Nanaimo Regional General Hospital (NRGH) Climate Change Vulnerability Assessment Report

In 2018, RDH Building Services conducted a vulnerability assessment for Nanaimo Regional General Hospital (NRGH) using the Public Infrastructure Engineering Vulnerability Committee to identify potentially vulnerable infrastructure systems, determine possible climate change induced effects, and suggest adaptation measures. NRGH is an acute care hospital facility providing a wide range of healthcare services. It is the second largest hospital campus on Vancouver Island, serving approximately 350,000 people. The hospital is approximately 85m above sea-level and situated on an east-facing slope west of the downtown core of the City of Nanaimo. Hospitals have exigent operational requirements to provide medical service functions, which requires specialization in multiple fields to ensure properly designed and operating infrastructure. Building codes have traditionally been based on historical climate data for specific regions. As climate changes, there is a potential for infrastructure to be subject to climate conditions and loads that it was not designed for. The scope of this project consisted of identifying the potentially vulnerable infrastructure systems, determining possible climate change induced effects on relevant climatic parameters, and developing a risk rating for each possible interaction. The assessment focused on future vulnerabilities caused by climate change, as projected from climate models out to the year 2050. The NRGH constitutes the first applications of the PIEVC protocol to a large and complex building campus with unique requirements to fulfill its prime function of providing medical services to the local community.

Understanding and Assessing Impacts

In the identification of impacts and risks, climate parameters were obtained through iterative discussions with the Pacific Climate Impacts Consortium (PCIC). The selected timeframe by the NRGH team for climate risk and vulnerability analysis was projected out to the year 2050. To provide conservative estimates (high-estimates) in climate projections, an Representative Concentration Pathway (RCP) of 8.5 W·m-2 was assumed for all climate parameters. The risk scores were provided by PCIC from a combination of professional judgment and statistical evaluation of climate model projections. A facilitated workshop was also organized to identify the severity scores for each infrastructure component and climate parameter interaction. Workshop participants included Island Health Facilities, Maintenance, and Operation Staff (FMO), Facilities and Planning Managers, Clinical Practitioners, Clinical Operations Managers, a member of PCIC, and the consulting team. The purpose was to achieve a consensus-based severity score that aggregates the professional experience of the consulting team with the inservice performance knowledge of the systems of FMO staff and Island Health facilities managers.

The assessment found that the three climate parameters that are responsible for most of the medium and high-risk interactions are heat waves, humidity, and water shortages. Other climate parameters that were considered included: contaminated water, strong winds, sea level rise, flooding, among others. The assessment summarized risks of the interaction between the infrastructure components and climate parameters. For example:

  • Mechanical – The main effects on the mechanical systems are caused by heat waves and high humidity conditions. The cooling system seems most sensitive to effects of heat waves, whereas the critical air and other ventilation systems are susceptible to air pollution (forest fires) and high humidity.
  • Electrical – Overheating of the elevator controllers and main distribution transformer during heat waves may pose some issues. Strong winds and storms may also damage BC Hydro supply. Premature failure of the electrical systems due to higher outdoor humidity is a lesser concern.

Interactions were also considered for civil services, water, the building enclosure, and structural elements.

Identifying Actions

The overall objective of the Nanaimo Regional General Hospital Climate Change Vulnerability Assessment (Assessment) was to assess infrastructure components of the Nanaimo Regional General Hospital (NRGH) that are at risk of failure or impaired service function due to extreme climate events or a change in climate normals. The PIEVC Engineering Protocol for Infrastructure Assessment and Adaptation to a Changing Climate (Protocol) version PG – 10.1 (June 2016) was used for this work to analyze both infrastructure and climate information and evaluates potential interactions between them. The methodology of the Protocol includes five key steps to ensure the assessment is consistent and rigorous. The five key steps are:

1. Project Definition
2. Data Gathering and Sufficiency
3. Risk Assessment
4. Engineering Analysis (optional as necessity and resources permit)
5. Recommendations and Conclusions.


The PIEVC protocol resulted in a number of technical adaptation measures to be considered for the hospitals infrastructure. The recommendations were organized according to engineering disciplines and then further sub-divided into respective systems and sub-systems. Subsequent adaptation measures will define the required level and extent of renewal of these vulnerable systems. From here, it was recommended that further consideration for cascading impacts between systems and operational actions is included for implementation of adaptation actions. Examples of adaptation recommendations include:

  • Review health of vegetation during prolonged dry periods and flooding incidents.
  • If prolonged heat periods destroy vegetation, replace with mixture of drought and flood tolerant species, depending on local topology.
  • Ensure low-ground cover near to buildings to mitigate fire-risk.

Outcomes and Monitoring Progress

This case study emphasizes the importance of recognizing that management, maintenance, and operational practices can exacerbate or mitigate the impacts of climate risks. Risk and vulnerability assessment should therefore extend to decision-making practices, operating guidelines, and emergency planning. For instance, the planning process for future facility upgrades or expansions should include mandatory consideration for adaptation and mitigation strategies, or procurement could include additional requirements for energy efficiency on new clinical equipment. The assessment suggests that impacts and associated actions are reassessed overtime to remain flexible in the face of new information and a changing climate, and value continuous improvement philosophy and adaptive management. The PIEVC protocol is a valuable tool for conducting climate change risk assessments. To date, the protocol has been used primarily on civil infrastructure systems, such as culverts, bridges, and to an extent, some buildings. The NRGH constitutes the first applications of the PIEVC protocol to a large and complex building campus with unique requirements to fulfill its prime function of providing medical services to the local community.

Next Steps

The final recommendations for next steps to come out of this assessment included the consideration of overall resilience building for the hospital. These recommendation were not specific to climate change (i.e. adding additional access locations), but would increase the overall resilience of the hospital and its operations to cope with future risks. There are a variety of significant climate change resilience concerns and approaches that fall outside of the pure engineering focus and scope of the PIEVC protocol, but which are nevertheless integrally linked with, and influence, the physical risks and resilience of NRGH. Addressing these concerns, as part of a comprehensive climate risk and resilience analysis, could help tie the PIEVC results into the broader emergency planning and resilience initiatives that the hospital is engaged in, and/or that may be advisable next steps as part of Island Health’s climate resilience planning.


Link to Full Case Study

Additional Resource:

  • Further understand how climate information can be applied in decision-making by exploring the Health Module on