Episode 18: Where There’s Smoke, There’s Fire: A Conversation on Property Risk with FM Global and Kingston Health Sciences Centre
Advice from the experts on how to prepare for the worst and mitigate property risks facing healthcare organizations.
Today, your host Michelle Holden, Communications and Marketing at HIROC, speaks with Dave Thompson, Senior Vice President with FM Global, and Rocky Prosser, Director of Protection Services at Kingston Health Sciences Centre (KHSC).
As an insurance partner of HIROC, FM Global works with subscribers like KHSC to help keep facilities safe and to help mitigate property losses. On this episode Dave and Rocky share their unique perspectives around facility risks like water leakage, surface water, fire, and contractor management.
Dave and Rocky offer safety tips and trends, but also recommended resources for healthcare organizations across the country.
Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers, and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to those leaders about the joys and challenges of driving change in our complex and demanding healthcare organizations.
Michelle Holden: Hi everyone. I'm Michelle Holden, Communications and Marketing Specialist at HIROC. On today's show, we're going to be talking to two leaders from the insurance and healthcare sectors. We'll have a conversation about property and facility risks facing organizations today. Dave Thompson is a Senior Vice President with FM Global, an insurance partner of HIROC. We're with Dave in Vaughan, Ontario today.
Also on the line from Kingston is Rocky Prosser, Director of Protection Services at Kingston Health Sciences Centre. So let's get started. Rocky, for those who don't know you, you have a really fascinating background working with the army police, social work, and now healthcare, professions that are all about keeping people safe. Why is that important to you?
Rocky Prosser: Well I think it was part of my upbringing. My father was a career military man and one of the principles that he always instilled in me was to help the vulnerable and the helpless. And I've always had that with me. I've always had a soft spot, I guess, in my heart and in my being that those that are in need of help, I wanted to be there for them. And through a series of events I've been at, I've had the pleasure and opportunity to work in law enforcement, in a fire service field, and in the military. So I've been blessed that way and spent the last 30 years working in healthcare.
Michelle Holden: Yeah, that sounds like a really long, fulfilling career. David, can you tell me about how you got to where you are in your career?
Dave Thompson: Well, unlike Rocky, I've had a pretty fixed line. I started with FM Global 35 years ago as a young engineer out of university. Like most engineers, I didn't plan to end up in the insurance business, but I started out doing what a lot of people who are exposed to FM do, doing field engineering visits. And after a few years, I moved over into the marketing side of insurance. Then I moved into underwriting, then I moved into management and I've been running Toronto's operations here for 15 years now. So I kind of obviously like the company I work for, I've been here 35 years.
Michelle Holden: Yeah, that's pretty clear. And what motivates you to come to work each day?
Dave Thompson: Well, like everybody, I think things change as time goes on. But I'm a manager of managers to a degree now, but I think what gets me out of bed every morning is two things. One, I get to work with a whole lot of really neat businesses and neat people. FM just doesn't insure healthcare business. We insure the commercial risks, a lot of other institutional risks. We insure a lot of big industrial risks. And plus or minus, they're all the same thing that we're trying to do for them, help them prevent losses in their business.
So when you get out of bed in the morning, it's never the same thing two days in a row. It's always a different client. A different issue, a different challenge that we're trying to deal with. So that's kind of one of the things that I like about what I do. And then the second thing is I, kind of like a lot of older guys, you have got a pretty young crew that you're trying to bring along and get them into the business and get them excited about what we do. I'm lucky here, I've got a great group of young people who are really jazzed about what FM's doing and what our clients are trying to do. So I kind of like that too. So even if I didn't need to work, I think I'd still come to work.
Michelle Holden: I wanted to talk about the word resilience, Dave, something that we hear a lot from FM Global, particularly the ability to bounce back from a tough event. So how can healthcare organizations, our subscribers, be more resilient?
Well, I think when you think about resilience, the first thing that comes to mind is, how do you bounce back from something bad? But really it all begins with understanding what can happen to you. In the healthcare business, I always kind of take the point of view when I talk to people in your industry is, all we want you to do is take care of your facilities the same way you take care of your patients. I mean if you talk to anybody in healthcare, it's patients first, patient care first. And I always kind of make the point of view that people are really important but you put them in a box and that box is called a hospital and we're really all about how do we protect the building, the box, that we put our valuable people inside of.
