MISHE NEWS
Second Quarter 2010 Pier-George
Zanoni, PE
Volume 163 MISHE
Newsletter Editor
IN THIS ISSUE:
ASHE Recognizes Five Hospitals for Energy Reduction
Gregory Cole Receives Internship Award
Nashville 500 YR Flood – Hospital Remains Open
FCC Rule Would Allow Ham Radio Use During Disaster Drills
Historic Change In The Operating Room Environment
New Mandatory Green
Building Code For California (CalGreen)
Download and read the entire issue in Acrobat
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The Annual Conference will soon be here. September 22nd,
23rd, and 24th should be marked on your calendar and you
should click here to register
for the conference. Visit the MiSHE web
and click on the Annual Conference link to read the agenda, info and bios of
speakers that are listed. Over the next few weeks, breakout presentations will
be posted, as well.
As always, there will be ample time to network.
Wednesday, kicks off the conference with many opportunities to converse, share,
and gather information from other members. Golf and fishing will begin the
networking sessions and the “Member Reception” will be the culmination of
events of the day. Food and refreshment will be entertained with information
and awards for the activities of the day!
Our Keynote speaker, York Chan, ASHE Region 5
Representative will have an energy-packed opening that will give us a
perspective on the evolving healthcare industry.
This year the conference theme is “Adapting to Reforms
in Healthcare.” Reforms are essentially changes. The “reforms” highlighted in
this conference are changes in thinking about energy, changes in policy about
infectious disease transmission and humidity levels, and changes how we communicate using wireless
devices.
The conference ends on Friday with our “regulatory”
theme. The Keynote will be Richard Gudkese, TJC, who will discuss standards
that seem to be the hardest to attain. The conference will end by noon after
updates from Fire Safety and Health Facilities.
To see more information about the Annual Conference, click
this link.
In observance of Earth Day, the American
Society for Healthcare Engineering (
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St.
Mary's
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For information on the
E2C program, please click here.
Editor’s note: Many
MISHE members are encouraged to
participate in the
Gregory Cole is the most recent recipient
of the Internship Award offered by MiSHE. The award requires that the intern be
required to do an internship as part of the degree or by their program of
study. The internship must be done in a MiSHE-member healthcare institution.
Mr. Cole is interning within the Spectrum Health system and being mentored by
Brian Crum, a MiSHE Member of the South West Regional Chapter.
Gregory is attending
The award was presented on June 18th
at the MiSHE Board meeting. As part of the award requirements, Gregory will be
in attendance at the MiSHE Annual Conference and may be requested to make a
presentation about his intern experience.
We all hope to see him at the conference and in the future as a
healthcare manager!
Hospitals and EPA's new
greenhouse gas rule
From: Health Facilities Management
This article first appeared in the April 2010 issue of HFM.
Article Location: http://www.hfmmagazine.com/hfmmagazine_app/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/04APR2010/1004HFM_FEA_CS
By Mitchell M. Wurmbrand and Thomas
C. Klotz
In late 2009, the Environmental
Protection Agency (EPA) issued a new rule addressing greenhouse gas (GHG)
emissions reporting.
The information EPA has published to
support the "Mandatory Reporting of
Greenhouse Gases Rule" states that
EPA believes the majority of smaller GHG-emitting facilities will not have to
report. However, there is uncertainty about where some institutions may fall.
To determine whether a hospital is
subject to the rule, which can be accessed by clicking here, a number of
factors must be considered.
Rule applicability
Reporting requirements under the final
rule will apply not only to certain fossil fuel suppliers and manufacturers of
certain vehicles and engines, but also to certain downstream facilities that
emit 25,000 metric tons per year of carbon dioxide equivalent (mtCO2e) of GHG
emissions. It is under this broad umbrella of downstream facilities that some
hospitals may be included.
The reporting rule defines a
"facility" as "any physical property, plant, building,
structure, source, or stationary equipment located on one or more contiguous or
adjacent properties in actual physical contact or separated solely by a public
roadway or other public right-of-way and under common ownership or common
control, that emits or may emit any greenhouse gas."
A hospital campus is considered a single
facility if the structures are located on contiguous or adjacent properties and
are under common ownership or common control. The buildings do not have to be
connected by walkways, tunnels or pipelines to be considered a single facility.
Even if the structures are separated by a public road, they would still be
considered contiguous. This definition broadens the scope of the reporting rule
and differs from how a facility may be defined under other environmental
regulations.
