Welcome to Health Care Climate Change Introduction – Webinar #1 Resiliency Mentoring Introduction – Webinar #1 Cohort #1 April 10, 2017 Canadian Coalition for Green Health Care

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Agenda Welcome & Objectives Brief intro to climate change impacts Meet Mentoring Team Meet fellow Cohorts Members - 30 sec intro – Why are you here? Resiliency Checklist Getting Ready - Your next steps Proposed schedule To Do: Surveys/Green Hospital Score/Case study info To Select: Logo Design Selection Questions/Discussion

Overall objectives: to develop – 1. Welcome Overall objectives: to develop – climate change resiliency practitioners & champions organisation-specific climate change resiliency & adaptation plans community of practice for Health Care Sector (HCS) resiliency/adaptation enable a national conversation on impacts of climate change with the HCS

World Health Organization (WHO), 2015 2. Realities of Climate Change Climate change will be the defining issue for health systems in the 21st century, interacting with all social determinants of health. World Health Organization (WHO), 2015 http://www.who.int/globalchange/publications/didyouknow-health-ministers.pdf?ua=1

Resiliency ≈ Sustainability “The benefits of addressing climate change include reduced pollution, improved public health, fewer disasters, cleaner, cheaper, more efficient energy, better managed forests, more livable cities, increased food security and less poverty.” past UN Secretary General Ban Ki-Moon

Examples of climate change impacts in Canada Extreme heat Extreme cold Extreme rain and snowfall Extreme weather – freezing rain, ice storm, hailstorm Extreme weather – thunderstorm, lighting Extreme weather – tornado Extreme weather – hurricanes, and related storms Extreme weather – avalanche, rock, mud & landslide Rising sea levels – coastal water storm surges Drought Wildfire Poor air qualify & smog Food-borne contamination &/or diseases Waterborne contamination &/or diseases Vector & rodent-borne diseases New & emerging infections diseases

Sample Climate Change Impacts on Health Care Sector Damage to health care infrastructure such as hospitals, long term care, nursing homes and clinics Power outages Confusion during CC event due to inadequately trained personnel or lack of suitable emergency plan Contracted essential services interrupted (e.g. laundry and food) Medical supplies delivery interrupted Overcrowding in emergency shelters during a disaster may increase exposure to infectious diseases (e.g. influenza) of health care workers Electronic medical records could face access delays of in the event of a power outage during a disaster Delays or cancellations of medical testing or procedures Transportation of staff/patients may be impacted For example, climate related extreme weather can damage health care infrastructure, structural elements, damage machines, equipment and disrupt operations, diagnostic procedures and treatment. Climate-related hazards can overwhelm a facility with inadequately trained staff or one that lacks an emergency plan. Hospitals that contract out essential services are vulnerable if these services are interrupted in an emergency. [read] Source for Text: Health Canada, 2008

3. Meet the Mentors Stewart Ed Linda Kent Dankner Rubinstein Varangu Waddington UHN Director, Environmental Compliance, Energy and Sustainability UHN Director, Facilities and Support Services CCGHC Executive Director CCGHC Communications Director

UHN Climate Change and Sustainability Awards Global Climate Change Awards - 2020 Healthcare Climate Challenge Climate Leadership 2016 & 2015 - GOLD Climate Resiliency 2016 & 2015 - GOLD Sustainability Awards Energy and Environmental Stewardship Award 2016 - CCHL Greenest Hospital 2015 Award – OHA & CCGHC Green Hospital Award

CCGHC Climate Change and Sustainability Awards Global Climate Change Awards - 2020 Healthcare Climate Challenge Climate Leadership 2016 – GOLD Sustainability Awards Energy Star Advocate 2015 Award

4. Meet Fellow Cohort Members – 30 sec intros North Bay Regional Health Centre North Bay ON Dorthy Duguay Environmental Services and MDR Dep't. Eileen Benedictus Supervisor, Environmental Services Hôpital Montfort Ottawa Michel Picard Directeur – infrastructures Fraser Health Authority Vancouver BC Angie Woo Climate Resilience & Adaptation, Lead Albright Centre Beamsville Jim McArthur Director of Properties Hôpital Glengarry Memorial Hospital Alexandria Louise Quenneville Emergency Preparedness Coordinator Interior Health Kelowna Tanja Stockman Manager, Environmental Sustainability Hamilton Health Sciences Hamilton Victoria Brzozowski Waste Management Coordinator West Park Healthcare Centre Toronto Diane Zdybal Director Support Services Vancouver Island Health Auth. Nanaimo Ting Pan Sustainability Coordinator

5. Climate Change Resiliency Mentoring Program Enhance education/knowledge of climate change impacts on health care facilities & delivery of care Webinars, resource materials, information sharing Support for Checklist use Step-by-step Checklist review to better enable Resiliency Champion to administer at own facility Conference calls, onsite visits, one-to-one advice Expert mentoring from UHN Support resiliency/adaptation options development Information sharing #3 – could be a feedback loop between participants and project team

Healthcare Facility Climate Change Resiliency Toolkit

Climate Change Resiliency Checklist - website http://greenhealthcare.ca/mentoring

6. Process Overview Recruit team members from the Emergency Management Committee and others Identify climate risks Conduct checklist assessment together Discuss options for what would be useful to the organization beyond our resiliency score

