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Canadian

HealthcareFacilities Journal of Canadian Healthcare Engineering Society

Volume 33 Issue 2

Winter/hiver 2012-2013

Woodstock General Hospital Takes the LEED in Ontario WGH becomes first new Silver LEED facility in province

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INSIDE Restigouche Hospital Centre's P3 Treatment Norfolk General Hospital Earns OHA Award Healing Garden Flourishes at Edmonton's Cross Cancer Institute

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Niagara Falls 2013

SEPTEMBER 22-24 SEPTEMBRE The CHES 2013 National Trade Show & Education Forum will be held in Niagara Falls ON at the Scotiabank Convention Centre, September 22-24, 2013.

The theme of the 2013 conference is

“Powering into the Future” The CHES 2013 Education Program will once again feature 2 major tracks, one on Regulatory Compliance and one on Health Care Facility Management Best Practices. The 2013 Education Program will kick off Monday, September 23, with

Keynote Speaker, Jay Ingram, former co-host and producer of Daily Planet. Our Conference will kick off with the Opening Reception in the

Exhibit Hall on Sunday September 22, 2013, join us for food, friends and fun! Again this year we will be holding the Great CHES Golf Tournament on Sunday September 22, 2013 at Legends on the Niagara – Ussher’s Creek Course. Join us for the CHES President’s Reception and Gala

Banquet in the Oakes Grand Ballroom, Marriott Gateway on the Falls Hotel on Monday September 23, 2013. We will again celebrate the accomplishments of our peers at the Award Dinner. We look forward to seeing you in Niagara Falls in 2013! For more info visit our website at www.ches.org

Ussher’s Creek Golf Course

contents

Canadian Healthcare Facilities Volume 33

Number 2

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

PUBLISHER

Steve McLinden e-mail: stevem@mediaedge.ca

EDITOR

Matthew Bradford e-mail: matthewb@mediaedge.ca

ADVERTISING SALES

Sean Foley MediaEdge Communications 416-512-8186 e-mail: info@mediaedge.ca

DEPARTMENTS 6 8

Message from the Publisher By Steve McLinden Message from the President By John J. Knott Chapter Reports

SENIOR DESIGNER

Annette Carlucci

DESIGNER

Jennifer Carter

PRODUCTION MANAGER

Rachel Selbie

SCISS JOURNAL TRIMESTRIEL PUBLIÉ PAR MEDIAEDGE COMMUNICATIONS INC. SOUS LE PATRONAGE DE LA SOCIÉTÉ CANADIENNE D’INGÉNIERIE DES SERVICES DE SANTÉ Steve McLinden e-mail: stevem@mediaedge.ca

ÉDITEUR

RÉDATRIC INTÉRIMAIRE

Matthew Bradford e-mail: matthewb@mediaedge.ca Sean Foley

PUBLICITAIRE

MediaEdge Communications 416-512-8186 e-mail: info@mediaedge.ca

ARTICLES 12 16 16

Call for Nominations: CHES Board of Directors / CHES Awards Woodstock General Hospital Takes the LEED in Ontario: WGH becomes first new Silver LEED facility in province By Matthew Bradford Healing Garden Flourishes at Edmonton's Cross Cancer Institute: CCI's natural approach to patient comfort By Bernard Tong Restigouche Hospital Centre Undergoing P3 Treatment: Construction underway for new psychiatric facility in New Brunswick By Matthew Bradford

The Case for Pipe Lining: Advantages and benefits of in-pipe lining technology By Amanda Strouse

TV Service Providers to Jostle in New Markets: Differing TV service models forseen for long-term and short-stay occupancies By Barbara Carss

Norfolk General Hospital Earns OHA Award: NGH honoured at OHA Green Health Care Awards

PUBICITÉ

Annette Carlucci

COORDINATEUR DE PRODUCTION

Rachel Selbie

CHES Canadian Healthcare Engineering Society

SCISS

Société canadienne d'ingénierie des services de santé

PRESIDENT

John J. Knott

VICE-PRESIDENT

Peter Whiteman

PAST PRESIDENT

Michael Hickey

TREASURER

Ron Durocher

SECRETARY

Robert Barrs

EXECUTIVE DIRECTOR

Donna Dennison

CHAPTER CHAIRMEN

Maritime: Phil Langford Alberta: Ken Herbert B.C.: Mitch Weimer Ontario: Allan Kelly Manitoba: Reynold Peters Newfoundland & Labrador: Brian Kinden

FOUNDING MEMBERS H. Callan, G.S. Corbeil,

J. Cyr, S.T. Morawski CHES

4 Cataraqui Street, Suite 310 Kingston, Ontario K7K 1Z7 Telephone (613) 531-2661 Fax (613) 531-0626 e-mail: ches@eventsmgt.com CHES Home Page: www.ches.org Canada Post Sales Product Agreement No. 40063056 ISSN # 1486-2530

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Publisher's Message

A new year brings new opportunities Another year begins, and with it comes the promise of new successes, developments, and evolutions for the healthcare engineering industry. I am honoured to be a part of CHES' ongoing growth through Canadian Healthcare Facilities (CHF), and we at MediaEdge look forward to documenting the association's ongoing achievements in 2013. In this new year issue, we've turned the spotlight on a number of healthcare projects throughout the country. In our cover story, “Woodstock General Hospital Takes the LEED in Ontario”, we narrow in on WGH's new Silver LEED facility, and what it represents for the future of healthcare construction. Next, Bernard Tong with Alberta Health Services' Edmonton Zone gives us a sneak peak at AHS' refreshing patient care initiative in, “Healing Garden Flourishes at Edmonton's Cross Cancer Institute”. We also turn our attentions to New Brunswick for a look at Restigouche Hospital's public-private partnership project in “Restigouche Hospital Centre Undergoing P3 Treatment.” Please also read with interest Barb Carss' investigation into how upcoming changes will affect hospital entertainment systems in “TV Service Providers to Jostle in New Market”, and Amanda Strouse's look in pipe maintenance alternatives in “The Case for Pipe Lining”. As always, CHF seeks to recognize the movers and shakers of the industry. In this issue you'll find nomination calls for both CHES' Board of Directors and the yearly CHES Awards. We also pay tribute to a recent healthcare achievement in Ontario in, “Norfolk General Hospital Earns OHA Leadership Award”. I hope you enjoy this issue and look forward to speaking to many of you in the new year. And remember: Your ideas and feedback for future stories are always welcome.