Hospitals may be regulated under this
rule because they operate stationary fuel combustion units that are listed in
Part 98.2(a)(3) of the rule. A stationary fuel combustion source is a device
that combusts any solid, liquid or gaseous fuel generally to produce
electricity, steam, useful heat or energy for industrial, commercial or
institutional use or reduces the volume of waste by removing combus¬?tible
matter. These devices include, but are not limited to, boilers, engines,
process heaters, combustion turbines and incinerators. The rule excludes
portable equipment, emergency generators, emergency equipment, agricultural
irrigation pumps, hazardous waste combustors (except for co-fired fossil
fuels), flares and research and development activities.
EPA has not set a minimum heat input
capacity level below which a stationary fuel combustion unit does not have to
be included in a facility's calculation of annual GHG emissions. As a result,
every piece of nonexcluded, fossil-fuel-fired stationary equipment, regardless
of size, must be accounted for. This includes devices such as space heaters and
rooftop units that burn fossil fuel.
If a hospital operates stationary fuel
combustion sources, the rule requires health facilities professionals to
determine if the facility emits 25,000 mtCO2e or more from stationary
combustion in any calendar year starting in 2010. If so, GHG emissions from
stationary fuel combustion devices must be reported. However, if the maximum
rated heat input capacity for all stationary fuel combustion equipment combined
is less than 30 million British thermal units per hour (mmBtu/hr), the facility
is presumed to emit less than 25,000 mtCO2e, and health facilities
professionals do not have to calculate or report emissions. If a facility has
an aggregate maximum rated heat input capacity equal to or greater than 30
mmBtu/hr, the facility will need to complete further calculations to determine
if it meets the threshold for reporting.
It is likely that many hospitals exceed
this 30 mmBtu/hr threshold. Those facilities will, at a minimum, need to
calculate their historical annual mtCO2e emissions to see if the facility can
be expected to exceed the GHG reporting threshold.
Estimating and reporting
For facilities that exceed the 25,000
mtCO2e reporting threshold, facilities professionals must report annual
emissions of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) for
each fuel combusted.
EPA has prescribed specific calculation
methodologies within the reporting rule for estimating emissions. To address
the proper level of reporting rigor, EPA developed four calculation options, or
tiers, that may be selected based on combustion unit size, type of fuel burned
and other factors.
For example, Tier 1 represents a
simplified calculation methodology where company records may be used to
determine fuel use and default emissions factors, and fuel high heating values
may be used to estimate emissions. Tier 4 methodology presents the opposite end
of the spectrum and requires a continuous emission monitoring system (CEMS) for
estimating emissions from certain units. Tiers 2 and 3 use combinations of the
simplified and complex approaches.
Generally, all combustion units with a
rated heat input capacity of 250 mmBtu/hr or less are allowed to use the
simpler Tier 1 or Tier 2 calculation methodologies. Certain combustion units
with input ratings above 250 mmBtu/hr that combust pipeline quality natural gas
and distillate oil are also allowed to use Tier 2. However, units rated above
250 mmBtu/hr that combust residual oil, other gaseous fuels, and solid fossil
fuels will need to apply the Tier 3 or Tier 4 methodologies.
Depending upon the chosen method, some
facilities will need to comply with requirements for conducting fuel sampling
and analysis, and installing/calibrating monitoring devices (e.g., fuel flow
meters). It is likely that most hospitals will be able to use Tier 1 or Tier 2
calculation methodologies.
As an option, EPA will allow many
facilities to aggregate emissions reporting from individual units with maximum
rated heat input capacities less than 250 mmBtu/hr. Units may also be
aggregated based on the use of a common fuel supply line or pipe or a common
stack or duct configuration where CEMS are used.
While this may provide some relief for
many reporting facilities, there are a few particularly burdensome requirements
that remain, including the obligation to report an identification number for
each combustion unit reported in a group and the cumulative maximum rated heat
input capacity of the group (mmBtu/hr).
Consequently, regardless of whether a
health facility elects to report by individual unit or multiple units
aggregated by group, the facility will likely need to prepare a comprehensive
stationary fuel combustion equipment inventory for all nonexcluded combustion
units. The development of a combustion equipment inventory could be complicated
for facilities that employ the use of many smaller combustion units.