Michelle Holden: Yeah, I don't think I've ever heard that comparison between protecting the patient and protecting the building. And also the staff, because I know that at HIROC it's about the patient, but it's also about your team as well as protecting them and keeping them safe. So Rocky, I wanted to talk to you a little bit from the front lines of healthcare; what does resilience look like to you?
Rocky Prosser: The way I look at being resilient here at Kingston Health Sciences Centre is being able to come back from an incident with as little impact on patient care, on staff workflow, and on costs to the organization. And that's done through mitigating strategies such as proper planning, proper inspections, identifying risks upfront, and having a plan to address those risks in a timely and effective manner. And consulting with the people, the experts such as HIROC and FM Global. They can provide some very good insight as to what they've learned through their work with other healthcare organizations.
Michelle Holden: I know Rocky you work with not just Kingston Health Sciences, you work with other organizations, correct?
Rocky Prosser: So we're contracted out in my department from KHSC to Brockville for emergency management. So we help them formulate plans, do their hazardous identification risk identification for their region and their area. I sit on the City of Kingston's emergency preparedness committee and their city planning committee as well for disasters and emergency planning. So we have some good linkages and partnerships that are established in order for us to be able to respond to anything that may happen to our organization.
Michelle Holden: I want to make a little bit of a shift and talk about water because we know that water is the number one loss driver for healthcare organizations increasingly so with flooding, freezing, and other climate issues. Dave, I wanted to ask you why water has become such a loss driver.
Dave Thompson: Well I think it's not so much it's become, it's always been. When you think about hospitals versus say, a standard commercial building or a standard industrial building, the one unique thing about hospitals is there is water everywhere. I don't think you can walk 20 feet in a hospital where you don't bump into a bathroom or a sink or something. So there's water absolutely everywhere, which means the more piping you have, the more probability something's going to go wrong. Now, I guess the challenge when we think why has loss history kind of been tweaking up in hospitals, I think it's because they're getting bigger and they're getting more complicated. You think of a water damage in your home and you say, okay, I got a leaky pipe at home while everybody just goes down into the basement or whatever, turns one valve and the water's isolated.
You get into a big complicated hospital with pipes running everywhere. The first question is where's that valve? And we always talk about it at FM, first thing, if you have a water leak, it's isolate, contain, and drain. And the problem is it takes a long time to isolate in a lot of hospitals if there isn't a plan in place to do it. So that's kind of the first issue is how do you get water ... when bad things happen, how do you deal with it? But really the best way to deal with water showing up in your facility is to know what you're going to do before it happens. And a lot of people we talked to in the healthcare industry or municipalities or rec centers, it doesn't really matter when you say, have water damage, why did this get so bad?
And the first thing is nobody knew what to do. So they ran around, they picked up the phone and they started phoning people who knew what to do because generally speaking, water breaks happen not in the middle of the day shift, but in the middle of the night shift and the maintenance guys aren't around or whatever's going on. So we kind of always say, "Look, if you want to know what to do, anybody can shut a valve, as long as they know what valve to shut." So if a water break's on a floor, where's the shutoff valve? Does the nursing station know where it is? Go shut it off instead of waiting for a half an hour. I was talking to your CEO yesterday about this subject and I said, "At FM Global, we've got kind of this basic line that when a water break happens in a commercial or institutional building, it's kind of like $5,000 a minute of damage for the first 20 minutes and after that it's $50,000 a minute."
What Catherine told me is that we're probably low by a factor of 10. So this tells you exactly, water is going to find its lowest point all the time and it's going to find it a lot faster than you can run. So in hospitals, especially now with health issues and cleanup issues and everything else, everybody, when you dump water somewhere, the first problem is you got to stop it. Once you've stopped it, then you've got to clean it up. And water tends to find low points and a lot of valuable stuff is in the basements of buildings and it does a lot of damage on its trip down there. Mold is an issue. If it's the middle of summer, how do you dry it out without creating mold? And again, what you're doing is you're, to a degree, contaminating the environment that patients are in.