Steve McLinden Publisher stevem@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. 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. 6 Canadian Healthcare Facilities

Message from the President

Wishing good health and prosperity in 2013 It is hard to believe we've closed the door on the year 2012 and are beginning to embrace the new year. I hope that this message finds all of our members in good health! As I move into my second year as president, I find I have many projects to report on. First, let me say that CHES has successfully completed negotiation of a partnership agreement with the Canadian College for Healthcare Leaders (CCHL). This agreement will serve as a springboard to ongoing dialogue with CCHL about sharing of opportunities between the two organizations, and help us promote the value of CHES member education to those in healthcare administration. I am really looking forward to watching this relationship blossom. CHES has been in conversation with the International Association of Healthcare Security and Safety (IAHSS) about forming a partnership with their group and I hope to see something come to fruition from those talks as well. I am sure there are many overlapping issues that concern both groups and it should make for a great partnership. CHES is also hopeful that a couple of new provincial chapters may be in the works, and this can only serve to strengthen the organization. It would go a long way toward increasing the organization’s credibility as a group that represents all Canadian healthcare engineering and facility management folks; as well as all the industries that work with us on a day-to-day basis. I have just returned from the Clarence White Education Session in Red Deer, and must say the Alberta Chapter did an excellent job on their conference this year. This will be last time I visit their conference as CHES National President and I would just like to say thanks, once again, to all the folks in Alberta for their warm hospitality! I would also like to say thanks to our long-standing partners at the Coalition for Green Healthcare for continuing to work alongside us on many projects and partnerships. In closing, don’t forget to take part in the CHES Webinar Series and forward any webinar ideas our way. Our Communications Committee is always looking for good articles as well. Here is wishing everyone all the best in this new year. Remember to take time out to have fun with family and friends, and see you all in 2013! John J. Knott, CET, HMT, CEM CHES National President

8 Canadian Healthcare Facilities

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ALBERTA CHAPTER

Chapter Reports On behalf of our new Executive Committee for the Alberta Chapter, I would like to take this opportunity to congratulate our 2012 Clarence White Conference & Tradeshow Planning Committee. Since the conference’s inception 35 years ago, the 2012 Tradeshow has exceeded our expectations with record attendance by both delegates and booth exhibitors (54). Great job, team! A special thank you also goes to the senior management of AHS’s Capital Management for their support in this event. It was great to have two CHES National guests, Peter Whiteman and J.J. Knott, attending and participating in the two-day event. I am looking forward to 2013 as we start the year with the “Canadian Healthcare Construction” course in Calgary on March 21 - 22. The precise location has not yet been determined. Please keep checking the CHES website for updated information. Our intent is to have our meetings throughout the province and have an educational component at each meeting. If anybody is interested in hosting a meeting, please contact me directly. At this time, I hope everyone enjoyed a happy and festive holiday season, and wish everyone the best for the new year.

From left to right: Preston Kostura (AB Chapter Chair and Director, Rural North , Facilities Maintenance & Engineering, Central Zone, AHS), Tom Howard (AB Chapter Vice-Chair and Manager, Rural North, Facilities Maintenance & Engineering, South Zone, AHS), Gus Rettschlag (AB Chapter Secretary and Director, Property Management, Real Estate, AHS), Randy Badry (AB Chapter Treasurer and Director, Rural East, Facilities Maintenance & Engineering, North Zone, AHS), and Ken Herbert (AB Chapter Past Chair and Senior Project Manager, Project Management, Edmonton Zone, AHS).

MANITOBA CHAPTER

Preston Kostura, Alberta Chapter Chair

CHES Manitoba will be holding its annual Trade Show and Education Conference at the Victoria Inn in Winnipeg on Wednesday May 1, 2013. The topic for this year’s conference is Electrical Energy; Efficiency and Maintenance. It will be a fantastic day featuring speakers from Manitoba Hydro, Toromont, and Schneider Electric. Morning sessions will include such topics as “Finding Energy Savings in Healthcare” and a moderated session entitled, “Getting Projects Started”, both with Manitoba Hydro. The early afternoon session, called “Generator & Transfer Switch Gear Maintenance”, will be hosted by Toromont, with the late afternoon session on “Breaker & Switch Gear Maintenance” to be presented by Schneider Electric. And don’t forget: The MB Chapter AGM will be held just before lunch on this day as well. We look forward to seeing all of the MB Chapter members there at the Victoria Inn. Registration packages will be sent out shortly. In so far as future work within the chapter, the Manitoba executive is looking for more overall involvement from its members across the province, as well as having more interaction with the various venders that we all do business with throughout our facilities. The chapter executive will be contacting the newly amalgamated regions in the province to help promote the chapter within their own regions. We are continuing to look for Manitoba representatives for the national committees. Vacant positions include Partner and Advocacy and Communications. If you are interested in working with these national committees, or as an additional member in the Membership Committee or Professional Development Committee, please feel free to contact myself or any one of the chapter executive.

