The Middlesex-London Health Unit puts aquatic facility training program into action

November 14, 2016

By Anne-Maria Quin and Fatih Sekercioglu

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Middlesex-London Health Unit (MLHU) provided Operator Guide and record book.

Authors’ note: This article provides an update on what has transpired with the London, Ont.-based Middlesex-London Health Unit’s (MLHU’s) ‘Public Pool & Spa Operators Regulatory Training Program’ since it received the Association of Pool & Spa Professionals’ (APSP’s) Dr. R. Neil Lowry Grant in 2014. The MLHU’s article, “Setting the bar high: The Middlesex-London Health Unit strives to achieve excellence” published in the December 2014 issue of Pool & Spa Marketing, outlined the role of public health inspectors (PHIs) and what the MLHU intended to do to enhance the training program.

The relationship between the local health department and the owners, operators, lifeguards, and support staff of public pools and spas, can be seen as multi-dimensional, but from any angle it is directly related and essential to the health and safety of patrons. The inspectors’ role ranges from inspection and enforcement to training and support. Numerous risks can be associated with recreational water facility use, including potential exposure to waterborne illnesses, not to mention life-threatening injuries. Inspectors, and those who manage or oversee the operation of these facilities, can work together to ensure they are operated in compliance with relevant public health legislation.

Legislation recap

The MLHU is responsible for the public health-related regulatory oversight of 175 public pools and 50 public spas in London and Middlesex County, resulting in more than 680 routine annual inspections. The regulations Ontario’s public pool and spa operators must adhere to are found in the Ontario Ministry of Health and Long-Term Care’s Health Protection and Promotion Act. On the other hand, the Ontario Public Health Standards Recreational Water Protocol 2014 provides boards of health with direction on recreational water program delivery. The ultimate goal is to reduce the burden of illness and injury related to recreational water facility use.

Making sense of the legislation

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Deficiencies in record-keeping and water chemistry parameters were identified among the top non-compliance issues.

Often, regulations can be overwhelming to navigate. This is where public health and industry members can play a role in developing appropriate training and support.

To increase compliance with regulations, it is important for aquatic facility owners and operators to understand the requirements and to have the tools necessary to conduct their duties appropriately. Public health can assist them by making it easier to follow their obligations under the legislation; among the ways it does this is by providing interpretations of the regulations and lists (taken from the full inspection report) of what inspectors are looking for. These interpretations provide an outline of the minimum safety requirements and aim to bring consistency to the entire inspections process.

Where has the time gone?

Over the last two years, the MLHU has been planning, developing, pilot-testing, and fine-tuning its new enhanced training program. Feedback from operators and inspectors, coupled with best practices collected from published literature, has driven many positive changes in the way the MLHU administers its revised Public Pool & Spa Operators Regulatory Training Program. The program is designed to be accessible, and to provide value-added content, for aquatic facility staff, while improving compliance with provincial pool and spa legislation. The ultimate goal is to reduce and prevent waterborne illness and injuries related to the use of public pool and spa facilities.

The redevelopment of the training program

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Demonstrations on proper water chemistry testing techniques are provided.

The majority of the program redevelopment work outlined in the previous article has been completed and integrated into the MLHU’s ever-evolving training program. This includes:

The MLHU was also fortunate to conduct an additional focus group with owners, operators, lifeguards, and other support staff who had attended a training session since 2012 (when the training program was first enhanced) and who had not attended its training program prior to the newly redeveloped training in November 2015. The goal was to determine what was working well and where further training program enhancements could be made. The MLHU wanted to know specifically whether knowledge of the relevant legislation increased and whether skills related to chemistry testing and record-keeping improved as a result of the training.

Finally, the MLHU is looking forward to pre- and post-comparison assessments of compliance items (planned for 2017) to determine whether the training resulted in improved compliance with the legislation.

What did the MLHU find?

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Those who attend the Middlesex-London Health Unit’s (MLHU’s) training session receive materials such as public pool and spa record books, as well as an operator’s guide.