So how do we stop that? And we're not going to stop it, but we can control how we respond to it. And if there is no plan, then you're just going to be recover. If there is a plan and you implement it quickly, the damage will be minimized, the upset to the operations will be minimized. To get back to the old resilience thing, when you're resilient, you're back in business quick. So a pipe break could be a minor inconvenience for five hours of cleanup or it can be a multi-week event tearing walls apart and replacing equipment. So it's really, what's the difference between A and B? It's how well you're prepared for it.
Michelle Holden: So I was going to ask you what things facilities can do on their own to mitigate those risks. And you kind of just mentioned to have a plan. Is there anything more specific to that?
Dave Thompson: Well, I think, and Rocky can probably weigh in on this a little better than me, but I kind of say, if somebody walked me out into a hospital day and say, "Okay, we don't know what we're doing, what would you do with us?" I'd grab three or four people and I'd walk every floor in the building. Say, "Okay, there's that room, there's that room. Where's the water in that room? Where's it coming from?" Trace it all back to the control valve. Make a little sketch if that helps and make sure the people who are working there 24/7 a day, know where it is. So if water comes in, they know where to go.
It sounds really simple. Sometimes it's really complicated. If you get into a small hospital, it's probably pretty simple. There's probably half a dozen valves to control all the water in the building. If you get into a big, big hospital, it can be incredibly complicated. It can be like following a snakes and ladders exercise running around the hospital, but as complicated as it might sound, it's not that hard to do. It's just time. And guess what? So time invested before the loss to make sure you understand what you're going to do if the pipe breaks is one thing. Time to recover from a loss, if you didn't have a plan? That's a little more time and a little more damage, and a little more inconvenience. So it's about investing time.
Michelle Holden: And Rocky, did you have any thoughts on what Dave just said, in terms of planning and investing time?
Rocky Prosser: Obviously I concur with David. I mean, I think time is essence in mitigating damage. I can't underestimate that. My experience has been, when you're dealing with a facility that's over a million square feet and the oldest part of your building is 200 years old, the newest part is built in the '90s, and the rest of the buildings are somewhere in between there. You've got all kinds of different building code standards that came out through the years. And the reality is that you've got really, really old piping that's hooked up to newer piping and some of the piping is well over a hundred years old. It's the same thing with our city infrastructure here, that everybody was trying to get their minds around. Those things are high risks because of the integrity of the pipes are worn down to the point that they may be breached.
And if that happens you need to know where your shut off valves are. You need to know how to shut them off and how to get to it quickly. Because the longer you wait, the more damage there's going to be. So I agree. I agree that time is of an essence and you got to know not only where those valves are, but who knows where they are. Because not everybody needs to know where they are because, frankly, in our organization we've got literally hundreds of different shutoff valves throughout the building. So we need to have a place where these are housed, where we can access very quickly to say we're in this wing on this floor, there's the shutoff valve for this particular area and it will not impact the rest of the building, but it will stop that water flow from coming in and creating more damage.
So I mean that's one thing and so you need to have that in place. I think you need to have a good response team that can act very quickly, 24/7. And here we use our security department, our environmental services, and our facilities department and they're our initial response team. So they can get there quickly. And facilities guys, they know where the shut off valves are. Our security team also has access to that so they can do it. If facilities are tied up doing something else, and our enviro team have the tools necessary to do a quick cleanup and to barricade or to dike if they need to.
Michelle Holden: Dave, I wanted to ask you, I know that FM does a lot of things with flood mapping and other types of preventative work, not just for in-hospital but also weather related. Is there anything else that you can mention?
Dave Thompson: Well I guess the one thing that we are very cognizant of at FM is flood risk. It's a pretty well-understood science even though a lot of people don't think it's well-understood, it is pretty well understood. The challenge that we're going through as a society right now in Canada and US, North America is we know floods are getting worse. And everybody says it's climate change. I'm not quite ready to weigh in on that side of the equation, whether it is or it isn't. But I will tell you one thing is for sure, we are urbanizing faster. And when you look at floods that have happened in Calgary few years ago. Toronto, every time we get a big rain in Toronto, we flood a whole bunch of the downtown core and everybody says, well how is that possible?