I would like to take this opportunity to thank the outgoing chair, Randy Cull, for his service to CHES NL and wish him every success in his future endeavors. I would also like to apologize to our members for the cancellation of the October PD Day. This was cancelled due to circumstances beyond our control. Early in the new year, we will be having an executive meeting to discuss this issue and other issues surrounding CHES NL. I would also like to wish everyone a world of holiday cheer and a joyous New Year! Brian Kinden, Newfoundland and Labrador Chapter Chair

10 Canadian Healthcare Facilities

ONTARIO CHAPTER

NEWFOUNDLAND AND LABRADOR CHAPTER

Reynold J. Peters, Manitoba Chapter Chair

With our provincial conference finished, we are now planning for the CHES National Conference in Niagara Falls in September 2013. The conference will be held at the new Scotiabank Convention Center. This will be a great conference and I hope to see everyone there. A call for elections will be going out soon for the new executive. Take a look at what is available and consider running. Michael McRitchie from Sunnybrook Hospital has agreed to represent CHES Ontario on the advisory committee for the Revolving Energy Fund led by the Canadian Coalition of Green Healthcare. On behalf of CHES Ontario, I want to thank Michael for taking on this role. The executive met face to face in November at the Healthcare Achieve Show. We set very specific goals and objectives. Our meeting minutes are posted on the web site. Ontario will be hosting an education day on April 3rd, 2013. Gordon Burill and Michael Keen will be presenting on Z8000. The new CSA Z 8000 standard provides a nationally recognized baseline for the design and construction of hospitals. This will be a full day education session. It will be held at the Center for Healthcare Safety Innovation on Creekbank Road in Mississauga, conveniently located near the airport. The cost is $50 per member and $225 for non-members. A portion of non-member registration fees will go towards a 1 year membership. Also, the executive is developing a scholarship for members' immediate families who are pursuing education that relates to healthcare engineering. The model will be similar to the one developed by the Atlantic Chapter. We hope to present the award recipient at all of our provincial conferences. There will be more information to follow. In closing, I would like you to keep sending your ideas and feedback. The goals and objectives we set come from listening to our members. In order to have a strong chapter we must have committed and motivated members. That is why I have enjoyed serving as your chapter chair because of the committed executive and members we have. Keep the ideas and feedback flowing. Kelly Allan, Ontario Chapter Chair

Canadian Healthcare Construction Course Presented by the

Canadian Healthcare Engineering Society

Regina SK – February 21-‐22, 2013 Delta Regina Hotel

Calgary AB – March 21-‐22, 2013 Calgary Marriott Downtown Hotel

Ottawa ON – October 21-‐22, 2013 Hampton Inn Hotel & Conference Centre Check website www.ches.org for other dates & locations that may be offered in the future. Registration is available on-‐line. For further information: &+(6 1DWLRQDO 2IÀ FH Tel: 613-‐531-‐2661 | Fax: 866-‐303-‐0626 ches@eventsmgt.com | www.ches.org 4 Cataraqui Street, Suite 310 Kingston ON K7K 1Z7 Canada Executive Director: Donna Dennison Meetings Manager: Luc Deptuck

www.ches.org

MARITIME CHAPTER

Chapter Reports The Maritime Chapter has been busy over the past several months. The main business has been the revamping of the by-laws to put them more in line with those of the National Society. In addition, several members on the Executive Committee have reached (or are nearing) retirement age, and this has caused the chapter to look at bringing in fresh blood to take it to the next level in providing services to our membership. As a chapter with a large contingent of bilingual members, we are presently trying to implement action items that will entice more of these bilingual members to become actively engaged in chapter activities. Several suggestions have been brought forward as possible project stories for the Journal, and one has been earmarked as a possible contender for the Wayne McLellan Award of Excellence at next year’s CHES National Conference. A group has been established to assemble the application. This year, instead of holding one educational day, the Maritime Chapter executive team has decided to sponsor four 2013 webinars, put on by the Society, for its membership. Our chapter conference has been booked for the Delta Hotel in Moncton for May 5-7, 2013. This year’s theme will be on 'commissioning' and several speakers have been already confirmed, including Bill Carson as the keynote speaker. Bill is the chair of the CSA sub-committees, which is putting together the new CSA Standards on 'Commissioning' and 'Maintenance and Operations'. The planning committee continues to firm up further details to make this a great conference. This year’s Bursary sub-Committee, under Bill Goobie, the immediate past chair, is busy preparing applications for our 2nd annual $1000 bursary, which we hope to give to some lucky family member from our membership at our annual conference. Last year’s winner, Janelle Poushay from Sydney Nova Scotia, is studying engineering at Dalhousie University. Who knows? Maybe she will end up replacing her father, Nelson, who is soon due to retire as Director, Physical Plant, at the Cape Breton Health Authority. Ralph Mayfield, Past Chair of the Maritime Chapter, has graciously agreed to chair from the National Planning Committee for the National Conference to be held in Saint John, New Brunswick. He and Donna from the national office have been busy selecting the site of the conference and will soon have a contract signed so his Planning Sub-Committee can start working on the program as well as other details. Currently, we are trying to ensure that we have a Maritime representative on all national and chapter committees and SubCommittees so we can ensure our voice is heard and we can get as many members within the chapter active. As you can tell, we have a number of committees operating and are a very active chapter. Phil Langford, Maritime Chapter Chair

Award Nominations

CALL FOR NOMINATIONS FOR AWARDS

2013 Hans Burgers Award For Outstanding Contribution to Healthcare Engineering

2012 Wayne McLellan Award of Excellence In Healthcare Facilities Management DEADLINE: April 30, 2013

DEADLINE: March 31, 2013 To nominate: • Please use the nomination form posted on the CHES website and refer to the Terms of Reference. Purpose • The award shall be presented to a resident of Canada as a mark of recognition of outstanding achievement in the field of healthcare engineering.

