CHF Fall

HealthcareFacilitiesJournal of Canadian Healthcare Engineering Society

InSIdE

Canadian

Volume 33 Issue 1 Fall/automne 2012

Reducing Infection Through Proper Air Filtration Green Certification SystemsISO 50001

PM#

4006

3056

Canadian

HealthcareFacilities

CHES 2012 AwardsCHES 2012 AwardsCelebrating success in Montreal

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

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

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

The location and inspection of the hospital ventilation fire doors may be part of

your building audit this year. Some of you have already taken advantage

of our new software program which in conjunction with our patented robotics, allows us to minimize ceiling access requirements.

To date, of the thousands of fire doors inspected approximately 30% are not humanly accessible from traditional ceiling

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

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

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

The location and inspection of the hospital ventilation fire doors may be part of

your building audit this year. Some of you have already taken advantage

of our new software program which in conjunction with our patented robotics, allows us to minimize ceiling access requirements.

To date, of the thousands of fire doors inspected approximately 30% are not humanly accessible from traditional ceiling

access points. Our patented robot overcomes

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Ventcare CHF.indd 1 27/04/10 2:26 PM

contents

departments

6 message from the publisher By steve mcLinden

8 message from the president By John J. Knott

10 Chapter reports

artiCLes

12 CHes Wayne mcLellan award profile: alberta Health services, Capital management, response team, north Zone By matthew Bradford

14 CHes Hans Burgers award profile: steve rees By matthew Bradford

16 seeing is Believing: st. michael's Hospital's real-time approach to inventory management By michelle dickinson

24 environmentally approved: Understanding green certification systems

By richard marriott

28 isO 50001 By Barbara Carss

32 reducing infection through proper air Filtration

By dave Blackwell, matthew Crouch, Berni Baier, and Larry isford

Canadian HealtHCare faCilities is publisHed bY under tHe patronage of tHe

Canadian HealtHCare engineering soCietY

Publisher steve Mclinden e-mail: [email protected]

editor Matthew bradford e-mail: [email protected]

Advertising sAles sean foley Mediaedge Communications 416-512-8186 e-mail: [email protected]

senior designer annette Carlucci

designer Jennifer Carter

Production rachel selbieMAnAger

sCiss Journal triMestriel publié par Mediaedge CoMMuniCations inC. sous le patron-age de la soCiété Canadienne d’ingénierie des serViCes de santé

Éditeur steve Mclinden e-mail: [email protected]

rÉdAtric intÉriMAire Matthew bradford e-mail: [email protected]

PublicitAire sean foley Mediaedge Communications 416-512-8186 e-mail: [email protected]

PubicitÉ annette Carlucci

coordinAteur de rachel selbieProduction

CHES SCISSCanadian HealthcareEngineering Society

Société canadienne d'ingénieriedes 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: [email protected] CHes Home page: www.ches.org Canada post sales product agreement no. 40063056 issn # 1486-2530

canadian healthcare FacilitiesVolume 33 number 1

November 28-30, 2012METRO TORONTO CONVENTION CENTRESOUTH BUILDING

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6 Canadian Healthcare Facilities

Another year, another memorable CHES National Conference. Congratulations to everyone who played a role in organizing and conducting this year's annual event. By all accounts, the 2012 conference in Montreal was a great success which left attendees with fresh ideas, new insights, and bold strategies for the healthcare engineering challenges ahead.

On the topic of challenges. In speaking with CHES members outside of conference sessions, the conversation revolved around the growth of membership. No doubt, the association brings value to its membership, but the challenge remains how to communicate that to prospective members. The location of this year’s national conference is certainly a step in the right direction. Quebec is a vibrant healthcare community, however attracting members in the province presents its fair share of challenges. If the association is to grow, creative and collaborative efforts have to be made in order to move in the right direction.

This edition of Canadian Healthcare Facilities provides insight into this year’s Wayne McLellan Award winner Alberta Health Services, Capital Management, Response Team, North Zone. Response Team; and the Hans Burgers Award winner, Stephen Rees, who also hails from AHS. My congratulations go to both award recipients.

Please also read with interest Michelle Dickinson's look at St. Michael's Hospital's approach to real-time inventory management in “Seeing is Believing”; contributor Barb Carss' report on the ISO 50001 Energy Management Systems Standard; and a report on proper air filtration strategies in “Reducing Infection Through Proper Air Filtration”; among other informative article.

As always, I hope you enjoy this issue and look forward to hearing your ideas and feedback.

Steve McLinden

Publisher

[email protected]

Publisher's Message

Celebrating Excellence in Montreal

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 RateExtra Copies (members only) $25 per issueCanadian Healthcare Facilities (non members) $30 per issueCanadian 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 trimestrielExemplaires additionnels (membres seulement) 25 $ par numéroJournal trimestriel (non-membres) 30 $ par numéroJournal trimestriel (non-membres) 80 $ pour quatre numérosL’abonnement au Journal trimestriel est inclus dans la cotisation annuelle de la SCISS.

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.

New in CHES/SCISS January 25, 2011 Benchmarking Study

The Benchmarking Study is now available online as a downloadable pdf. Members must first login and then click on Resources. Read this article > Benchmarking Study



The Benchmarking Study is now available online as a downloadable pdf. Members must first login and then click on Resources. Read this article > Advertise in the CHES/SCISS E-News For additional information, please click here.

Call today to book your spot. CHES e-news will mail twelve times (monthly) in 2013.Steve McLinden, Publisher • Tel: 866-216-0860 x239 • Local: 416-512-8186 x239 • Email: [email protected]

CHES e-news 2013…now publishing

monthly

CHF_ENews_Fall_2012.indd 1 12-10-25 1:28 PM


Welcome CHES members. I hope that this message finds you all in good health.The better part of 2012 seems to have flown by already and the magnificent CHES National Conference in Montreal is now behind us. Congratulations and thanks go out to Gordon Burrill and his team for planning such a great event. I think I can speak on behalf of all in attendance when I say we were treated with warm hospitality wherever we ventured in that great city.