And I said, "Well when you put a couple more million people here than were here 20 years ago, all those pipes that handle rainwater are the same size as they were 20 years ago." So the system backs up… you think of hospital row in Toronto here, with all the hospitals. As urbanization grows around them, the risks of surface water and rainwater happening starts increasing too. So we would kind of try and work with our clients first to kind of say, "Okay, is this building subject to a surface water risk? Is it subject to a sewer backup risk? If it is, how do we deal with that? Is there a way to manage it?" The reality is it's just like getting prepared for an event inside the hospital with a pipe break. It's recognizing, are we exposed to a surface water event or a sewer backup event if the hospital's in a low part of, say Toronto down by the waterfront?
The probability of getting sewer backup increases exponentially, if you're up on a hill, not so much. So it's really ... we always say to our engineers when they're out there, that's one of the things you have to evaluate. Is the river going to flood you? If the river is not going to flood you, is the surrounding topography going to expose you to surface water? If it is, where's that surface water going to go? If it's going to go into the hospital basement, is there something we can do to prevent that? Is there some curving we can put in? Is there a plan we can put into place? So again, not a lot different than the internal break. It's really understanding the hazard that your facility is exposed to putting plans into place. So when you see the big cloud coming across the Doppler radar, you can say, you know what? This one looks like a big one. We need to get ready for it.
So preparation, although we can nag about it as much as we want, people who are prepared for the bad things that can happen to them, identify the risks that you're exposed to and prepare for them in front, then chances are when the event kind of rolls in, you'll be ready for it. And you won't be running around saying, "Holy crap, there's water coming into my basement and it's coming in so fast and I don't know what to do." We'd rather say, "You know what? We know how water's going to get in." And when the rain's coming or the surface water's coming across, we know what to do to stop it getting in the building.
So if you look at the US and some of the big, big, huge events in places like Houston, that's been flooded by big tropical storms. When it got flooded about 20 years ago, huge flood, surface water event, nobody was ready for it. Some very large hospitals down there had some very big submerged basement losses. And you look at the same event happen not too long ago, and FM insures a lot of hospitals in the US. Our losses from hospitals in Houston were almost zero because they were all prepared. Because they'd learned from the first event, this is how water gets into our facility. They stopped it, so the second time they got hit it, they didn't get hit. Because they were prepared for it. So that's kind of, again, it keeps going back to basically awareness of the exposures and recognizing that Mother Nature is Mother Nature. She doesn't discern whether you're a good hospital or bad hospital. If the rain comes, you got to be ready for it.
Michelle Holden: So getting back to the Houston story that you just told Dave, was a really good success story of learning from what happened first and then changing. Can you tell us a little bit about what you did after that first incident and what FM decided to do to help prevent it in the second one? Because we know because both HIROC and FM are coming from this mutual purpose of helping our clients and our members save costs and increase safety, we want to kind of learn from those incidents.
Dave Thompson: We always kind of knew Houston was flood exposed, but we didn't kind of recognize the interconnectivity of the underground structures in Houston. So when Houston got hit the first time, basically because the underground of the city's all connected, the water went everywhere in the underground and the hospitals were all connected to the underground network. So water found a way through the system. We actually at that point did… you know it scared us because it cost us a few hundred million dollars of an unrecognized hazard by us at that point, because we were looking at the ground level a hospital, but we weren't looking down in the underground. If you go into Houston now, every hospital's underground has almost a submarine door on it now to isolate that hospital from the system, the infrastructure that's underground in Houston.
At the same time as that, how do we share this information in FM? People ask me who is FM, because nobody's ever really heard of us. We've been around since 1835 as I kind of described to people. My company was founded the same month Charles Darwin was landing on the Galapagos Islands. So we've been around for a little while. But being a mutual insurance company, a little like HIROC, we have a very simple rule. I describe us to people, is we are the most socialistic company on the planet you will ever find. We basically ... everything we learned from all our clients, we share with all our other clients. The fact we're owned by the biggest capitalists on the planet is a little ironic. But the reality is everything we learned from every flood, everything we learned from every individual loss our client has, we try and share with our other clients so they can learn from the misfortunes of others, for want of a better term.
So after Houston as a great example on water, we went to every major city, kind of, where we have clients. We looked at a lot of huge universities that are interconnected underground in floodplains, and we started identifying that hazard and started mitigating that hazard before it happens. So when big floods happen in the US now, or big surface water events, we're rarely surprised now.