One particularly time-sensitive
requirement within the reporting rule is the written GHG monitoring plan, which
affected facilities are required to have in place this month. The monitoring
plan is expected to identify individuals responsible for the collection of
emissions data; explain the methods used to collect data and perform emission
calculations; and describe the procedures used for quality assurance,
maintenance and repair of monitors and other instrumentation.
The plan may rely on references to
existing documents (e.g., standard operating procedures and quality assurance
programs) and, as such, EPA has not prescribed a specific format. Facilities
are not required to submit the monitoring plan to EPA for approval, but must
retain the plan in accordance with the record-keeping requirements.
Other key aspects
There are a number of general provisions
and other key aspects that should be carefully considered by reporting
facilities. They include the following:
• Facilities subject to reporting
should have initiated data collection and recordkeeping activities on Jan. 1,
2010.
• The first annual GHG report is due March 31, 2011.
• Records must be retained for at least three years.
• Records must be available to EPA for review upon request.
• A single individual should be made responsible for certifying, signing
and submitting GHG emission reports.
• Revisions to a report submitted to EPA must be provided within 45 days
of discovery or notification by EPA.
Once a health facility is subject to the
reporting rule, it must continue to report each subsequent year, even if the
facility does not exceed thresholds during future reporting years. EPA allows
facilities to cease reporting after five consecutive years if reported
emissions are less than 25,000 mtCO2e or after three consecutive years if
reported emissions are less than 15,000 mtCO2e.
Additionally, EPA reserves the option to
verify the completeness and accuracy of GHG emissions reports and may take
enforcement action for any violation of a reporting rule requirement. GHG
regulatory enforcement likely will be a high priority of the EPA in the short
term.
Evaluating responsibility
Health facilities professionals will need
to evaluate their responsibilities under EPA's GHG reporting rule.
It may be that many smaller hospitals
will not have to report their GHG emissions to EPA. It is also likely, however,
that most hospitals will need to calculate their emissions to document them.
Mitchell M. Wurmbrand is an associate principal and
certified consulting meteorologist in the
|
Sidebar - Origins
of the GHG reporting rule |
|
Hidden away in
the fiscal year 2008 Consolidated Appropriations Act was a provision for the
Environmental Protection Agency (EPA) to develop a rule "to require
mandatory reporting of greenhouse gas (GHG) emissions above appropriate
thresholds in all sectors of the economy of the In April 2009, EPA proposed the "Mandatory Reporting of Greenhouse Gases Rule." The purpose of the rule is to provide EPA with the data it will need to make future policy decisions regarding GHGs and climate change. During the official 60-day comment period and beyond, the EPA held public hearings, received nearly 17,000 written comments, met with 4,000 individuals and 135 groups. A little over five months after publishing the proposed rule, the EPA issued its final rule on mandatory GHG reporting. The rule was
then published in the Federal Register on |
|
Sidebar - Checking
facility applicability |
|
If a health care facility operates stationary fuel combustion sources that, in the aggregate, exceed 30 million British thermal units per hour heat input capacity, the table below provides a rule of thumb for how much fuel must be consumed on an annual basis to exceed 25,000 metric tons per year of carbon dioxide equivalent.
|
Steam generators help
By Glenn Adgey
For 65 years,
But, like other hospitals throughout the
Significant
Savings Realized
The program provides a comprehensive building plan
customized to meet the needs of the individual client. In this case, Siemens
experts focused on energy efficiency. Nearly four years since the audit, the
energy makeover has amounted to a huge savings for the hospital, thanks to
major changes to the physical plant’s power, lighting, HVAC and water systems.
“Prior to the audit, Mount Clemens Regional Medical
Center boiler plant consisted of four high-pressure steam boilers; two 400 HP
units that provided wintertime heating load and two 300 HP units that provided
the summer thermal loads,” explained Keith Miller, Director of Facilities
Management at Mount Clemens. Siemens experts knew this system needed to be
replaced with something that ran cleaner, simpler and more consistently. They
looked to Clayton Industries to replace the old boiler with a vertical steam
generator.
