1. 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

2. Call in via Internet or Phone for Audio
Local call-in numbers
Brantford
Montréal
Ottawa
Quebec
Toronto
Vancouver
Winnipeg
Access Code: # Mute/Unmute Phone: press *6

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

12. 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

13. 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

14. Healthcare Facility Climate Change Resiliency Toolkit

15. Climate Change Resiliency Checklist - website

16. 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

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

18. 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

19. 6. Getting Ready - Your Next Steps
Go to
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

20. 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)

21. 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.

22. 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

23. 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

24. 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

25. 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

26. 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

27. 7. Proposed Mentoring Schedule 11:00 AM
Dates
Topics
Q #s
#1 Tue April :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

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

29. 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

30. 9. Logo Design Selection – Cohort Chooses!

31. Gratuitous Self-Promotion
Next Climate Change Resiliency Mentoring begins Fall 2017.
Contact:
Kent Waddington

32. 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:

33. Questions? Contact Your Mentors:
Stewart Dankner
Ed Rubinstein
Linda Varangu
Kent Waddington