Michelle Holden: So Rocky back to you. I wanted to ask, in terms of surface water flood we did talk about how being so close to Lake Ontario in Kingston, this is definitely a reality for you. Can you speak to that a little bit?
Rocky Prosser: Yeah. And I think I'll just pick up a little bit from where Dave left off. I think it's important and I can't stress enough, the mitigating or the prevention strategies in place to prevent, or at least minimize, the amount of damage to whatever catastrophe you're going to be facing. And I think the first tool that we use here is the HIRA, which is called the Hazardous Identification and Risk Assessment tool. And it's a risk tool and there you can say, "Okay, what are the most likely risks that we're facing?" And those risks, what level, if they do happen, of catastrophic outcomes could happen. So that's the first thing.
And I think FM Global does this very well is they do regular inspections with the facility. We do regular inspections with our fire department with our facilities people. And so the whole purpose of that is to identify, in this case pipes and building systems that may be approaching end of life. What are we going to do for replacement, how are we going to replace them, all that kind of stuff. And then some of the other things that we're doing, and I recommend other places to take a look at, is working with their local municipality to maybe upgrade the water system distribution system and infrastructure.
We've had some very similar things to Houston, not to the same degree. I can tell you and I'm glad of that, but one thing we've identified is that the city infrastructure cannot no longer hold the current population and the buildings that are within the city limits right now. So they're in a upgrade mode. And even with the upgrades around the hospital, which was scheduled a couple of years ago, it still doesn't seem to be enough.
So we've had to put other strategies in place. Such as now we have our security operations center and our mobile patrol that have Environment Canada weather alerts sent to their mobile phones so that we can respond upfront. So if there's something coming, we're going to start responding right away. And we bought diking and absorption kits as part of our response now. We've provided training to certain individuals and security environmental services to use them, especially in our high risk areas. We've got agreements with pump truck in case the water coming in is just coming in too fast, we can't shut it off, we can't stop the source cause it's coming in from the outside. We've got now, an agreement in place with a pump truck company that within 30 minutes they will be here to start pumping out.
The other thing is fire department. We've made arrangements with the fire department that, in the interim while waiting for the pump truck, if we feel that the outcome can be catastrophic, we can call the fire department. Their trucks can also, not only pump water out but pump water in, so it can do both. We can get that. We've got sandbags that are on the exterior waiting to be used in those areas to stop water from coming into the hospital. We've got our steam plant, which is important because for us at Kingston Health Sciences Centre, that steam plant provides power both to Queen's and to the hospital. So we need to protect that plant. So we've got a cement dike that will stop water up to, I think, six to eight inches from coming in and then after that well then everybody's going to be ... I guess the level of the lake is too high for anybody to be around.
We got a ton of stuff. We have small pumps at our smaller facilities, like our urgent care center. We got small pumps there so that we can pump water out to lowering levels, lower grades around the hospital. Because what happens in some of these cases is that even with sump pumps you're pumping water out, but you're just pumping water back out into the same system that is draining into your hospital. So we've identified where we could set up pumps to pump it out into areas that are lower than the hospital and that will take the water actually away from the hospital.
Michelle Holden: Well what strikes me is that a lot of these things that you're talking about are not just applicable to hospitals. They also work with non-acute and other facilities that don't house patients. So it's important for all of us and all of our subscribers to kind of pay attention to what you're doing and what Dave is talking about. Dave, can you share with us a few of the other loss drivers for healthcare?
Dave Thompson: Okay, well I guess as most people when they think of FM Global and they know anything about us, they think of us as the sprinkler guys. We're the guys who recommend sprinklers everywhere and when you think about a hazard in a hospital, the frequency one is certainly water. There's a lot of frequency of loss, but that real scary one is fire. What do we do to prevent fires and hospitals? I always kind of tell people, what would you rather insure – a hospital that's fully sprinklered with no kind of control systems or would you rather insure a hospital with really tight control systems and no sprinklers. That's a catch-22 because the reality is most fires are started accidentally. And the biggest starter of fires in hospitals is contractors, believe it or not. It's not the hospital personnel that start fires. It's the people who come in from the outside to weld a pipe, to work on a roof, to do whatever, and they're using torches and they're starting hot work.
