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Welcome to Health Care Climate Change Introduction – Webinar #1
Resiliency Mentoring Introduction – Webinar #1 Cohort #2 December 6, 2017 Canadian Coalition for Green Health Care
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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
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Agenda Welcome and 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 Questions/Discussion
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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 Health Care Sector
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2. Realities of Climate Change
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Welcome to our new NORMAL
2. Realities of Climate Change Welcome to our new NORMAL Climate change will be the defining issue for health systems in the 21st century, interacting with all social determinants of health. World Health Organization 2015
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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
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Examples of Climate Change Impacts in Canada
Extreme heat Extreme cold Extreme rain and snowfall Drought Sea level rise – coastal storm surges Wildfire Extreme weather - tornado Extreme weather – freezing rain, ice storm, hailstorm Extreme weather – thunderstorm, lighting Extreme weather – hurricanes, and related storms Extreme weather – avalanche, rock, mud & landslide Permafrost melting Poor air qualify & smog Food-borne contamination &/or diseases Waterborne contamination &/or diseases Vector & rodent-borne diseases New & emerging infections diseases
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Future Global Health Impacts from Climate Change
Heat waves and forest fires Reduced labour productivity Increased under-nutrition Foodborne diseases Water-borne diseases Vector-borne diseases Very high confidence High confidence Medium confidence IPCC, 2014
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Health Risks in Canada from Climate Change
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Examples of Climate Change Impacts in Canada
Watts et al., 2015
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Canada’s Mid-Century Climate Change Policy
Canada is committed to creating a cleaner, more innovative economy that reduces emissions and protects the environment, while creating well-paying jobs and promoting robust economic growth. Canada’s Mid-Century Strategy sees net emissions falling by 80% in 2050 from 2005 levels. Consistent with Paris Agreement’s 2°C to 1.5°C temperature goal.
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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
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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
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UHN Climate Change & 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
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CCGHC Climate Change & Sustainability Awards
Energy Climate Change Resiliency GOLD for Climate Leadership by Global Green and Healthy Hospitals’ 2020 Health Care Climate Challenge
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4. Meet Fellow Cohort Members – 30 sec intros
Halton Healthcare Milton/Oakville ON Kassondra Stockman Emergency Preparedness Advisor Horizon Health Network Fredericton NB Blaine Lynch Regional Director Facilities, Engineering and Property Management Fraser Health Vancouver BC Rick Molnar Manager, Facilities Maintenance and Operations Maple Ridge Barry (Doug) Davis Relief Supervisor/Power Engineer Thunder Bay Regional Health Sciences Centre Thunder Bay Ann-Marie Heron Executive Director of Capital Planning & Operations Interlake-Eastern Regional Health Authority Selkirk MB Jay Ferens Regional Director of Disaster Management Jason Mushaluk Regional Coordinator – Disaster Management William Osler Health system Etobicoke Eddie Camilleri Corporate Energy Manager TRANE Toronto Matthew Sharp Project Development Leader - Comprehensive Solutions Markham Stouffville Hospital Markham Allan Kelly Manager, Plant Maintenance Trillium Healthcare Partners Mississauga Qasir Rashid Environmental Management System Lead Hôpital Glengarry Memorial Hospital Alexandria Louise Quenneville Emergency Preparedness Coordinator Chartwell’s The Wynfield Oshawa Shelly Rainford Environmental Services Manager
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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
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Climate Change Resiliency Checklist - website
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Healthcare Facility Climate Change Resiliency Toolkit
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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
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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
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6. Time to Complete the Checklist (UHN)
Divided checklist for independent research with the key stakeholders Time to coordinate the process 5-8 days Get experts involved early Utilize existing key committees currently working on different checklist topics Energy Committee Environmental Care Committee Emergency Management Committee
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6. Time to Complete the Checklist (UHN)
Met face-to-face 4 times to complete the checklist collaboratively Time invested by team members 2-3 days Suggest using: Facilitator’s PowerPoint® Resource Guide
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6. Getting Ready - Your Next Steps
Go to Log into the Toolkit page and review checklist & resources Review slide decks in “Other Resources” section Consider need for slide presentation on this project to your team
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6. Getting Ready – Resiliency Assessment Team
Consider co-leads for the Resiliency Assessment Team UHN Core internal team Strategic Planning, Facilities, Emergency Preparedness, Emergency Department, Patient Safety and Clinical Risk, Energy and Environment, Executive Team, Spiritual Care Team UHN internal consultation Nutrition Services & Infection Prevention and Control, Procurement External members (i.e. Public Health, municipality)
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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.