6. CC Resiliency Checklist Online Checklist – register on website http://greenhealthcare.ca/mentoring 78-questions divided into 3 sections Scoring of results Notes section to detail current situation Confidentiality of responses Resources

6. Time to Complete the Checklist (UHN) Divided the checklist for independent research with the right people Time to coordinate the process 5-8 days Met face-to-face 4 times to complete the checklist collaboratively Time invested by team members 2-3 days

6. Getting Ready - Your Next Steps Go to http://greenhealthcare.ca/mentoring Log into the Toolkit page and review checklist & resources Review ppts from Resiliency webinar in March Consider need for slide presentation on this project to your team

6. Getting Ready – Resiliency Assessment Team Consider co-leads for the RA Team UHN Core internal team Strategic planning, Facilities, Emergency Preparedness, Emergency Department, Patient Safety and Clinical Risk, Energy and Environment UHN internal consultation Nutrition Services & Infection Prevention and Control, Procurement External members (i.e. Public Health, municipality)

6. Checklist: General Information 1. Please record your name and role at your health care facility, the others who are engaged I this initiative, and the date you completed the checklist. *Examples: emergency management, facilities management, health care services, supply chain management, food and nutritional services, waste management etc. Name Role Area of Work*   Date 1. 2. 3. 4. 5. 6. 7. 8. 9.

6. What are your Climate Change Impacts? Start thinking about where you can get info on the impacts of CC for your area: Review internal info for evidence of CC impacts i.e. flooding, impacts due to winter storm, Public Health – local, provincial Municipality Conservation Authorities Experts from local/regional University

6. Getting Ready – Climate Change Impacts For UHN- City of Toronto climate model priority weather drivers: Increase in extreme weather events Extreme heat Higher ave. annual & max. temp. More intense rain events Secondary weather drivers Extreme cold

6. Assessing Climate Related Risks Climate Risk Yes Somewhat No I don’t know This is not a risk for my region a. Extreme heat   b. Extreme cold c. Extreme rain and snowfall d. Drought e. Wildfire f. Extreme weather – tornado g. Extreme weather – freezing rain, ice storm, hailstorm h. Extreme weather – thunderstorm, lightning i. Extreme weather – hurricane and related storms j. Extreme weather – avalanche, rock-, mud- and landslide, debris flow k. Rising sea level – coastal flooding; storm surges l. Poor air quality and smog m. Food-borne contamination and/or diseases n. Water-borne contamination and/or diseases o. Vector-and rodent-borne diseases p. New and emerging infectious diseases

6. Start with what you know Time horizon of 5-10 years is maximum to keep administrative attention Discuss what people, programs, departments are in place already at your facility to compliment this process

6. HC Resiliency Checklist Section Subsection Questions Risk Assessment Assessing risks to inform emergency management and risk reduction strategies 14 Assessing risks to infrastructure and systems 5 Risk Management Risk Management to Reduce Climate-Related Risks 21 Procurement of Health Care Resources and Supplies 4 Notifications, Monitoring, and Surveillance 3 Clinical Risk Management Infrastructure and Systems Risk Management 8 Energy Supply and Use Building Capacity Sustainable Health Care and Climate Change Mitigation Total Questions: 78

7. Proposed Mentoring Schedule 11:00 AM Dates Topics Q #s #1 Tue April 25 1:00 PM Develop Site Team, Assess Local CC Risks, Feedback Loop, Resources #2 Wed May 10 Review Team Development & local CC Risks, Assess Climate-Related Risks 1-19 #3 Wed June 7 Review Risk Assessment Progress, Assess Risk Management 20-40 #4 Wed June 28 Review Risk Management, Resources, Procurement, Notification, Surveillance, Clinical Risk Management 41-52 #5 Wed July 12 Infrastructure/System Risk Management, Energy Use 53-64 #6 Wed Aug 2 Building Capacity, Sustainable Health, Mitigation 65-78 #7 Wed Sept 13 Review Building Capacity, Case Study Review, Exit Survey

Mentoring Calls 1. Reporting/Check-in Progress (Email? Other?) Challenges Successes Questions 2. Housekeeping Timely replies to emails “Regrets” if not attending webinar If you miss a webinar, sessions will be recorded Phones on MUTE when you are not speaking

Compare Resiliency Score to ‘Green Hospital Score’ 8. Surveys, Green Score, Case Study info Entry Survey Exit Survey Compare Resiliency Score to ‘Green Hospital Score’ Request - case study info by end of the program ~ 500 words How has climate change impacted your facility/organisation? Strategies to assess and deal with impacts Strategies to prevent future occurrences Resultant forward-looking resiliency strategies Approval for sharing: Resiliency Profile publication

9. Logo Design Selection – Cohort Chooses!

Gratuitous Self-Promotion Next Climate Change Resiliency Mentoring begins Fall 2017. Contact: Kent Waddington kent@greenhealthcare.ca

Funding for the Climate Change Mentoring project is provided by: An agency of the Government of Ontario, the Ontario Trillium Foundation (OTF) is one of Canada’s largest granting foundations. With a budget of over $136 million, OTF awards grants to some 1,000 projects every year to build healthy and vibrant Ontario communities. For more information, please visit: www.otf.ca 

Questions? Contact Your Mentors: Stewart Dankner stewart.dankner@UHN.ca Ed Rubinstein edward.rubinstein@uhn.ca Linda Varangu linda@greenhealthcare.ca Kent Waddington kent@greenhealthcare.ca