It is hard to believe my first year in the office of president is now complete. I have had the privilege of working with a great executive and some very hard working committees, resulting in a lot of milestones being achieved in this year, and many more targeted for this coming year.

CHES is very close to signing a mutually beneficial partnership agreement with the Canadian College for Healthcare Leaders (CCHL). This, along with the successful distribution of a special edition of our Healthcare Journal, will go a long way toward drawing the attention of healthcare executives to the hard work of facility managers everywhere. It will also allow CHES to enter into ongoing dialogue with CCHL about the sharing of educational opportunities between the two organizations.

CHES continues to work with partner organizations such as the American Society for Healthcare Engineering (ASHE), the International Federation of Healthcare Engineers (IFHE), the Canadian and American Colleges of Healthcare Leaders and Executives, Canadian Standards Association (CSA), the Canadian Coalition for Green Healthcare (CCGHC), and many more. We do this in order to broaden our influence and to participate in the setting of standards, the development of educational programs, and other initiatives that will benefit our membership.

CHES has appointed Steve Rees as our representative to the IHFE. Steve will be a great ambassador for CHES on the international front. Steve was also the 2012 recipient of the Hans Burgers Award and I congratulate him on reaching this personal achievement.

My congratulations also goes out to members of the Slave Lake, Alberta, project team for being recipients of this year’s CHES, Wayne McLellan, Award of Excellence. This was a true team in action, if I have ever seen one.

I would also like to take this time to thank Ken Herbert of the Alberta Chapter for his time serving on the national executive, and to welcome his incoming replacement, Preston Kostura.

In addition, I am happy to welcome back Interim Chair for the Maritime Chapter, Phil Langford.

Lastly, I wish to thank members who replied to our member survey and remind folks to participate in the CHES, ASHE, and IFMA benchmark survey which will close at the end of November, 2012.

Let’s continue to build on the great organization that CHES is and let’s grow together. Members make all the difference in CHES!

John J. Knott, CET, HMT, CEMCHES National President

Message from the President

Looking back on a year of achievements

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Chapter ReportsBC

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CHes BC celebrated the completion of another highly successful conference in penticton BC on June 3 – 5, 2012. it was a great time, and we saw lots of new faces and, as always, many old friends. this year’s education line-up was top notch and received rave reviews from the conference delegates. the “sOLd OUt” trade show had fantastic representation from all sectors and we received outstanding feedback from both delegates and exhibitors alike.

the CHes BC-hosted session of the Canadian Healthcare Construction Course, conducted adjacent to our annual conference, was deemed a great success by those who attended.

i would like to give special thanks to our 2012 Conference planning committee which consisted of steve mcewan (Chair), sarah thorne, steve mctaggart, Gary sveinson, norbert Fischer, mark swain and last – but definitely not least – Wendy macnicoll for a huge job well done. the only thing they couldn’t do was conjure up the normally hot penticton weather for us.

the BC Conference Organizing committee is now hard at work planning the next conference, to be held in Whistler, BC, in June 2013. the CHes BC conference has been so successful in the last few years that our growth has now limited us to only a handful of locations in BC which can host a conference of this size.

at the 2012 BC aGm held in penticton, we announced the results of the 2012 CHes BC executive elections. this year there were no nominations from the membership; hence all four elected positions were acclaimed at the aGm for a further term of office. these positions are mitch Weimer, Chair; steve mcewan, Vice Chair; norbert Fischer, secretary; and Ken van aalst, treasurer.

at the same time, CHes BC has seen two of its non-elected positions vacated as Gary sveinson, (education) and sam Campese (membership) have both stepped down. We are in the process of filling these positions over the fall.

CHes BC has dramatically ramped up its education program and has increased the value of its bursary offerings at the local colleges. We have also provided funding to BC members for the CHes Webinar series, and increased our personal education bursary program from $500 and $1000 per member.

Mitch Weimer, BC Chapter Chair

the alberta Chapter would like to congratulate Gordon Burrill and his national conference committee members for a great 32nd annual trade show and education Forum. alberta had again over 20 delegates attend and i need to thank our senior administrators in alberta Health services and Covenant Health in supporting our attendance.

in addition, i also wish to congratulate the winners for the CHes national awards, both of whom were from alberta. they included steve rees, who accepted the Hans Burgers award, and Chris Chamberlain, representing the north Zone Capital management, who accepted the Wayne mcLennan award for the slave Lake Fire response team.

the annual Clarence White Conference and trade show will be held nov. 19 - 20, 2012, at the sheraton Hotel in red deer, alberta. Watch the CHes website for conference details. On behalf of our CHes alberta members, i want to thank our committee chair, Jeff smith, and committee members randy Badry, preston Kostura, rod Vestby, Bernard tong, Lester eldridge, and Cora Husoy.

Our aGm will be held during this conference. this was an election year for the alberta Chapter and all nominations were completed via the CHes website. the new executive starting their two year term of office will be: preston Kostura, Chair; tom Howard, Vice-Chair; Ken Herbert, past Chair; Gus rettschlag, secretary; and randy Badry, treasurer.

thank you to our out-going executive – Henry doornberg, Glenn stowkowy and his assistant tammy Brady – for their contributions to the alberta Chapter for the past several years.

alberta will be hosting a Canadian Healthcare Construction Certificate Course in the spring of 2013. Watch the CHes website once the location and dates are confirmed.

On a final note as i move into the past chair position, i need to thank my fellow executive members for making the past several years as fulfilling and awarding as they have been. i wish good luck to our new executive and i know that CHes alberta is in very good hands as we move into 2013-14.