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6. Resiliency Assessment Team Management
Ask team to go beyond bottom dollar value and see how actions are having negative impact on environment Record team attendance at meetings Work from an Agenda Have team share successes, challenges, questions Can be virtual meeting Face-to-face dialogue Set dates, targets, timelines, milestones Engage w/CCGHC for feedback and assistance
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6. What are your Climate Change Impacts?
Start thinking about where you can get info on climate change impacts for your area: Review internal info for evidence of CC impacts i.e. flooding, impacts due to winter storm Public Health Local Provincial – Ontario Health & Climate Change Vulnerability Assessment Toolkit Federal Health Canada Natural Resources Canada
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6. What are your Climate Change Impacts?
Additional sources of info: Municipality/City/County Conservation Authorities Experts from local/regional schools College University Agencies and groups (i.e.: 100 Resilient Cities Project) Media News reports Articles Weather warning
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6. Getting Ready – Climate Change Impacts
For UHN- City of Toronto climate model priority weather drivers: Increase in extreme weather events Extreme heat Higher average annual and max. temps. More intense rain events Secondary weather drivers Extreme cold
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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
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6. Assessing Climate Related Risks
Where is climate change happening in Canada? Arctic – Dramatically higher temperature, increased precipitation, Loss of permafrost and sea ice. West Coast – Higher temperatures, sea level rise, coastal flooding, increased snow, glacier retreat, more severe spring floods, more frequent and intense summer drought. Prairies – Hotter and drier conditions, increased severity and length of droughts, greater frequency of flooding, warmer winters Quebec and Ontario – Hotter summers, warmer winters with less snow, more storms and heavy rain events. Atlantic – Rising sea-level, greater risk of flooding, coastal erosion, more intense storms
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6. Assessing Climate Related Risks
The real life impacts Puerto Rico Hurricane reduces Baxter Pharmaceutical’s supply of 50 ml & 100 ml IV bags to SW Ontario hospitals Nurses using ‘slow push’ delivery but reduces efficiency Churchill MB Rail lifeline to northern MB washed out Impacts delivery of medical supplies and movement of patients California/BC Wildfires (BC) 45,000 evacuees Exacerbates medical conditions in vulnerable populations Treatments cancelled, delayed, Increased deaths
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6. Start with what you know
Time horizon of 5-10 years is maximum to keep administration’s attention But… should look at years as sustainability actions have dramatic future consequences Discuss what people, programs, departments are in place already at your facility to compliment this process (Existing Committees) Discuss all questions in group brainstorming sessions
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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
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7. Proposed Mentoring Schedule 12:00 PM
Dates Topics Q #s #1 Wed Dec 6 Develop Site Team, Assess Local CC Risks, Feedback Loop, Resources #2 Wed Jan 17 Review Team Development & local CC Risks, Assess Climate-Related Risks 1-19 #3 Wed Feb 14 Review Risk Assessment Progress, Assess Risk Management 20-40 #4 Wed Mar 14 Review Risk Management, Resources, Procurement, Notification, Surveillance, Clinical Risk Management 41-52 #5 Wed Apr 18 Infrastructure/System Risk Management, Energy Use 53-64 #6 Wed May 9 Building Capacity, Sustainable Health, Mitigation 65-78 #7 Wed May 30 Review Building Capacity, Case Study Review, Exit Survey
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7. 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
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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
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Green Hospital Scorecard
Basis for organising a formal Green Team and furthering sustainable growth Made-in-Canada Benchmarking Environmental Performance Dashboard Components Energy use/Intensity Waste/Recycling Water use/Intensity Corporate Leadership Pollution Prevention Policy & Planning
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Green Hospital Scorecard
Program Coordinator Dan Ritchie Survey Link Project Details Submission Deadline: February 28, 2018
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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:
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Questions? Contact Your Mentors:
Stewart Dankner Ed Rubinstein Linda Varangu Kent Waddington
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