Dear Colleagues,

As you will see in the news today, Dr. Eric Hoskins, Minister of Health and Long Term Care, will be releasing updated Provincial guidelines tomorrow on the requirements that hospitals will need to have in place for the safety of our staff.  We are ensuring we meet those guidelines and if fact feel that our plans already exceed them given we have been preparing for some time now.  As you know, Toronto Western is the hospital which would receive a repatriated Canadian healthcare worker with Ebola, and we need to be prepared to see any patient who could arrive in our ED's.  This means that:

  • We have a large number of PPE kits (over 750) on site stored centrally in Stores as well as in the high risk areas where a suspect or confirmed Ebola patient will be cared for (ED, ICU as well as security). More kits are in our distribution center and are being prepared.

  • We have completed and continue to train staff in those high risk areas (ED, ICU, Housekeeping/Transportation, Security, Labs, Medical Imaging and Anesthesiology for the donning and doffing of the PPE. Sessions for PPE training are scheduled and will be ongoing. Practice drills are being planned and conducted so staff are well prepared and feel very confident in the process of putting on and taking off their PPE. No staff will care for any suspect or confirmed case of Ebola until they are trained thoroughly. A buddy system is in place for donning and doffing PPE using a prescribed checklist so staff have the time and support to eliminate any error in this process. This buddy is mandatory for the PPE process.

  • Our PPE includes N-95 masks with faceshields and goggles under the shield; 2 pairs of gloves (a third pair is optional), 2 head covers (one bonnet and a surgical hood to cover the neck front and back), booties, full body protection (level 4 surgical gown, disposable plastic apron and boot covers to under the knee). All PPE is disposable. The training is about putting on and removing all of this equipment without cross-contamination (inverting all materials so that nothing external touches the staff member's body).  We will provide staff with as much training and practice as they need to feel confident in this process.

  • We are also planning for screening in the high risk outpatient clinics, starting with the tropical diseases unit, immunodeficiency clinic, tuberculosis clinic, family health team and hemodialysis units.

  • ​We are taking recommendations from the CDC, Health Canada, PHAC, WHO, PHO, peer hospitals, our own Infection Prevention and Control as well Joint Health and Safety and working with frontline staff to ensure all our processes and equipment are in place so that everyone feels safe and secure in their practice.

  • ​​Given that the Province of Ontario and the Minister are working with all health care organizations to ensure the safety of health care workers as we think through the response to a potential Ebola case, there will clearly be discussions around the designation of hospitals to receive Ebola cases.  Given our preparations and our facilities, it is clear that UHN may be asked to take part in this way and, as always, we will work with everyone to ensure that we response in a safe, professional and caring manner.

 

Our commitment to the safety of our staff is paramount.  If you have questions or ideas please email………

 

Kathy Sabo                         Dr. Susy Hota                     Dr. Jeff Singh​

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