Canadian facilities leader offers unique perspective

The Holliss File

CV

• Current president of Holliss Consulting Inc., Waterloo, Ontario
• Director of engineering and redevelopment, St. Mary’s General Hospital, Kitchener, Ontario, Canada.
• Joint director of engineering and biomedical, Grand River Hospital and St. Mary’s General Hospital, Kitchener, Ontario.

Accomplishments

• Current president of the Canadian Healthcare Engineering Society (CHES).
• Past chair of the Ontario Chapter of CHES.
• Technical subcommittee member on the Canadian Standards Association’s (CSA’s) Cleaning & Disinfection in Healthcare Facilities (CSA Z317.2-20) standard.
• Vice chair on the technical subcommittee of the CSA’s Medical Gas Pipeline Systems (CSA Z 7396.1-22) standard.
• 2016 Leadership Award from the Coalition for Healthcare Acquired Infection Reductions.

Education

• Bachelor’s degree in mechanical engineering and management from McMaster University, Hamilton, Ontario.
• Master’s of engineering from the University of Western Ontario.

Roger Holliss, president of the Canadian Healthcare Engineering Society (CHES) and a reciprocal participant in American Society for Health Care Engineering (ASHE) events and programs, talks about his organization and his views on the differences and similarities between the Canadian and U.S. health facilities management fields.

How many members does CHES have?

Currently CHES has over 700 members comprised of six member categories, including regular and corporate memberships. Within this membership group, we represent more than 200 different hospital/health care authorities and over 100 companies across Canada.

What are some challenges facing hospital facilities managers in Canada?

My suspicion is that our challenges in Canada are shared by our U.S. counterparts. Although COVID-19 has positively impacted this to some degree, the understanding and appreciation of the C-suite relative to the positive and substantial impact the health care facilities managers play is still not where we think it should be. This often manifests itself on two fronts. There’s an underestimation of the educational and vocational assets now required to be an effective facilities manager. The second manifestation underestimating our impact is the lack of, or deferred, investment in the facility’s infrastructure — until a major system fails.

What is the relationship between CHES and ASHE?

ASHE and CHES have a long and positive relationship, both formally and informally. Informally, it is typical that at least CHES and ASHE executives attend each other’s national and regional/chapter conferences. Similarly, the CHES national presidents are regular participants at the ASHE leadership training offering. It is also common to have U.S. representatives sitting on the technical subcommittees charged with updating Canadian Standards Association (CSA) standards (e.g., medical gas). Formally, there are contracts dealing with common topics like the health care construction course. We see maintaining and growing our ASHE relationship as being only a good thing and look forward to propagating this more in the future.

What do you perceive are the major differences between hospital facilities managers in Canada and in the U.S.?

I’ve been fortunate to meet and break bread with at least a dozen of my U.S. counterparts through various ASHE events and courses over the years. Through the course of my conversations, there are certainly far more common experiences and challenges between our two countries than differences. That said, it seems the two largest differences relative to managing facilities between our two countries is how health care facilities are funded and the existence of The Joint Commission and other accreditation organizations in the U.S. with no true equivalent in Canada. On the funding side, the Canadian model is fundamentally public, which reduces the potential external funding biases but has the downside of capital and deferred maintenance being significantly and typically underfunded. Relative to the accreditation organizations, I see this as a positive to the U.S. system as they play a significant role in compliance management across the U.S. and seem to have significant influence with health care decision-makers. In Canada, that single compliance entity doesn’t really exist. Compliance management in Canada is decentralized both geographically and by health care topic.

How are facility codes and standards developed for Canadian hospitals?

From a source standpoint, they range from a few federal agencies for things like national building and electrical codes. Then, there are those from municipalities including local bylaws, with the majority being provincial. Of the many provincial code requirements, like building and fire, there is a high degree of overlap to their national equivalents. From a standards perspective, most standards come from the CSA, which has a significant international presence in the code world. Within CSA’s library are hundreds of standards, including a dedicated segment of CSA that focuses entirely on health care standards. These health care-specific standards address all aspects of health care facilities management, including designing, constructing, operating and maintaining health facilities. CSA standards in and of themselves are not legally required unless they are directly cited within any of the previously mentioned regulatory codes (e.g., building and fire codes). Unfortunately, there only are a few CSA standards (e.g., HVAC, medical gas and emergency electrical systems) that are, in fact, cited, which makes complying with many non-legally required CSA standards tough to garner funding and support for. But, even though the majority of CSA codes are not legally required, they are still considered the preeminent documents for how to build and manage hospitals and, therefore, establish the benchmark for legal due diligence.

What are some of the major initiatives and programs offered by CHES?

Given that our mandate is “for member benefit,” we continue to focus on the initiatives that make our health care facilities managers the best they can be. To that end, we are always looking to increase CHES’s presence on the various CSA standard technical committees. Similarly, we’re looking to increase and improve specific CSA training programs, both in-person and virtual, for these same CSA health care standards. Finally, we’ll be increasing our efforts to raise CHES’s profile with the many organizations our folks work with or that have a common interest. This awareness initiative will also reach out to the decision-makers and associations that have a direct impact on how our members manage our health care facilities.

Where do you see CHES going over the next several years?

Certainly, COVID-19 has forced all of us to reinvent ourselves. We’ve migrated much work and offerings to a digital, virtual format — tons of Zoom meetings and expansion of our typical annual webinar offerings, to name a couple. We will also continue to take our more popular and significant in-person training courses and create online equivalents. Changes like these are likely to stay. But, after essentially no face-to-face conferences, both nationally and provincially, these last two years, CHES is now starting to plan and host face-to-face events across Canada with all the typical caveats that come with hosting large events in a COVID-19 world. This includes hosting the international congress for the International Federation of Healthcare Engineering in Toronto this fall. The benefits of people physically interacting are undeniable and need to be restored. Additionally, even though CHES always managed its finances conservatively, we’ve gained a critical appreciation of the importance of being fiscally reasonable, both in the present and looking out multiple years to ensure the long-term viability of CHES.

Lastly, we’ll continue our outreach program to the key decision-makers and organizations, both nationally and provincially, to improve their awareness of properly managed health care facilities and, in turn, support their staff in becoming CHES members so they can take advantage of CHES’s numerous professional offerings.