Ken Herbert, Alberta Chapter Chair

CHes manitoba will be holding its annual trade show and education Conference at the Victoria inn in Winnipeg, may 1st, 2013. some of the event's topics include electrical Breaker maintenance (sub distribution to mCC), Generator maintenance, and arc Flash. We are also looking at including a presentation from manitoba Hydro to tie into the day's topic.

the chapter is looking at purchasing an interactive display to help promote CHes manitoba to potential members and market the chapter itself within manitoba. Currently, the manitoba Chapter sits at 60 paid members and 30 unpaid members.

additionally, CHes manitoba is looking to fill vacant spots for manitoba representatives for the national committees. available positions include partner and advocacy and Communications.

the manitoba Chapter is now in very good financial position to begin working towards further promoting the chapter in ways such as conducting additional education days or sessions throughout the year.

manitoba Health has just restructured the former eleven health regions in the province to five. this amalgamation has posed some normal problems throughout the province, and we are taking this opportunity to recruit more members as well as gain more participation from the current chapter membership.

i would like to thank the other members of the manitoba executive, including Craig doerksen (Vice Chair), tom still (treasurer), and Gary Yuel (secretary) for their ongoing involvement and direction with the CHes manitoba as we move forward to promote the chapter across the province.

Reynold J. Peters, Manitoba Chapter Chair

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the spring conference was fantastic, from the excellent presenters to the very scenic and entertaining cruises of the thousand islands. my hat goes off to Chris and his team – you have done us all proud.

i would like to welcome roger Hollis to the executive as secretary. roger is a seasoned Facility director from st. mary’s General in Kitchener, and brings a great deal to the table. We look forward to working with roger over the next year. Likewise, i want to thank Jayne novak, our former secretary, for her hard work and dedication to CHes Ontario.

2013 is an election year; we will have several positions open. please consider running as you will find it is the most rewarding thing you will ever do in your life.

the second education session was held in Cambridge in april. We doubled our attendance from the first session, and the event included an excellent presentation from Garland on roofing. stay tuned for other education sessions coming up in the near future.

Our proposal with the Canadian Coalition of Green Health Care and the Opa regarding revolving energy fund has been accepted. at this point we are ironing out a few details of the agreement before signing. this will be great for all the hospitals in Ontario and especially the smaller ones that do not have the resources or funding to do projects. i want to thank Linda Varangu and ron durocher for taking the lead on this project. You are amazing people!

Jeff Weir is doing a great job to ensure members are renewing. please help him out and check your membership dues to ensure that they are paid. CHes Ontario receives a portion of each paid membership and this helps run our business in providing education to our members.

in terms of finances, we are doing very well and ed davies is keeping us on track by ensuring the spreadsheets are balanced and reports are filed with revenue Canada. Considering the set back in the economy, our investments are doing well.

Allan Kelly, Ontario Chapter Chair

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Chapter Reports

12 Canadian Healthcare Facilities12 Canadian Healthcare Facilities

Wayne McLellan Award of Excellence

On May 15th, 2011, wildfires ripped through the Town of Slake Lake, forcing the evacuation of its 7,000-plus residents and rendering massive damage to the northern Alberta town in its wake. By the time the flames subsided two days later, over one-third of the community's homes and properties had been destroyed, and many of its facilities were in dire need of repair.

As such, once the smoke cleared, re-commissioning Slave Lake Healthcare Centre became priority number one for the town's officials; not only to prepare Slave Lake for the speedy return of its displaced population, but to provide onsite medical support for the small army of emergency responders and utility crews who had descended upon Slake Lake to assist with the restoration efforts.

“It was a very difficult situation, and the town didn't want to bring people back until the hospital was functioning,” says Penny Rae, Senior VP of Capital Management with Alberta Health Services (AHS). “At that time, It was really important to the city that the hospital be a symbol of 'the town is still here', so there was a lot of pressure on the AHS team to get in there and bring the hospital back up as quickly as possible.”

With this monumental task in mind, the AHS North Zone Northern Response Team worked day and night with AHS staff and volunteers from across the province to bring the critical healthcare centre back online. Over the two weeks that followed, their efforts would help fast track Slake Lake's recovery,

and solidify the AHS's North Zone Northern Response Team as the deserving recipient of CHES's 2012 Wayne McLellan Award of Excellence.

A team success The wildfires left the community and hospital without electrical power or natural gas for heating, and a contaminated potable water supply. In addition, it was discovered that the hospital's interior and air duct systems had suffered significant smoke damage, and key systems and equipment were in need of recovery, including those related to water, boilers, nurse call, medical gasses, and sterilization equipment .

“Our main priorities included the restoration of the site including utilities to restore essential clinical services,” explains David Ponich, Zone Director for FM&E North, noting, “Our other priority was to coordinate and establish temporary liv ing accommodations for staff that were unable to return to their homes since many staff members, including physicians, lost their house and personal possessions to the fire.”

AHS's FM&E North Zone team wasted no time analyzing the wildfire damage and planning a repair sequence. Site maintenance workers Brian Schamehorn and Shayne Ruch were the first to lend their efforts to the cause, and were soon joined by AHS staff and volunteers from Cold Lake, Westlock, Athabasca, including Maintenance tradesmen Daniel Diaconescu, Dean Babuik, and Dean Cail from the

by Matthew bradford

Alberta Health Services, Capital Management, Response Team, Zone North


Royal Alexandra Hospital, Edmonton. In col laboration with AHS's Disaster Management team, Security Services, Accommodation Planning, Capitol Management, Infection Control Practitioner Kimberly Miller, and other organization departments, the team moved quickly to bring Slake Lake's hospital back on line.

“The coordinated efforts of FM&E at the ground level, at the EOC command table, and in conjunction with the multitude of separate stakeholders was vital,” insists Ken Herbert, CHES Alberta Chapter Chair and AHS Project Manager with Capitol Management. “Clear leadership was exhibited, and true collaboration with all parties in and outside of our division was evident throughout the entire process.”