To nominate: • Please use the nomination form posted on the CHES website and refer to the Terms of Reference. Purpose • To recognize hospitals or long-term care facilities that have demonstrated outstanding success in completion of a major capital project, energy efficiency program, environmental stewardship program, or team building exercise. Award sponsored by

For nomination forms, terms of reference, criteria, and past winners, visit: www.ches.org / About CHES / Awards Send nominations to: CHES National Office • ches@eventsmgt.com • Fax: 613-531-0626 12 Canadian Healthcare Facilities

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CHES Board Nominations

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. To nominate: • Nominations can be received either by: • Members identify and nominate 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. Candidate 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, 2013 and should be sent by fax or email to: CHES National Office Fax: 613-531-0626 ches@eventsmgt.com Sincerely.

Michael Hickey Chairman, Nomination & Elections Committee Past President, CHES

14 Canadian Healthcare Facilities

CHES Canadian Healthcare Engineering Society

SCISS

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WOODSTOCK GENERAL HOSPITAL TAKES

THE LEED IN ONTARIO

WGH becomes first new Silver LEED facility in province By Matthew Bradford

It was an inaugural year for the history books for the staff and patients of the new Woodstock General Hospital (WGH). Merely eleven months after settling into their new, 178-bed facility on November 20, 2011, the hospital was officially awarded with Silver LEED status, becoming the first healthcare facility in Ontario to carry the designation. The status was made official in October 2012, just weeks shy of WGH's first year anniversar y. Standing for Leadership in Energy and Environmental Design, LEED designations are awarded based on a facility's ability to meet various building sustainability standards (aka “credits”) set by the Canada Green Building Council (CanGBC). To reach LEED Silver certification, a building

16 Canadian Healthcare Facilities

must obtain between 33 to 38 of these credits out of a possible 70. Woodstock Hospital received 35. “The primary reason for incorporating LEED initiatives was to ensure a progressive, green, and healthy environment for our patients while reducing our carbon footprint,” says Natasa Veljovic, President and CEO of WGH, who played an instrumental role in spearheading WGH's sustainable design back in 2002, when plans for the new hospital were first being drafted and the LEED program was still in its infancy. “From the inception of design, the hospital board and senior management, led by Natasa, requested that the architects strive to make the building energy efficient and

Fall/automne Winter/hiver 2012 2013 17

“All through construction, we made critical decisions from energy modelling to balancing cost with environmental sustainability.”

environmentally friendly,” adds Blake Hughes, Director of Capital Projects with WGH. Located in the heart of Oxford County, the new facility provides primary care to a population of 55,000; and specialized care to 110,000. The state-of-the art facility was built from the ground up to provide a vast range of health programs to its community, including maternal child, women's health, specialized surgical services, inpatient and outpatient mental health services, systemic therapy, and dialysis and rehabilitation—all of which are supported by sustainable programs, equipment, and systems. The WGH team was assisted in its green designing efforts by Parkin Architects, which introduced the team to a successful US LEED program that would later serve as the baseline for the hospital's construction. Parkin Architects also worked extensively with project partners to ensure WGH's environmental mandates were carried out through all aspects of the projects. “Parkin Architects worked with their consultants to find construction materials and methods that demonstrated benefits in reducing medical recovery times and increasing the quality of the physical environment for patients and staff, while also minimizing the effects of construction on the public and the surrounding areas,” says Hughes. He adds WGH also brought additional consultants on board to complete energy models and investigate ways to exceed Canadian sustainability standards; as well as worked hand-in-hand with EllisDon Construction to see its designs come to fruition, noting, “The hospital and consultants strived to meet standard LEED accreditation. With the assistance of EllisDon's construction and LEED specialists, the project was able to elevate its goals and achieve LEED Silver Certification.” Speaking to its involvement in this landmark LEED project, Cameron Blair, EllisDon's Manager of Sustainable Building Services for Eastern Canada, says, “A great deal of time and energy goes in to certifying a building. It takes dedication, collaboration, and cooperative spirit from a team of individuals for certification to meet with the success of a project such as Woodstock Hospital.” That team also consisted of Honeywell Building Solutions. Commenting on WGH achieving its LEED Silver certification, Jeff Mumford, Vice President and General 18 Canadian Healthcare Facilities

Manager of Honeywell Building Solutions, says, “We are very pleased that WGHs has achieved their LEED Silver Certification. As the Facilities Management provider for WGH, Honeywell’s role in the LEED certification has been the creation and implementation of the facilities energy utilization models and Measurement and Verification Plan. The energy models and M&V Plan allow WGH and Honeywell to verify that the building is meeting the LEED standards to which it was built. As part of our FM agreement, Honeywell has provided a performance guarantee on the future utility consumption of WGH. Critical to the achievement of the performance guarantee has been the implemented of a sub-metering program that allows WGH and Honeywell to track where energy is consumed, so that we can pinpoint and resolve system anomalies quickly and effectively.” Honeywell, along with Ellis Don Construction and Fengate Capital, are part of the Alternative Finance and Procurement team awarded the design–build, finance, operations and maintenance contract for the new hospital. Jeff concludes, “The long-term impact of the energy models and M&V plan will be to help maintain WGH as a leader in sustainable healthcare.” Defining features Evidence of WGH's focus on sustainability can be found t h ro u g h o u t t h e f a c i l i t y. Fro m e n e r g y a n d w a t e r conservation systems to waste reduction initiatives, the use of natural lighting in public and workforce areas, enhanced indoor air quality systems, and the selection of construction materials and practices that minimized environmental impact—no stone was left unturned in WGH's march to LEED Silver status. One of the facility's defining features is its awe-inspiring central courtyard and continuous corridor, which were created to provide a healing atmosphere for patients, visitors, and staff. These touches also helped Woodstock become one of the first new hospitals in Canada to obtain an Innovation and Design Process LEED point for “Places of Respite”. “All through construction, we made critical decisions from energy modelling to balancing cost with environmental sustainability,” recalls Perry Lang, Chief Operating Officer