A list of infractions found between 2011 and 2014 was gathered from the software inspectors used to enter inspection data. It was found that while there had been an increase in compliance, there were reoccurring items that still needed to be addressed, including some items which showed decreasing compliance with legislative requirements. Deficiencies in record-keeping (including monthly, weekly, daily, hourly, bi-hourly tests and inspections that need to be conducted by operators), and water chemistry parameters (chlorine/bromine, pH, and/or total alkalinity) were identified among the top non-compliance issues.

The MLHU also found several items gathered during its literature scan which aligned with feedback provided by the focus groups. These included:

So what is being done now?

By engaging facility operators and PHIs and incorporating the feedback with information gathered from the literature, it is hoped the MLHU’s training program will add value to the recreational water landscape in London and Middlesex County. It is expected the program will better reflect the needs and wants of recreational water facility owners and operators, while providing a supportive environment to increase legislative compliance. To be successful, the training program has to adjust and adapt as new evidence and best practices become available. As part of the redevelopment project, the program has been designed to be adaptable so training material and content can be adjusted to focus on the most common non-compliance issues, and modified as new information becomes available, or when regulatory changes are announced.

One of the key findings from the program review was the importance of including adult learning principles and strategies that have been successful in other regulatory compliance programs. As a result, the following activities have been incorporated into the training program:

The revised training provides an overview of the eight components recommended in the Recreational Water Protocol, 2016 under the Ontario Public Health Standards (OPHS) and Protocols. To make the training more relevant, each year’s training will have an overarching theme. The training will focus activities and content on the top two or three non-compliance issues identified from the previous year. For example, in 2015, the top two issues identified from inspection data were: water chemistry parameters outside of regulatory ranges, and incomplete record-keeping. As a result, a significant portion of the 2016 training program focused on these issues. A quick review of participants’ post-training surveys indicated the level of knowledge and importance of these two items has increased. Many of the activities listed in Table 1 aim to address some of the barriers operators face in their efforts to manage facilities in a safe and sanitary manner.

Customized on-site training pilot

Table 1: Training program activities

Activity Reason or importance Materials/resources
Focus on top non-compliance issues Increases the relevance of the training by aligning it with issues operators may be experiencing. Non-compliance data from the previous year is analyzed to provide the current year’s ‘theme.’
Job-specific and hands-on training (the ‘how’) Turning theory into practice so operators can develop the skills in a supportive environment. Demonstrations are provided and participants have an opportunity to try it themselves (e.g. chemistry tests and record-keeping).
The ‘why’ and importance of compliance Provides an excellent opportunity to have a conversation about the consequences of not being in compliance. The rationales behind the regulatory requirements/industry best practices have been incorporated into training and print material.
Active recruitment of staff from each employee level It is important for staff at all levels of employment to understand and receive training with respect to responsibilities and what is required for safe and sanitary facility operation. The MLHU has enhanced how training dates are made available (e.g. e-mailing/mailing invitations to operators, owners, lifeguards, and property managers; website and social media).
Delivered using a combination of learning methods (e.g. interactive) A combination of learning methods is beneficial. Lecture-style training has been enhanced by incorporating questions, interactive case studies, hands-on activities, and supplemental materials (e.g. record book, a resource sheet, copies of regulations, etc.).
Timing and location It is important to find a time and location that will increase training accessibility.

Feedback indicated parking at the MLHU’s main facility may not make it an appropriate location for the training.

A majority of the sessions are now offered in the spring to accommodate seasonal pools/spas.

In addition to the MLHU’s main facility, training is now also offered at other locations to improve attendance and accessibility.

The MLHU has also added a customized on-site component to the training program to address facilities that have new operators or those which struggle frequently to remain in compliance. This involves a one- to two-hour visit with the operators and staff of the facility on-site, to go over specific regulatory issues. It has also been observed that attending a training session is beneficial and ensures operators are better prepared about site and regulatory specific questions or issues related to their facilities.

What is yet to come?