“It was the most rewarding experience of my working career,” adds Chris Chamberlain, AHS's Facility Maintenance & Engineering (FM&E) Manager for Rural East, North Zone, who accepted the Wayne McLellan award on behalf of the FM&E team at the Annual CHES Convention in September. “We were able to accomplish the task of re-commissioning the healthcare centre in a short time frame, thanks to additional on-site managers, directors, and tradesmen supplied and coordinated by North Zone Facility Maintenance and Engineering”.

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Ref lec t ing on t h e te a mwor k exhibited by AHS personnel on the ground level, Chris notes: “The AHS teamwork from 'all' programs was s imply amaz ing . The wor k ing knowledge, experience, initiative, and professional attitude provided by maintenance staff attending the Slave Lake Hospital was exemplary, and truly a positive reflection of Alberta Health Services, Facility Maintenance and Engineering Program as a whole”.

In addition to receiving support from AHS's network of staff and volunteers, the FM&E crew were a s s i s te d by nu m ero u s o ut s i de resources and service partners who helped supply potable water trucks and generator fuelling for their o p e r a t i o n s a n d t e m p o r a r y accommodations and meals for AHS staff. Vital support was also provided by air filtration and medical gas testing professionals; as well as s e r v i ce co n t r a c t o r s i n c l u d i n g locksmiths , painters , and BMS programmers.

“From my perspective, it was an excellent example of how people can be so compassionate and determined to help each other,” says David. “Personal losses were put aside in an effort to contribute to the restoration of essential services. It was an incredibly large community of volunteers and multiple agencies that worked as partners to overcome the disaster.”

It's been over a year since the Slake Lake fires put AHS's North Zone team to test, but the memories of those weeks in May are still clear for all those who gave of their time, sweat, and skills to restoring the town's hospital. Looking back on its award-winning effor ts , Br ian Monaghan, Zone Director for FM&E Central says, “It is truly an honour to be recognized. We are a group that understands the merits of teamwork and in having pride in our work. We believe in supporting one another and in putting our best effort forward daily. This award and the recognition of everyone’s efforts is a reinforcement of these core beliefs. We are very thankful to CHES for this acknowledgement.”

Chris Chamberlain (top, bottom) and Daniel Diaconescu (bottom) accept the Wayne McLellan Award of Excellence on behalf of Alberta Health Services

14 Canadian Healthcare Facilities14 Canadian Healthcare Facilities

Hans Burgers Award for Outstanding Contribution to Healthcare Engineering

Pass through any facility within the Alberta Health Services (AHS) Edmonton network and you'll be hard pressed to find someone on staff who doesn't know the name Steve Rees. Over the last thirty years, Steve has left an indelible mark on the many healthcare professionals he's worked with, and continues to promote positive growth, responsible leadership, and teamwork in his current role as AHS's VP of Capital Management for its Edmonton Zone. It's these traits that have made him a welcome sight at any Edmonton hospital, and a natural pick for CHES's 2012 Hans Burgers Award for Outstanding Contribution to Healthcare Engineering.

“There's not one hospital I go to where someone doesn't give him a hug,” says Penny, Senior VP of Capital Management with AHS. “He's one of those people who genuinely cares about every single employee we have and really does a lot of work to connect frontline staff to what he's doing.”

CHES's honour comes as no surprise to Steve's colleagues. According to Steve himself, however, it was an industry nod he never saw coming, admitting, “I was actually shocked when I heard about it, to be honest. It was one award that I really didn't think I would receive because there are so many people that

volunteer so much of their time for CHES and have done so much for the Canadian healthcare engineering field ... Just to have my name beside the other recipients of the Hans Burgers Award is pretty amazing.”

Steve received his first taste for the healthcare industry as a plumber at the Misericordia Hospital in 1977. After leaving for a brief time to pursue other interests, he was drawn back to the field and spent the following decades honing his expertise in facilities maintenance jobs in hospitals across Edmonton. His natural talents and ability to lead earned him numerous top roles including that of Director of Facilities Management and Facilities Planning and Corporate Director of Support Services for the Caritas Health Group, and later as Director of Site Operations at the Royal Alexandra Hospital.

“Steve possesses really strong attributes in terms of people skills and paying attention to the culture not only within his own team, but also with customers,” says Dean Olmstead, Edmonton's FM&E Zone Director, speaking to the secrets of Steve's success. “When we do tours of hospitals, it always takes longer to walk with him because he's been in these hospitals, and everyone wants to stop and talk to him.”

by Matthew bradford

Steve Rees

When AHS was formed in 2009 – creating Canada's first fully integrated, province-wide healthcare system – Steve became its first Vice President of Facilities Maintenance and Engineering; a position that made him responsible for over 128 hospitals and 1200 staff. His success eventually lead him to his current position as Vice President of Capital Management for the Edmonton Area, which he assumed following AHS's zone restructuring. In this role, he continues to look after operations in Facilities Maintenance & Engineering, as well as Project Management, Clinical Engineering, Protective Services / Parking Services, and Property Management portfolios.

“It was really like starting your own business, because we started from scratch and built the organization from the ground up,” says Steve, recalling AHS's early days. “That is something I'm proud of.”

During his time with AHS, Penny says Steve has embraced the organization's vision and dedicated his efforts to creating a culture of integrity, transparency, and responsibility amongst his staff and colleagues. “When I first joined AHS, Steve was probably one of the first people within our team to truly start thinking provincially. He and I travelled together extensively across the province to start engaging front line staff in what is possible, understand their concerns, and figure out how to help them achieve what they need to be achieving.”

In addition to establishing and attending regular LEAN meetings, Steve was also instrumental in setting up the Facilities Maintenance & Engineering Safety Committee in collaboration with Workplace Health & Safety. For both initiatives, Steve meets regularly with staff to collect insights, generate new ideas, and involve everyone in AHS's growth.

“He's had an impact on such a broad group of people. His ability to engage staff, genuinely hear their ideas and how to implement them, and personally follow up with people, is outstanding,” says Penny.

Explaining his motivation behind the LEAN initiative, Steve adds: “We're just trying to continuously improve AHS. Remember, we started from scratch and we're slowly improving it and making it a great place for people to work and provide great patient care.”