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with WGH. “Our goal was to construct an environmentally friendly, cost efficient building that our community could be proud of.” Achieving Silver LEED status for a healthcare facility was not without its challenges, however. Balancing WGH's need to provide top-tier hospital services with its LEED design goals meant assessing each component of WGH's facility individually, and arriving at solutions that met the hospital's high standards. “As the LEED program is developed to address all types of building, the consultants were challenged in finding a balance between healthcare design standards, infection control, and energy efficient design. Healthcare requirements for mechanical ventilation systems are more stringent than the greater public centre type facilities,” says Lang, explaining, “For example, operating rooms require a greater exchange of fresh air changes per hours—to minimize infections and to exhaust the anaesthetic gases in order to provide a safe work environment for staff. Typical office facilities only require two air changes per hour, which results in more energy required to condition the outdoor air in the operating suites. Additionally, some features, which are acceptable for other structures, require increased maintenance to address infection control standards, such as the storage of grey water—as in hand washing or rain water—for use in waste water reduction.” Lasting benefits The sum of Woodstock General Hospital's sustainability efforts have equalled long lasting benefits for both its occupants and community. Reflecting on the latter, Hughes says the ongoing diversion of waste from landfills, reduction of green house gasses through low maintenance planting, and the implementation of Facilities Management programs have combined to drastically reduce WGH's environmental footprint. As to the former, he says staff, patients, and visitors alike stand to benefit greatly, noting, “The staff, patient and the public are subject to a viable facility that promotes, provides, and monitors its impact on the environment and energy usage. Patients and staff have greater control over the environmental conditions of the spaces they occupy.” Reflecting on what WGH's Silver LEED certification represents for the Ontario healthcare community in whole, Lang adds, “WGH is proud to be a leader in the development and implementation of an environmentally and efficient facility. The collaborative efforts from the Ministry of Health and Long Term Care, WGH staff, design team members, and construction counterparts demonstrate that by working together we can have an effect on the environment for not only patients and staff, but for future generations.”

Woodstock General Hospital's LEED credit allotments Point Allocation

Achieved Credits

Possible Credits

Sustainable Sites

Water efficiency

Energy & atmosphere

Materials & resources

Indoor environmental quality

Innovation and design

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in g G a rd e n

A rendering of CCI's future Healing Garden

HEALING GARDEN

FLOURISHES AT EDMONTON'S CROSS CANCER INSTITUTE CCI takes a refreshing approach to patient comfort

By Bernard Tong

20 Canadian Healthcare Facilities

The Cross Cancer Institute Volunteer Association (CCIVA) in Edmonton has approximately 350 members. The volunteers’ mandate is to welcome, comfort, and care for patients, families, and visitors during their time at the Cross Cancer Institute (CCI). To commemorate its 50th Anniversary of dedicated service, the association initiated a legacy project: An outdoor Healing Garden. The Association wanted to leave a legacy that would be both permanent and substantial, as well as one that would be in keeping with their mandate to enhance patient care and comfort. In February 2012, the association engaged a team of consultants to conduct a feasibility study and site analysis for the purpose of reviewing garden themes and features and confirming scope and cost. The association signed off on the conceptual design in May 2012, and a sod turning ceremony was held on November 14, 2012.

“I spent six weeks as an inpatient and still remember that my view of the real world was limited to a roof top where a small seedling was heroically attempting to grow. When I was finally able to step outside and enjoy the fresh air, it was so remarkable; feeling the sun on my face and being amongst nature felt like the best cancer therapy ever.“ - Debra Hall-Lavoie, Board Member, Cross Cancer Institute Volunteer Association.

Features such as barrier free walkways, an aboriginal medicine wheel, a custom designed curved pergola and seating space, a feature wall, and a variety of plants have been creatively incorporated into the design. In addition, several features have been designed to accommodate and showcase artwork created by cancer patients. All in all, a much needed natural get-away from the tiring, stressful and often intimidating regime of cancer treatment will shortly be available at the Cross Cancer Institute. PLANTING THE SEEDS Edmonton Zone Project Management of Alberta Health Services was tasked to assist with managing and expediting the completion of design development and tender documents by Labour Day, 2012. The documents were duly completed, with

pre-tender estimate substantially over budget. To move forward, it was decided to request separate prices from the bidders and that the association would seek additional funding support. Alberta Cancer Foundation endorsed the project with a generous financial offer. Bidding proceeded in mid-September 2012. Bids were opened in mid-October and the bids received were substantially over budget. As the bids were examined, it was found that the contractor with the lowest bid also undertook to make a generous donation. The contractor, Delnor Construction Ltd., together with sub-contractors and suppliers, had joined forces to secure the financial viability of the Healing Garden project. A contract was awarded to Delnor on November 1, 2012. The enthusiasm, diligence, generosity, and commitment of the Association and its two partners have made it possible to plan

“The Alberta Cancer Foundation eases the journey for Albertans facing cancer and the Healing Garden is one of the ways we can do that. We are pleased to be a partner in the creation of this garden and privileged to invest our donors’ dollars in an initiative that will provide enhanced care at the Cross Cancer Institute.” - CEO of the Alberta Cancer Foundation.