The two existing 300 HP Johnston gas-fired boilers and
burners were removed, as well as all of their accessories and accompanying
equipment to accommodate the new gas-fired steam generators. The new units were
a 300 HP generator and a 500 HP one. Miller said almost immediately after the
installation,
According to Siemens Energy Engineering Manager Keith
Kazan,
Steam
Generation Saves Time, Energy, Dollars
So, what makes a steam generator that much more energy
efficient? First, these units heat up faster, within about 15 minutes as
opposed to a conventional boiler, which takes between two and three hours. They
can also be turned on and off when needed without the risk of damage to the
system. Hospitals are required to have
back up generation, which when the plant is run with a conventional boiler, it
is generally kept in hot mode so it comes on-line quickly, if need be. That
means that even if the hospital is not currently using the back-up boiler, it
is consuming energy, just in case it is needed.
According to Miller, because the steam generator
starts so quickly, it can be kept turned off until needed. “With the steam
generators, steam production is nearly instantaneous. It allows us the ability
to not have a fire tube boiler on standby in case of an emergency. If we were
to have an issue with our primary system, the operators are able to get the
second system up to full steam in less than 15 minutes.” In addition, hospitals
have fluctuating, seasonal loads and under conventional boiler methods
sometimes operate in low fire or low load for a considerable time—a very
inefficient process. Clayton’s operating efficiency averages 85 percent, no
matter what the load or firing rate. The generator’s design creates less heat
loss and chemical loss. What’s more, the steam generators are explosion-proof,
providing the highest level of safety in the boiler industry. Miller said
another major benefit using steam generation is minimal maintenance.
He said as long as general maintenance procedures are
followed, preventive maintenance is fractional, compared to that of traditional
fire tube boilers. “Overall, the steam generators have been a valuable addition
to the
for Steam Systems ASME
EA-3-2009
The American Society of Mechanical Engineers has just
released the ASME EA-3-2009 Energy Assessment for Steam Systems Standard. The
Standard sets forth the requirements for conducting and reporting the results
of a steam system energy assessment that encompasses the entire steam system
from energy inputs and steam generation and cogeneration through distribution
to users and condensate return. A representative from Armstrong International
was selected to participate in authoring the standards designed to help
industrial, institutional and commercial facilities identify and capture energy
efficiencies and optimize the overall performance of their steam system. When
you engage Armstrong International for energy engineering services you can be
assured every member of our team will follow the ASME guidelines. Moreover, we
won't take a "cookie cutter" approach. We will work with you to
assess your system and identify your needs. Once your unique needs have been
identified, we will review a number of options to meet your short- and
long-term requirements. Whatever your individual solution, you can be sure it
will be built to meet the highest standards possible.
Vanderbilt.
Posted:
May 02, 2010 2:28 PM
See
http://www.newschannel5.com/global/story.asp?s=12412401 .
The Federal Communications Commission (FCC) will accept comments
through May 24 on a proposed rule allowing
licensed amateur radio operators who are employees of hospitals and other
organizations to transmit messages during government-sponsored emergency
readiness drills. Hospitals accredited by the Joint Commission must test their
emergency operations plans twice a year, including how they will communicate in
an emergency or disaster. Some hospital emergency plans include the use of
amateur (or HAM) radios as backup when traditional means of communication fail.
FCC regulations currently prohibit employees from operating amateur stations
during drills without a drill-specific waiver from the agency. AHA plans to
comment on the proposed rule.
The National Standard for Establishing
Relative Humidity in Operating Rooms
Has Been Reduced to 20% Over the years,
relative humidity levels have been a source of continued debate in the health
care community. In an effort to debunk an age-old requirement, the
Seminar: New Requirements
for Operating Room Humidity Levels
Be Aware, Knowledgeable, and Ready to Respond
At the end of June,
new requirements for humidity levels in the operating room take effect as a
result of actions taken by the ASHRAE Standing Committee responsible for
continuous maintenance of
ASHRAE 170 has been
incorporated into the 2010
Continuing
Education Credits
5 contact hours pending. This activity has been submitted to the Association of
periOperative Registered Nurses, Inc. for approval to award contact hours. The Association
of periOperative Registered nurses, Inc. is accredited as an approver of
continuing nursing education by the
AHA CEU
information: 6 contact hours (.60 CEU) for the on-site program (including the
live broadcast); or 2 contact hours (.2 CEU) for those participating in only
the live Internet broadcast.
Click here for detailed program and
registration information
Editors
note:
As we head toward January 2011, many previously certified mechanics at both the Certified and Senior Certified levels will be asked to recertify. Since, September of 2007, all mechanics have been notified of the recertification requirement. Certified Healthcare Mechanics (CHM) and Senior Certified Healthcare Mechanics (SCHM) will be required to recertify every five years. MECH recertification is not as complicated as other national certifications, but requires the same commitment to maintaining and upgrading technical skills.