Outside of his day-to-day work with AHS, Steve has also contributed greatly to CHES. He served as its Vice-President from 2003 to 2005, its President from 2005-20007, Past President from 2007-2011, and is currently on its Partnership & Advocacy Committee. He was also recently appointed CHES's ambassador to the International Federation of Healthcare Engineering (IFHE) and is working alongside the American Society of Healthcare Engineers (ASHE) and the International Facilit ies Management Association (IFMA) on a North American-wide benchmarking project.

Steve is also a member of Canadian Standards Association Technical Committees for z8000 Design and Construction of Health Care Facilities, Z317.13 Infection Control in Health Care Facilities during Renovations, Maintenance & Construction, and Z204-94 Managing Indoor Air Quality in Office Buildings.

To say Steve has been busy is an understatement. But of all his achievements, past and current, Steve claims the most rewarding part of his career is seeing his friends, colleagues, and staff find their own success, noting, “Probably the thing I'm most proud of is the development of people around me, and watching the people grow with me through the last 30-odd years. There are a lot of them that are working right beside me now that I've worked with for 30 years, and if I had anything to do with that, that would be probably be my biggest accomplishment.”

Steve accepted his award during the CHES Annual Conferences in September. In it, he thanked his friends, family, and co-workers, telling CHF Magazine after the event that, “I really consider this a team award, not a personal one. There's just no way I could have done it without incredible support from all areas, including my wife, my family, the people I work with, and Gordon Burill who mentored me while I was president of CHES. If I didn't have that support, there's just no way I could have volunteered that time and be successful in some of the things we did.”


CHES honours Steve Rees' contributions and successes with AHS during annual awards gala.


Seeing iS BelievingSt. Michael's Hospital's real-time approach to inventory management.by Michelle dickinson

The traceability and accountability of inventory is a fundamental need in the healthcare sector. There are countless areas within a facility where inventory is costly and/or whose shelf life has a direct impact on patient safety. As a result, considerable time and effort is consumed in tracking, tracing and returning items.

This is not merely an administrative issue. The need for real-time inventory capture and tracking is critical to ensuring patient safety. In particularly sensitive areas, such as implantables, real-time information on product quantity, expiry dates, and patient consignment can reduce risk while improving overall efficiency and accuracy.

Implantables was in fact the focus for a new supply chain initiative at St. Michael’s Hospital. Three years ago, we

realized that with the amount of consignment we had on our shelves, we did not have good traceability with respect to implantable products, quantity and expiry dates.

The question we asked ourselves was, “How could we capture information about our implants in our database so we could track them from the shelf to the patient?” In the case of a product recall, for example, there was no specific means to trace an implant back to a specific patient without a lot of manual research. Beyond knowing that it was on our shelf at some point and it was implanted, finding out the finer details often involved tremendous effort.

In assessing our implantable inventory processes, we looked at all the touchpoints throughout the value chain, including vendors, hospital administration, receiving,



nursing, and surgery, among others. The system worked as follows: At the time of surgery, stickers provided on implants were removed and entered into a chart or O.R. record, as well as in a “little black book”. An individual would then pick up the book and enter a requisition into the system for replacement. When items were drawn from inventory, the information also had to be mapped to the cost centre with the appropriate expense codes.

Clearly, automation was a potential solution. However, the question remained as to how to automate information transfer when working with limited resources and a legacy database.

When reviewing existing pre- and post-insertion traceability capabilities, it became evident that integration with supplier tracking systems for consigned items would simply not be robust enough and we could not determine a commercial application that met our needs. Given these limitations, it made sense to partner with our in-house IT department to work on a database integration strategy that

would enable end-to-end visibility into our implant inventory.

While the process may seem straightforward, a database project of this magnitude required considerable research and collaboration on the part of many constituents. During the initial planning stages, we conducted numerous focus groups as well as established committees with a cross-s e c t i on o f s t a ke h o l der s ( nu r s i n g , I T, d a t a b a s e , administration) to determine our goals and implementation strategies.

The end result was a unique barcode system in which items could be scanned on arrival and entered into our central repository using an internally-developed asset tag numbering system. Our approach was to use GTIN GS1 standards as a basis that could be applied to the items on arrival. This would allow us to enter and access complete information on the product code, description, lot and serial number and expiry in a standardized format.

This was arguably the most challenging part of this

“While the process may seem straightforward, a database project of this magnitude required considerable research and collaboration

on the part of many constituents.”

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database project, since vendor product identification systems can vary considerably. A number of vendors still produce implants in batches and codes them by lot numbers (no unique identifiers per item), while others code items according to their serial numbers.

A particular feature of note was our “grocery list” application that manages the consignment of plates and screws. This unique application lists these items specific to systems, where nurses can access information on specific trays to see where items are, when they were received, and what was used or wasted.

In order to ensure a smooth transition, implementation was done on a service-by-service/specialty-by-specialty basis, beginning with ophthalmology in 2009, followed by cardiovascular, gynaecology and surgery in 2011. In 2012, plans are to add services that were not previously part of

the OR area, including EVAR (Endovascular Aneurysm Repair).

With the new system in place, the asset tag is scanned upon receipt of inventory for automatic entry into the database. It is again scanned when it is removed from the shelf and in the OR for implantation. The information is automatically pushed out to the vendor’s purchase order system for product replenishment. An automated monthly reporting system also notifies us – and our vendors - when products are about to reach expiry thereby reducing the number of site visits to perform manual counts and inventory rotations.

Expiry management is an extremely important aspect of this information gathering in mitigating patient risk. With over 5,000 items in stock, we must ensure that inventory is always up to date and all items accounted for. As our system

“Expiry management is an extremely important aspect of this information gathering in mitigating patient risk.”