Winter/hiver 2013 21

“The Cross Cancer Institute does so much to provide hope to its patients - for us to be able to help provide comfort to those who need it the most is a truly humbling experience. Delnor, with our sub trade and supplier partners, are proud to donate a significant portion of the construction costs to make the project a reality.” - Ron Hinz, Principal of Delnor Construction. for an Official Opening of the Healing Garden in June 2013. Along with its partners, the association has once again sown seeds of compassion at the Cross Cancer Institute; seeds that will grow and flourish in the hearts and spirits of those whose cancer journey has brought them to a comforting and therapeutic environment ... a Healing Garden.

Bernard Tong (AAA APM CHES) is Project Manager, Edmonton Zone, Capital Management, with Alberta Health Services. The above article was prepared with the kind assistance of the CCI Volunteer Association and excerpts from Alberta Health Services website posting - News & Events, November 21, 2012 article entitled “Edmonton care centre welcomes Mother nature”.

“And those of us who have been on the brink of death, know that nature can have a profound effect on the human spirit.” - Susan Carr, Chair of the Cross Cancer Institute 50th Anniversary Committee in a speech at the sod turning ceremony, 14th November 2012.

Healthcare Engineering Sustainable Design

Lighting and Power

Plant Engineering

Communications & Security

HVAC Medical Gases

High Voltage Energy Management

Life Safety Systems

22 Canadian Healthcare Facilities Untitled-3 1

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RESTIGOUCHE HOSPITAL CENTRE UNDERGOING P3 TREATMENT Construction underway for new psychiatric facility in New Brunswick By Matthew Bradford

24 Canadian Healthcare Facilities

The shovels are in the ground in New Brunswick where an ongoing public-private partnership (P3) project will see the province's residents serviced with a new, Silver LEED psychiatric facility in 2014. The project was launched September 2010 by the government of New Brunswick to replace the former Restigouche Hospital Centre in the city of Campbellton, located on the south bank of the scenic Restigouche River. “The existing facility, Restigouche Hospital Centre, was fifty years old and certainly showing its age,” recalls Scott Gibson, Executive Director for Special Projects Developments, Buildings Division, with the Government of New Brunswick (GNB), explaining, “Because of the size and the complexity involved in doing this type of a facility— which was in excess of $100 million capital budget—the province made the decision to go out and entertain a request for proposal [RFP] for a P3 model.” What followed was an extensive RFP process in which potential proponents came forth with ideas and designs for a new 26,942 square

metre, 140-bed psychiatric building to be built on the site of the Campbellton Regional Hospital, which also housed the previous Restigouche Hospital Centre and the Regional Addiction Services Centre. The request for proposals was issued on September 13, 2010. It outlined GNB's primary goal for the project, which was to provide a modern standard of health care in four clinical programs: Tertiary Rehabilitation Psychiatry, Older Adult Psychiatry, Intellectually Disabled Psychiatry for the residents of RHA, and Forensic Psychiatry for the entire province of New Brunswick. The document also outlined core project objectives including: • A fully commissioned facility in accordance with all of the requirements of CSA Z318 latest edition. • The renewal of public infrastructure and improvement of the quality of the mental health services offered. • A positive economic impact on the province. • 'Value for money', through the transfer of key project risks during construction and operation phases. • LEED Silver certification, as obtained from the Canada Green Building Council (CaGBC). • Optimized energy efficiency. • The winning proponent to operate and maintain the facility for 30 years under the Project Agreement. • To have the facility handed back to the province in accordance with the terms of the Project Agreement at the end of the term; and • A completion date of October 15, 2014, at the latest. The RFP also detailed plans to design the new facility based on the 'house/neighbourhood/downtown' model, a concept patterned on the organizational structure found within a typical community setting. “In essence, when a patient enters the hospital, it is expected that due to the severity of their illness, they will spend most of their time in the unit (house) and as they become better, they will want to and be able to venture out of their unit into their neighbourhood and then subsequently into the downtown are,” reads the RFP'S project overview. “Each step will represent more independence on the part of the patient, a way in which they can test and improve their competencies with lessening control required by hospital staff. The safe environment provided by the hospital will support this increasing well-being and participation on the part of the patient.” Speaking to GNB's motivation for pursuing a house/ neighbourhood/downtown model, Gibson adds, “We were going for a recovery model of care, which would basically allow the facility and the community to work together to promote wellness in the context of a recovery model that supports individuals to live the most satisfying, hopeful, and productive life consistent with the limitation of their illnesses.” In the end, Gibson notes the RFP process was both time consuming and exhaustive, but that it was to be expected in a project of this scope and nature. Speaking to the differences between this and a traditional project, he explains, “The most significant change is that