Recertification basically involves documenting and verifying that each certificate holder has received a minimum of 6 hours of classroom instruction for each of the 5 years after certifying. Six hours of classroom time per year accumulates to the minimum required number of hours for recertification – 30 hours. It must be restated that each year, there must be a minimum of 6 classroom hours of instruction. Classroom instruction means time spent in training that requires the mechanic to leave his/her regular duties and to spend time focusing on learning something about a process, product, or system.
A recertification fee of $60 to process the paperwork and reissue a certificate is being charged at this time. Both the documentation and the fee must be received by the MECH National Office before the certificate holder’s recertification deadline. The recertification anniversary (or certificate expiration date) is printed on the official certification document. The recertification must occur during the month in which the certification expires. Persons not recertifying by the deadline date will need to take the certification test to retain certification.
Those holding Certified Healthcare Mechanic (CHM)
status may want to try for the Senior Certified Healthcare Mechanic (SCHM)
level; the highest level of certification. This level requires a minimum of 4
years of experience on the job, in a healthcare facility and an affidavit
verifying that experience. At the end of 5 years, a CHM would have acquired the
experience and would now qualify to take the next level of certification test.
This is the only way to attain the next level of certification – a certificate
holder cannot recertify to the next level!
Certificate holders that have been certified
before September 2007 were asked to register for recertification. All of those
who are registered will also be recertifying starting in January of 2011.
MECH is happy to have satisfied several needs with the recertification requirement. Some of those needs were for certificate holders; some were institutional; and some were national. A few of them are listed below:
01/12/2010 GAAS:27:10 FOR
IMMEDIATE RELEASE Print Version |
See http://gov.ca.gov/press-release/14186/
Governor
Schwarzenegger Announces First-in-the-Nation Statewide
Continuing
“With this first-in-the nation mandatory
green building standards code,
CALGREEN will require that every new
building constructed in California reduce water consumption by 20 percent,
divert 50 percent of construction waste from landfills and install low
pollutant-emitting materials. It also requires separate water meters for
nonresidential buildings’ indoor and outdoor water use, with a requirement for
moisture-sensing irrigation systems for larger landscape projects and mandatory
inspections of energy systems (e.g., heat furnace, air conditioner and
mechanical equipment) for nonresidential buildings over 10,000 square feet to
ensure that all are working at their maximum capacity and according to their
design efficiencies. The California Air Resources Board estimates that the
mandatory provisions will reduce greenhouse gas emissions (CO2 equivalent) by 3
million metric tons equivalent in 2020.
Upon passing state building inspection,
Note:
Adherence to the California Green Building Standards Code is voluntary until
Jan 1, 2010.
on Infection Control
May 6 2010
"Amy Mulonas-MSIPC"
<infectioncontrol@comcast.net> 05/11/2010 9:42 AM
Dear Members: On May 6 OSHA published their Request
For Information on whether they should develop a standard or guideline on
occupational exposure to infectious diseases in health care settings. OSHA had
announced this last December as an addition to their 2010 agenda published this
past March.
OSHA is considering what measures to take, including
rulemaking or guidelines, to protect workers against infectious diseases. The
agency will ask for information on the facilities and tasks that could expose
workers to risk, infection control programs, control methodologies used by
facilities, medical surveillance programs, training, and possible economic
impacts of a standard on large and small businesses. Comments on the request
will be due Aug. 4. Infection control measures might be necessary in
workplaces including health care, emergency response, correctional facilities,
homeless shelters, drug treatment programs, and others, the agency said. OSHA
also will ask whether it should focus its deliberations on droplet and airborne
transmission of diseases only, or also include contact transmissible diseases.
The RFI is appended along with a summary from BNA—the
actual Federal Register site is: http://www.dol.gov/federalregister/PdfDisplay.aspx?DocId=23847
APIC, SHEA and AHA will be developing comment and I’m
working with all 3 groups. We will keep you posted as it develops but thought
you should be aware
Advocacy Chair, Judene Bartley MS,
Editor’s
note: For further information, MISHE members can read David LaHoda’s blog
posted April 27, 2010 on the HC Pro OSHA Healthcare Advisor website. See http://blogs.hcpro.com/osha/author/dlahoda/page/5/ .