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has matured, vendors are now in fact turning to our process to support their own service delivery requirements,

Automation not only allows us to perform all of the above mentioned functions in real-time, it dramatically minimizes the risk of error. Among other benefits, we can easily track deployed implants on a per patient basis in the event of a recall or scheduled replacement requirement.

The automated reporting feature also provides a valuable window into what we have, what we need, and patient status in real time. To further improve efficiency, the information gathered - whether scanned on receipt of goods or on consignment to patients - automatically populates multiple files (e.g. patient chart, inventory, purchasing, surgeon’s records, etc.) saving considerable data entry requirements and reducing the risk of error.

As we became more familiar with the system and its capabilities, we have also used the asset tagging system to look beyond implant inventory to tracking high cost items in other areas.

The most interesting aspect of this project, beyond our new-found tracking capabilities, is that we were able to design and develop a system to integrate with our existing database infrastructure without the need for a wholesale and costly upgrade. Ultimately, we have created a real-time database that improves and streamlines inventory management, as well as enables controls to protect all our stakeholders, from vendors to staff to our patients.

Michelle dickinson is Materials Coordinator, perioperative services, at st. Michael’s Hospital and a featured speaker at Healthachieve 2012, held in toronto in november.one of the largest and most prestigious health care gatherings in north america, Healthachieve aims to inspire ideas and innovation with over 50 informative and engaging educational sessions along with its award-winning exhibit floor, where close to 300 exhibitors showcase the latest health care products, services and technologies. Visit www.Healthachieve.com for more information.

“Automation not only allows us to perform all of the above mentioned functions in real-time, it dramatically minimizes the

risk of error.”

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Reducing environmental impact is essential to creating a sustainable future. As you consider product choices that meet your healthcare facilities’ environmental needs, it’s important to take into account not just what a product is made with, but how it is made as well and how it will improve the experience for patients and visitors.

Creating products with 100% recycled fibre is one approach to environmental sustainability, but it does not take into account 100% of the picture. Manufacturers who take a holistic approach – examining a product’s

Understanding green certification systemsby richard Marriott

ENviRoNMENTAlly AppRovEd

entire lifecycle, from source to disposal – offer a balanced approach to the environment that is aimed at continually reducing the use of natural resources. That means designing products so users consume less, either through improved p e r f o r m a n c e , m o r e r e l i a b l e d i s p e n s i n g methods, or both. It also includes using sustainably sourced fibre, less packaging, and manufacturing technologies that reduce the amount of raw material used. Superior product performance allows people to use less and waste less.

There are a wide variety of products that can help you minimize your impact on the environment, as well as reduce costs. The following is an overview of key green certification systems used for tissue and towel products.

Forest Stewardship Council Chain of Custody Certification (FSC)F S C i s a n i n d e p e n d e n t , n o n -g o v e r n m e n t a l , n o t - f o r - p r o f i t organization established to promote the responsible management of the world’s forests. It was created in 1993 in response to concer ns over g loba l deforestation.

FSC chain of custody (CoC) tracks FSC certified material through the production process from the forest to the consumer, including all successive s tages o f process ing ,

transformation, manufacturing, and distribution. Only FSC CoC certified

operations are allowed to label products with the FSC

trademarks. The FSC label provides the link between responsible production and consumption and enables consumers to m a k e s o c i a l l y a n d

e n v i r o n m e n t a l l y re spons ib le purchas ing

decisions.FSC certification is a voluntary,

market-based tool that supports r e s p o n s i b l e f o r e s t management worldwide. F S C c e r t i f i e d f o re s t products are verified from the forest of origin through the supply chain. The FSC label ensures that the forest products used are from responsibly harvested and verified sources. FSC is also supported by such major env ironmental g roups as Greenpeace, the World Wildlife Fund (WWF), The Nature Conservancy, and National Wildlife Federation.

For more information, visit www.fsc.org.

EcoLogoEcoLogo is North American’s

largest, most respected environmental standard and certification mark. EcoLogo provides public, corporate, and consumer customers with assurance

that the products and

services bearing the logo meet stringent standards of environmental leadership.

The EcoLogo mark provides third-party, independent assurance that products meet stringent environmental standards. Many EcoLogo-certified products contain a balance of virgin and recycled fibres, resulting in improved quality and performance. This means less paper waste and less cost for your business.

The EcoLogo Program is a Type I eco-label, as defined by the International

Organization for Standardization (ISO). This means that the

p r o g r a m c o m p a r e s products and services with others in the same c a te g o r y, d e ve l o p s r i g o r o u s a n d scientifically relevant

criteria that reflect the entire l i fecycle of the

product, and awards the EcoLogo to those that are verified by

an independent third party as complying with the criteria.

For more information, visit www.ecologo.org.

Green SealGreen Seal is an independent, non-profit organization that develops lifecycle-based sustainability standards and offers third-party certification for those that meet the requirements in the standard. Green Seal has been actively identifying and promoting sustainability in the marketplace, and helping companies become greener, since 1989.



Green Seal certification ensures that a product meets rigorous, science-based l e a d e r s h i p s t a n d a r d s , g i v i n g manufacturers the assurance to back up their claims and purchasers the

confidence that certified products are better for human health and the environment.

Green Seal operates under the i n t e r n a t i o n a l g u i d e l i n e s f o r

environmental labelling programs, ISO 14020 and 14024, set by the International Organization for Standardization. Green Seal is also a founding member of the Global Ecolabeling Network, which has criteria for membership. Green Seal standards have been recognized and used by the United States Federal Government, many state governments, and other important entities.

For more information, visit www.greenseal.org

U.S. Environmental Protection Agency (EPA): Environmentally Preferable PurchasingEven if you’re not employed by the federal government, you may want to look for guidance from the EPA and i ts Environmentally Preferable Purchasing (EPP) program. The program’s web site offers information about popular environmentally preferable products and services, including environmental attributes to look for, procurement guidance, tools, case studies and other useful resources. Numerous guides are available on a range of topics, such as Sorting Out Green Advertising Claims, Integrating Green Purchasing into Your Environmental Management System and Buying Green Online.

