcare Engineering Society
Société canadienne d'ingénierie des services de santé
CALL FOR NOMINATIONS CHES BOARD OF DIRECTORS CHES members are invited to submit nominations for the following positions: Vice President Secretary Treasurer A member in the Regular Membership Classification is eligible for office.
Nominations can be received either by: • Members identifying and nominating eligible qualified candidates • Members who are interested in standing may submit their own name as a candidate. Basic function and responsibilities of a board member: • Set policy and direction of the Society • Serve as a spokesperson for the Society • Represent the interests and discipline of the Society • Serve as technical resource for Society education programs, publications and advocacy • Promote membership and Chapter affiliation • Participate in Society committees
In fulfilling these duties, the Board member: • Serves a two-year term, after which he/she is eligible for re-election • Attends Board Meetings by conference call and at annual conference (financial assistance provided for conference travel expenses) • Carries out projects as assigned by the President • Prepares written report of activities for each Board meeting
Candidates must be active in and a participating member of the Society for a minimum of two years. Candidates should be in compliance with all provisions of the By-Laws, having the ability to carry out the fundamental duties of the assignments of the Board. Candidates should obtain the approval of their superior for permission to serve on the Board. Nominations must be received by April 30, 2017 and should be sent by fax or email to: CHES National Office Fax: 613-531-0626 firstname.lastname@example.org Sincerely.
Peter Whiteman Chairman, Nomination & Elections Committee Past President, CHES
PATIENT PERSPECTIVE or other important medical information. Similarly, cognitive impairments or language barriers may further complicate already challenging conversations. CONNECTING SYSTEMS
The first step in participating in cGTA for any organization is a series of assessments that examine factors such as technical resources, privacy and security infrastructure, the end-user community and training resources. Fortunately, MSH is a Hospital Information and Managements Systems Society (HIMSS) Stage 6 facility — a healthcare industry standard that indicates an advanced level of maturity in technology and electronic systems. As a result, the assessment process was very smooth and little preparation work was required. From an implementation and use perspective, one benefit of cGTA is that it utilizes an Internet browser, making it relatively easy to use. That said, it was vitally important to implement the system in a way that integrated smoothly with existing clinical processes. To that end, MSH worked closely with its hospital information system vendor to link cGTA to the HIS application already being used by the organization’s clinical staff. This presented a unique challenge, however, as early cGTA adopters had used an older version of the HIS or a completely different system. So MSH and its vendor needed to come up with a new way to link the resources. CONNECTING WITH END-USERS
Early on, it was decided the key to successful cGTA implementation at MSH would be the tight integration of system rollout with training and communication efforts. This meant speaking with physician leadership at the hospital’s medical advisory
council, as well as meeting with physician groups and other clinical staff at their departmental meetings to introduce and demonstrate the cGTA application, not only offering an overview of its benefits but also answering any questions or concerns they might have. Key to this was having both the project manager and organization’s privacy manager available to present the system to clinical staff, answer procedural questions and address any questions that arose around the privacy and security of patient health records. To ensure the information remained fresh, departmental meetings were timed to coincide with their respective go-live schedules. In some cases, within hours of the meeting, clinical staff could access the application, testing out its functions firsthand. Another important factor was simplifying and streamlining training. When introducing any new system or application, it is easy to over complicate training. In doing so, there is significant risk of overwhelming the endusers and making them less eager to access and utilize the system. Fortunately, MSH clinical staff was already open to, and familiar with, the use of electronic applications. As a result, systems training largely involved showing clinical staff where to find the cGTA link from within the HIS, and a brief demonstration of how to navigate the different views of clinical information as well as the types of information they might access. After go-live, clinical application support staff toured different areas of the hospital in two-week segments as part of an ongoing communications effort that reminded people about cGTA, offered handouts and addressed any questions about accessing or using the application. This also allowed
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support staff to quickly troubleshoot and resolve any issues that had arisen. Supporting these training efforts were e-mails, posters, Intranet announcements and newsletter items designed to keep clinical staff informed at critical junctures of the project’s progress as well as reinforce its use by, and benefits to, staff and patients. The program ensured clinical staff understood the application and knew they were supported in its use. COMPLETING THE CONNECTION
MSH is already seeing the benefits of the new system. The rapid access to patients’ previous care from connected organizations and lab results from across the province has given the hospital the information needed to support medical decision-making. This is health data sharing at a level that provides the hospital with access when and where it needs it most. As cGTA rolls out across Ontario, the MSH-developed solution will be shared with other institutions using the same HIS and early adopter organizations as they upgrade to the same version. With respect to MSH, which presently views external patient data, the organization has begun the next phase of populating the cGTA repository with patient data. This completes the information loop, further strengthens cGTA and enhances the quality of patient care for all participating organizations. Leela Holliman is a project manager at Markham Stouffville Hospital. She led the implementation of ConnectingGTA. This article originally appeared in the Fall 2016 issue of Canadian Healthcare Facilities. Unfortunately, the first page was omitted due to a printing mistake. We apologize for the error.
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