when you do a traditional design, bid, build, the design is all done. You put out the specifications, you put out a price, and the risk is still born by the owner. In this particular case, however, you're doing a lot of your work up front because everything has to be detailed to the point where the project company can sit down and say, 'Yes, the risks have all been identified. We're comfortable with this, and you're comfortable.'” “It was a very lengthy and detailed process, but when you're building a $124-million facility, you want to make sure you get what you want,” he adds. PICKING A PROPONENT Following eight months of design presentations and meetings, GNB selected SNC-Lavalin as its preferred proponent, with Bird Construction as a partner in the design build component of the project and Parkin Architects Limited as a participant. On September 22, 2011, it signed an agreement with the firm, and moved into the final stages of cementing its design. Currently, the project's foundation is near completion, with structural steel well underway and SNC-Lavalin's team well in the process of closing the facility. “We have developed a very positive relationship with SNCLavalin; they have been good to work with,” reports Gibson. “The quality of construction has certainly been there.” Gibson adds that part of the agreement requires SNC-Lavalin to file quality assurance documents throughout all phases of construction, which are then observed and audited by GNB. A third party independent certifier has also been brought on board to audit areas of potential issues and to provide an impartial source of conflict resolution should issues arise down the line. The cost of that independent third party certifier is shared between SNC-Lavalin on the province. A CASE FOR P3 It's been nearly two years since Gibson and his team launched their P3 partnership. That's been two years to reflect on a long and detailed process, which Gibson admits isn't always ideal for all project owners; specifically, those who might not have as much of an investment on the line. “A deal like this is not for the faint of heart. There's a lot of money at stake, and there's a lot of quality assurance issues at stake, so there needs to be a lot of due diligence going through to make sure all the i's are dotted and t's are crossed.” Regardless of the risks, Gibson says the results have been promising. And while the decision to pursue a public-private relationship meant more upfront due diligence for the government, the project's ongoing success is evidence they're on the right path. “We recognized the need for a new psychiatric facility and our objective was to obtain good quality and good value for the tax payer's dollars, and we felt this was the appropriate way to go. So far, early indications are that things are working out very well.” Winter/hiver 2013 25

THE CASE FOR PIPE LINING Advantages and benefits of in-pipe lining technology By Amanda Strouse

The epoxy is blown through the pipe system to create an even coat, which will cure (aka: dry) and create a protective liner.

Technicians push the Nu Drain epoxy through the structural liner. Once completed, the liner can be inserted into a pipe line to create a protective liner.

26 Canadian Healthcare Facilities

They are used every time someone washes their hands, uses the restroom, disposes a substance in the laboratory, or cleans dishes in the cafeteria. Drains are used constantly in hospitals to exterminate all types of waste and chemicals. The regular maintenance and cleaning of these crucial drain lines often go over-looked until there is a problem. Common drain pipe system failures include, but are not limited to: leaks, water stains, mold, slow drains, and backups. These failures occur due to aged pipes, corrosive waste, and debris buildup. Even routine cleaning of a hospital’s drain systems cannot prevent inevitable pipe system problems, because plastic and metal pipes have a limited lifespan. The traditional fix for pipe system aging and failure is a repipe; a replacement process that can typically cost excess dollars and time for facility maintenance staff. Walls, floors, and ceilings have to be torn apart, equipment needs to be moved, and pipe systems are nonfunctional. After, different crews need to put the walls, floors, and ceilings back together. In a medical setting, this process can be disruptive to normal operations. An alternative to pipe repairs is a technology called in-place pipe lining; a solution that allows hospitals to install protective pipe liners in various pipe systems without having to dig up the pipes for access or replacement. In addition to being timeefficient, inexpensive, non-invasive, non-destructive, and ecofriendly, pipe lining greatly extends the useful life of the pipe system without causing interruption to patients or medical staff. When the Sudbury Regional Hospital in Sudbury, Ontario, opened a new wing and laboratory a few years ago, it was designed with copper drain pipes. The hospital’s management knew that corrosive chemicals that would be flushed down the drains would cause instantaneous problems, so a pipe lining solution was found. More than half of a mile of 2”-wide copper drain pipes were lined in-place. This pipe lining process prevented the need for any destruction to the newly built hospital wing. The copper drain pipes were lined with a protective epoxy coating that inhibits

chemicals from touching the copper metal. A traditional repipe would have closed the new hospital wing for several more weeks or months. With pipe lining technology, however, the hospital was able to move ahead faster. Earlier this year, a 7-story medical and commercial building in Ottawa, Ontario, which includes an established private Laser Vision Correction Centre, experienced restroom drain systems leaks and other failures. The building management knew that a long-term fix had to be found, but most importantly, a fix that would cause as little disruption as possible. The building’s 20-year-old copper drain pipes eroded, due to age. These pipes run behind marble walls, which the customer wanted to preserve. With innovative pipe lining technology, the pipe system was cleaned and lined in-place, without causing any destruction to the marble walls or b a t h r o o m s . T h e j o b w a s c o m p l e t e d w i t h o u t a ny inconvenience to the building’s tenants, visitors, or normal operations. In-place pipe lining technology is highly versatile and can be applied to all sorts of pipe systems, including drinking water, HVAC, storm drains, dialysis drain pipes, electrical conduit and fire suppression systems. This inside infrastructure solution can provide priceless benefits to hospitals and medical facilities, such as saving lives because equipment does not need to be turned off and surgical rooms do not need to be closed down while the work is performed. Amanda Strouse is with Nu Flow America (www.nuflowtech.com).