The site also offers a database of environmental information for products and services and a tool to facilitate the purchase of products and services with reduced environmental impact. For more information, visit www.epa.gov/epp.

Keep these green labelling options in mind when deciding on which products to purchase for your business or facility. And, remember that the steps you take today will help make the world more sustainable for future generations.

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“Creating products with 100% recycled fibre is one approach to environmental sustainability, but it does not take into account 100%

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The ISO 50001 Energy Management Systems Standard initially focuses more on commitment to performance than performance itself. Compliance is not tied to achieving a minimum level of energy savings or energy intensity within a facility. Rather, proponents must demonstrate they’ve followed a rigorous process that provides direction for oversight of all aspects of energy use.

“Once you implement ISO 50001, you are committed to doing better,” explains Bob Bach, an engineer and energy management specialist with Energy Profiles Limited. “It is based on a Plan-Do-Check-Act approach. Plan what you are going to do, do it, check, review and improve the process, and go back to the plan and modify it.”

The International Organization for Standardization released ISO 50001 in 2011. It applies the same methodology for driving continuous improvement found in earlier standards such as ISO 9001 for Quality Management and ISO 140001 for Environmental Management Systems. Third party verification is required for official certification, but the standard can also be used simply to guide an organization’s efforts and internal documentation.

“It does not establish absolute requirements for energy performance. Whatever your business is, you are going to establish those yourself,” Bach told attendees at an educational seminar in conjunction with the annual PM Expo last December. “What it does require is a commitment to achieve continual improvement of your energy performance.”

The standard’s definition of energy performance is broad, encompassing overall consumption, end use of energy, efficiency and intensity, as well as options for peak demand reduction, harnessing waste energy, and operational improvements. Organizations have flexibility to define intensity as it best fits their operations, whether that is energy use per patient-hour in a health care facility, by floor space measurement in the real estate sector, or per unit of output in an industrial scenario.

Prescriptive checklistsFrom this self-directed starting point, proponents must follow a prescriptive path. The standard includes a series of requisite elements, each with its own checklist of actions.

“It is very demanding for those who choose to apply an energy management system that is consistent with this standard,” Bach acknowledges.

The organization’s top management must endorse the energy policy and plan, ensure that it is communicated to all employees and contractors, provide necessary resources for its

An Exacting Framework for continuous Improvement

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ISO 50001

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implementation and review, and factor it into long-term decision-making.

The energy policy makes the broad statement of the organization’s commitment to energy performance improvement, while the plan sets out the framework for translating policy into outcomes. This includes an energy review, determination of the baseline for improvement, identification of performance indicators and targets, and documentation procedures.

“This is like energy efficiency 101,” Bach observes.Implementation and operation, or the “Do” part of the

strategy, occurs almost in tandem with the “Check” actions to measure what is accomplished and how it complies with the plan and supports the overarching policy. To close the continuous improvement circle, senior management must review these results, ensure underpinning plans and actions are effective, and revise them where necessary.

The process-oriented approach is more arduous and time-consuming than some other certification programs and mandates organization-wide involvement and obligations to supporting the energy policies, goals, and action steps. Prospective implementers are advised to weigh that commitment in light of other programs they may already have in place.

“ISO 50001 is really just an energy management system and we, as a company, have had our own energy management system in place for five years and that’s given us good results. I’m not sure there would be a lot of value in implementing

another one,” reflects Nada Sutic, Director of Sustainability with Bentall Kennedy (Canada) LP.

Guidance for regulatory compliance On the flipside, ISO 50001 provides a disciplined framework for improvement and ongoing assessment of opportunities to save energy, which conveys the status of ISO’s recognized meticulous methods. This could provide both guidance and assurance to kick-start new measuring and monitoring initiatives, particularly for proponents who must comply with regulatory dictates.

For example, most public sector entities in Ontario, including the health care sector, school boards, and municipal governments, and are now required to report on energy consumption and greenhouse gas emissions, and identify and implement actions to reduce energy use.

“I expect ISO 50001 will provide a useful framework as we further develop our Energy Conservation and Demand Management Plan under O.Reg 397/11 of the Green Energy Act,” predicts Michael Lithgow, Manager of Corporate Energy and Municipal Energy Conservation Officer in the Greater Toronto Area’s York Region.

Bach speculates it should also facilitate collaboration and links to other organizations and programs focused on best practices. “There is going to be a lot of sharing as an energy management system ages and matures because you must keep improving,” he says.

for more information, see the iso web site at www.iso.org. the preceding article is reprinted from Canadian property Management, april 2012..

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Hospital facility managers throughout Canada are working intently to reduce the incidence of healthcare-acquired infections (HAI). The problem is substantial: one in nine hospital patients in Canada suffers a healthcare-associated infection. Each year, more than 220,000 HAIs cause up to 12,000 deaths. Estimated costs top $1 billion annually and do not include the costs borne by patients and caregivers, or the program costs for home and community care. Healthcare associated infections are the fourth leading cause of death for Canadians, with pneumonia the most costly of all hospital acquired infections. Fortunately, it is also among the most preventable.

One of the most effective weapons against HAIs is properly filtered indoor air. It is therefore critical to be aware of the most recent air filter standards and testing protocols, including critical factors that are not always apparent regarding a filter’s “real world” performance inside an Air Handling Unit (AHU.)

The current laboratory test method used in the industry is ASHRAE Standard 52.2-2007, Method of Testing General Ventilation Air-Cleaning Devices for Removal Efficiency by Particle Size.

In 2008, the ASHRAE 52.2 Committee added Addendum B, which includes an option, Appendix J. This appendix details a “conditioning” step that yields an important new filter evaluation indicator called MERV-A. MERV-A is an indication of how well an air filter will continue to remove particulate throughout its service life. Thus, the MERV-A is arguably more important than MERV to users with a critical applications, including hospitals.