So if I had a magic pixie wand that I could wave over all the HIROC members, I'd say, put in contractor management. If they're going to come in to your hospital, and you say, "What are you doing here?" And they say, "I'm going to be welding some pipes or I'm going to be heating up some stuff." Then you've got to make them really aware of the hazard they're creating for your people as well as your building and make sure that they're managing that exposure really well… or you manage it around them.
Because quite honestly, the most dangerous thing in a hospital, in my opinion, is a contractor who is not monitored, who's got a torch in his hand and he's cutting things apart or welding things together. That to me is the most frightening thing you can have in a hospital because the knock on effects of that, whether the building is sprinklered or un-sprinklered, is as soon as you get smoke in a hospital, it's no longer about the building, it's about the people in the building.
The second one that's kind of emerging that would apply more to your rural members is the exposure or forest fires in Canada. Given the kind of way we're seeing forest fires developing in Canada lately, right now it seems to be more an Alberta problem than an eastern problem, but we think it's coming east. It's certainly going to come across, as Saskatchewan's the next one in the receiving line as the west seems to be drying out. So we're doing a lot of work, kind of trying to map some of these, what I'll call high-hazard forest fire areas, where we have clients who have assets to kind of say, okay, you know domestic water emergency response plans is one thing, but maybe if you're in the wrong space and you've got a rural hospital, maybe a forest fire emergency response plan is appropriate. So when you get home you don't have to clean the house.
Michelle Holden: Thank you Dave. So many good lessons for our subscribers across the country. So not just here in Ontario and definitely not just in a hospital. Rocky, just briefly, I wanted to touch on whether there are any specific FM Global resources that you find particularly helpful and anything you can tell our other subscribers about.
Rocky Prosser: One of the ones I've been using for years is FM Global's hot work [resource] that they put out. I can't even remember. I think it was back in the '90s and I'll never forget, it was when the Ontario fire code said that it was mandatory that we needed to have some kind of hot work program or system in place. And so a lot of us in the healthcare sector were scrambling around and saying, okay, how is this going to look? And I don't know how this unfolded, but there was someone was there from HIROC, I think it was a claims adjuster, for something else they'd run into. And we started talking and he said, "Oh, by the way," he said, "FM Global's got this hot work program. You should take a look at it."
So I called, and make a long story short, they sent it out and it was the complete program. I said, well, “I don't need to do anything. I just need to change a few names.” I asked them if they mind and they said, "No, we don't mind." So I changed the policy a little bit, but essentially what we had then was the FM Global hot work permit system. When I came to Kingston Health Sciences Centre nine years ago, I implemented that as well and we use that. And I just found out earlier this week that you just put out a water leakage emergency response plan template… or guidelines. So that's just been shared with me, so now that's going to become part of my team's review process to take this into consideration. And my instructions to my team is that you will, not ask me if they could, they will use this as the main source of putting their plan together.
Michelle Holden: Yeah, no. And both of those are available on HIROC's website and also through your representative so we can always get them to our subscribers. Just quickly, Dave, what keeps you up at night?
Dave Thompson: Well, I guess, FM Global insures a lot of really scary stuff and thank god hospitals don't fall into that really scary category. But as a citizen, nobody wants to pick up the news and hear a hospital's burnt down because that's a bad day for everybody, as citizens of this country. So if you said, what's Dave's missionary in life, I'd like to see every hospital in Ontario fully sprinklered.
Michelle Holden: Certainly. Rocky what, for you, is keeping you up at night?
Rocky Prosser: The fire itself is not the threat. The actual threat is what comes with it. And that's the smoke. There's more people and damage caused by smoke, and the second thing is by water than the actual fire itself. So I agree. If we can have our buildings fully sprinklered and we can act and have a plan that we can act swiftly and immediately, we reduce the risks to life and property.
Michelle Holden: Well it sounds like you guys are losing a lot of sleep. I wanted to thank both of you for being on our show today and for sharing your stories and also the important things that our subscribers can be doing to mitigate these property risks that are happening in hospitals, but also in healthcare organizations that don't serve patients. So I want to thank both of you for being here today.
Thank you for listening. You can hear more of our interview on our website, HIROC.com. Follow us on Twitter at @HIROCgroup or email us at Communications@HIROC.com. Healthcare Change Makers is recorded by Ellen Gardner and Philip de Souza and produced by Podfly productions for HIROC.com. Please rate us on iTunes.