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TV Service Providers to Jostle in New Markets

Differing TV service models foreseen for long-term and short-stay occupancies By Barbara Carss A recent decision from the Canadian Radio-television and Telecommunications Commission (CRTC) puts cable and satellite television providers in a better position to compete in some categories of commercial and institutional buildings where owners/managers still typically have bulk service contracts with one company. CRTC regulation 2011-774, released last December, clarifies that the owners of inside wire in properties such as hospitals, seniors’ facilities, hotels, restaurants, and student residences cannot deny access to the infrastructure to other licensed service providers. This mirrors rules that have already applied in residential condominiums and rental housing for several years, which have largely changed the business model for service provision. Contracts are now typically forged directly with end-users rather than the building owner/manager, and industry observers foresee a similar shift ahead in seniors’ and students’ buildings that accommodate longer-term residents. 28 Canadian Healthcare Facilities

“There are few bulk billing arrangements left because cable companies simply will not offer the bulk service in MDUs (multiple dwelling units),” observes Joe Hoffer, a partner with Cohen Highley LLP who specializes in residential tenancy law. “There was a business advantage in the past when cable services were simple, one-size-fits-all, and landlords could negotiate great prices and concessions. But, administratively, it’s a relief for landlords to let tenants deal directly with the service provider, particularly now when they want choice rather than being limited to a one-size-fits-all option.” Although hospital, hotel and restaurant operators are still going to be negotiating contracts on behalf of their short-stay patrons, the new regulation provides more practical flexibility to switch service providers. Until now, the incumbent service provider that installed and owned the wires within the building could prohibit competing companies from using it, meaning that subsequent providers would have to re-cable to bring their

service into the building. Few building owners/managers deemed that disruption worthwhile. “A lot of these [service] agreements may have been renewed five or six times in the last 30 years just because there was little choice,” suggests Geoff Baker, National Sales Manager for Bell Satellite TV. His company was the initial proponent to request a CRTC review and decision on the issue, but other service providers, such as MTS Allstream and Saskatchewan Telecommunications, and hospitality industry interests, including Hilton Worldwide and the Hotel Association of Canada, offered support. The CRTC decision stipulates that competing service providers will pay a fee to the owner of the wire, which in many building configurations will be the same $0.52 per subscriber monthly fee specified in condominiums and rental housing. In other cases where the original service provider had to invest either more or fewer resources than is the norm to wire the building, the regulation calls on the parties to negotiate an appropriate fee. “There are still some issues to sort out around the location of demarcation points, but the importance of the decision is that the CRTC made a clear determination that when a cable company owns this inside wire, it has to provide access to competitors wishing to use it ,” Baker maintains. “Previously, companies were outright denying access and this was a thorn in a competitive environment.” Bell’s status as a competitor challenging incumbent cable TV providers is a role reversal to its historical dominance in phone

service. Likewise, CRTC 2011-774 is something of a flipside to the 2003 CRTC ruling that gave competitive local phone service carriers access to existing inside wire in buildings. “It’s kind of going full circle,” muses JenniferSicilia, Vice President, Telecom Property Management, with the IT services consulting firm, Rycom TPM. “Now it’s opening up for a level playing field on both sides – phone and TV.” Sicilia identifies advantages for building owners/ managers, as well. The new regulation should ensure a smoother transition in switching to new service providers, and possibly open up more competitive pricing since installation costs should be lower. “It’s all about choice, price and turn-up times,” she notes. Hoffer advises owners/managers to retain some room to manoeuvre. “I used to see 10-year agreements with service providers, but I consistently recommend nothing more than three years, which in itself can be an eternity in this area of contract,” he says. Meanwhile, seniors’ and students’ housing operators may want to look at how condominium corporations and rental housing landlords have leveraged their position in a new kind of market. “Many landlords will still have a ‘preferred’ service provider to whom they extend exclusive marketing rights on-site and receive some form of benefit in return,” Hoffer reports. The preceding article is reprinted from Canadian Property Management, April 2012.

CHES e-news 2013 …now publishing monthly The Canadian Healthcare Engineering Society (CHES) has launched a new electronic newsletter. As a supplier to the hospital and long term care sector, you have an opportunity to reach out to every CHES member plus an additional 2,000 long term care facilities. Your advertising message will be delivered to over 3,000 inboxes with the latest in news and developments in the health care sector.

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Winter/hiver 2013 29 13-01-07 11:32 AM

Norfolk General Hospital Earns OHA Award NGH honoured at OHA Green Health Care Awards

From left to right: Linda Varangu (Canadian Coalition for Green Health Care), Joanne Keifer (Director, Nutrition & Foodservices/ Housekeeping/Laundry & Linen, NGH), J.J. Knott (Director, Plant Operations, NGH), and Terri Stenclik (Director, Purchasing, NGH).

30 Canadian Healthcare Facilities

This fall, Norfolk General Hospital's (NGH) sustainability stewardship was recognized with the 2012 Green Health Care Overall Leadership Award, as presented by the Ontario Hospital Association (OHA) and the Canadian Coalition for Green Health Care. The honour was announced during the Green Health Care session at the HealthAchieve 2012 Convention, which took place at the Metro Toronto Convention Centre on November 5, 2012. “It was very exciting to learn that we had been selected as the winners. This is truly a corporate award that all staff can be proud of,” said Joanne Kiefer, Director of Nutrition, Food Services and Housekeeping at NGH. “While certain individuals may be responsible for initiating green programs, without the staff participation in these programs (e.g. recycling, energy conservation, travel mug program) we would not be successful.” “Congratulations on demonstrating a significant organizational commitment to environmental sustainability and to reducing environmental impact, including evidence of progress in energy efficiency, pollution prevention, waste management and involvement with the community,” said Amanda Nilsson of the Ontario Hospital Association. The award recognizes leadership and excellence in reducing health care’s environmental impact. Over the past year, NGH has re-energized its waste minimization program; implemented several initiatives to reduce water and energy consumption; participated in a local foods initiative; and has hosted a green health care workshop for south-central and south western Ontario health care organizations. “NGH is a principal employer in our community and we want to demonstrate leadership in the area of green,” said Kiefer, adding, “Incorporating green into health care shows that we are committed to a healthier, sustainable env ironment and the protection of our staff, patients and visitors. “ It is a win win situation for all.”

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