Today’s filters employ one of two principles of operation: Those that depend on an electrostatic charge to achieve their rated efficiency, and those that do not. When electrostatic filter media is used, efficiency drops as the

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filter starts to load. In contrast, if a fine fiber or “mechanical” air filter is used, rated filter efficiency is maintained throughout the life of that filter. A fine fiber, mechanical air filter that is rated MERV 14 on the day of its installation will maintain its MERV 14/14A rating throughout its service life.

The highest quality secondary filters perform at their rated efficiency for 18-36 months or longer, depending on the application (CSA requires that secondary filters be changed-out based on pressure drop, but in no case, are they to remain in service longer than two years.)

In the ASHRAE 52.2 test, MERV-A indicates an air filter’s particle capture efficiency after it has been conditioned with a high concentration of ultra fine particulate – the same size distribution of particulate found in atmospheric air. In this way, changes in particulate removal efficiency during the test can be expected to be duplicated during actual use.

In the US, hospital buyers often specify both MERV and MERV-A. The reason is cost; and while electrostatic filters are less costly, and meet the required initial MERV level, the precipitous drop in efficiency they experience is certainly not consistent with the intent of the cognizant design authorities. To cite a specific example, a MERV 14 rated electrostatic filter falls as low as a MERV 11 level in as little as 500 hours.

Canada, a step ahead, has adopted rules that require MERV-A ratings for all applications where HEPA filters are used, including ORs and other critical care areas. This is certainly prudent for today’s hospital environments, where patients on

extended stay, or involved with complex treatments, are often immunosuppressed and otherwise vulnerable.

Aside from the primary benefits of higher, more predictable air quality, the advantage of maintaining one inventory, rather than two, is significant. In addition, hospitals are requiring filter manufacturers to submit test reports that document air filter performance on all fronts: ASHRAE 52.2, MERV and Appendix J MERV-A.

Facilities are well advised to maintain files with the appropriate test reports on their filtration in order to document compliance with applicable standards. This information may become critical if air filter performance or facility air quality is called into question. While court actions are far less common in Canada compared with the US, a growing number of lawsuits have successfully sought redress for lapses in patient safety. Other factors encouraging careful decision-making include the implementation of public reporting on the rates of key HAIs, which allows patients and benefactors to compare incidence rates for comparable institutions.

Fortunately for all of us who use – and care about - the healthcare system, we have entered an era of increased vigilance on matters regarding patient safety. Better still, there remains some very “low-hanging fruit” when it comes to actions we can take against many major causes of HAI.

New MERV-A filter technologies allow hospitals to maintain and often improve the filtration of indoor air, while also reducing HVAC-related energy costs. Factors that facilitate this



outcome include the larger surface areas of these filters, and the lower average pressure drop they generate. In addition, most hospital air handlers are outfitted with variable frequency drives (VFDs). For these facilities, the lower average pressure drop allows the fan to operate at a significantly reduced energy draw. The combination of lower energy costs, coupled with longer filter life cycles, can reduce the filters’ total cost of ownership – often substantially.

Boundary Trails Health Centre case studyBoundary Trails Health Centre is the most populated rural health authority in Manitoba, providing health care services to 108,000 residents in 37 municipalities, and 6 First Nations. Its annual operating budget of $180 M funds more than 100 health service programs and facilities. Boundary Trails supports prevention programs and builds community partnerships to ensure that the people of the Central Region “are as healthy as can be.”

In 2011, Boundary Trails Manager of Physical Plant Services, Dave Fehr was satisfied with the performance of the air filters installed in the Health Centre, but less so with the service life and life cycle cost of the prefilters, MERV 14 final filters and HEPA filters that were in place. Filter purchase cost was competitive, but associated costs for change-out labour, inventory management, shipping and disposal were significant, as was HVAC-related energy expense.

Larry Isford, Western Canada Regional Manager for Camfil Farr, suggested that then-new air filtration technology, (the “30/30” prefilter and Durafil ES final filter) had recently shown their ability to deliver a substantially longer life and significantly lower average pressure drop than conventional pleated panel filters. Specifically, this new filter technology (which, notably, does not depend on an electrostatic charge) had demonstrated a service life fully twice as long as conventional pleated filters.

More importantly, it had performed at its rated efficiency throughout the service life – a feat that was not possible with

electrostatic filters, since their charge begins to dissipate upon installation. The result, forecast by a powerful life-cycle cost analysis software, and documented by another health centre, had been a reduction in the frequency of filter changes, and, most importantly, a substantial lowering of HVAC-associated energy costs.

Fehr authorized the installation of a test bank and a test period of 9 months. Results matched projections, and Boundary Trails changed-over two of its air handlers, and subsequently its entire group of 12 AHUs. At time of writing, all air handlers, in all 23 facilities within the Central Region have been, soon will be, upgraded.

Soon after installation of the Camfil Farr filters, an observant physician complained to maintenance that “something must be wrong,” because he “did not hear anything.” The noise he was accustomed to hearing was air handlers working hard to move air through the old filters. With resistance lowered, and vibration no longer an issue, the noise was gone. A finance manager also expressed concern: noting that energy use had declined, he asked whether some machinery had been taken out of service.

Filters at Boundary Trails are subject to aggressively turbulent air. As a result, the metal frames on the original filters vibrated and, over time, sliced through the media. “30/30” media is pleated in a radial form and is bonded to a welded wire grid. Diagonal support members are bonded to each media pleat to maintain spacing and optimize stability. As a result, this filter design is impervious to vibration.

Boundary Trails Health Centre saved over $20,000 in filters, associated labour, and energy during its first year following the filter change-over. Where final filters had previously had a 6-month service life, they were now performing at rated capacity for the full two years specified in CSA standards. Prefilter life tripled from two months to six months.

dave blackwell, Healthcare segment Manager; Matthew Crouch, national segment Manager life sciences; berni baier, national account Manager; larry isford, Western Canada regional Manager; are with Camfil farr

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