The MLHU is committed to continuous quality improvement, and the Public Pool & Spa Operators Regulatory Training Program is no exception. The intention is to continually enhance the way the program is delivered to best meet the needs and learning styles of the operators, while improving the health outcomes of those who use their facilities. The following activities are to be completed in the near future:
1. Provide the most up-to-date regulatory information and incorporate adult learning principles into print material.
a) Redesign and reformat the MLHU’s existing Public Pool & Spa Operator Training Guide.
i. To enhance the delivery of written material using evidence-informed strategies and operator feedback. To be developed after updated legislation is enacted.

2. Assess the effectiveness of the enhanced facility operator training program.
i. Design and engage in a post-training survey, to determine whether training led to increased knowledge of the relevant legislative components.
b) Undergo a pre- and post-comparison assessment of compliance items.
i. To determine whether the training improved compliance of pool and spa premises.
3. Readjust the training program to meet future needs.
a) To enhance the training program and meet operator needs.

How can industry members help?

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Manual water chemistry tests are still required for record-keeping and to verify accuracy of automatic sensing devices which display pH and oxidation-reduction potential (ORP).

Having an understanding of how to operate the equipment associated with pools and spas is a crucial skill for operators. Service technicians and installers can provide the necessary education and training so operators can confidently and competently operate their equipment and test emergency features such as vacuum-relief mechanisms, emergency-stop buttons, and other associated equipment.

Conclusion

While the responsibility for the day-to-day operation of a public pool or spa falls to the operator, there are many other players in the process who have a role in ensuring a safe and sanitary facility.

The MLHU training program strives to provide those who are in positions of responsibility with the skill set necessary for them to fulfil their roles and responsibilities in maintaining safe and sanitary recreational water facilities. Service personnel can provide operators with training and support regarding equipment operation to help them remain compliant with public pool and spa regulations. Some of the methods highlighted in Table 1 may prove helpful.

Just as the role of a PHI ranges from inspection and enforcement to training and support, industry members can play a crucial part in training, and supporting facility operators as well. Ultimately, public health units, industry members, and facility owners and operators can act as partners to ensure public pools and spas are operated and maintained appropriately to protect the health and safety of patrons.

Note

The MLHU would like to thank everyone who had a role in the continuous improvement of this training program, including an epidemiologist, two program evaluators, PHIs and student PHIs, a communications/graphics team, co-trainer, project lead, and the manager of the Safe Water, Rabies and Vector Borne Disease (Environmental Health) Program.

Quin_Headshot[6]Sekercioglu_Headshot[7]Anne-Maria Quin, B.Sc., is a public health inspector on the Safe Water and Rabies and Vector Borne Disease Team at the Middlesex-London Health Unit. Quin is the recreational water program training lead and can be reached via e-mail at anne-maria.quin@mlhu.on.ca[8].

Fatih Sekercioglu is an environmental health manager for the Middlesex-London Health Unit. Sekercioglu can be reached via e-mail at fatih.sekercioglu@mlhu.on.ca[9].

Endnotes:
  1. [Image]: http://poolspamarketing.com/wp-content/uploads/2016/11/HS_operator-guide-cropped.jpg
  2. [Image]: http://www.poolspas.ca/wp-content/uploads/2016/11/HS_verifying-records.jpg
  3. [Image]: http://www.poolspas.ca/wp-content/uploads/2016/11/HS_water-testing.jpg
  4. [Image]: http://www.poolspas.ca/wp-content/uploads/2016/11/HS_resource-materials.jpg
  5. [Image]: http://www.poolspas.ca/wp-content/uploads/2016/11/HS_automatic-sensing-device.jpg
  6. [Image]: http://poolspamarketing.com/wp-content/uploads/2016/11/Quin_Headshot.jpg
  7. [Image]: http://poolspamarketing.com/wp-content/uploads/2016/11/Sekercioglu_Headshot.jpg
  8. anne-maria.quin@mlhu.on.ca: mailto:anne-maria.quin@mlhu.on.ca
  9. fatih.sekercioglu@mlhu.on.ca: mailto:fatih.sekercioglu@mlhu.on.ca

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