Good morning, TeamUHN!

It is a pleasure to connect with you across care, research, and education through this weekly CEO update – all in service of A Healthier World.  

Key reminders and updates

  • Yesterday on March 14th, we marked the 1-year anniversary of UHN receiving its first COVID-positive admission. I know the moment was anxiety provoking and seized us all at the time, especially our colleagues at Toronto Western, where this patient received their care. Since then, we have had the privilege of caring for countless patients with COVID-19 – including some of the most critically ill patients in the province. Last week, we also joined the world in marking one year since the World Health Organization declared the COVID-19 outbreak a pandemic. On behalf of UHN’s Board of Trustees and Senior Management Forum, thank you for your inspiring service over the last year – despite seemingly insurmountable odds – and for continuing to deliver hope to people across the province and country.    
  • Clarification on dose intervals for COVID-19 vaccines: At the directive of the Chief Medical Officer of Health for Ontario, all members of TeamUHN who are currently waiting for their second dose will be rescheduled to 16 weeks. There have been several questions about the spacing between first and second doses. While the Government of Ontario said the interval change would be effective March 10, we have been informed that the change is retroactive – meaning that it also applies to people who received their first dose before March 10.  Please watch your mailbox for your rescheduled second-dose appointment and check your junk mail too.

What happened at the Executive COVID-19 IMS Table 

In response to the concerning state of COVID-19, UHN activated its Executive COVID-19 IMS (Incident Management System) table. Membership includes our Executive Leadership Forum and other members of COVID-19 work streams. The group meets on Tuesdays and Thursdays. This is a snapshot of the discussion.

Vaccines: Update on UHN’s Vaccine Registry for people 80-years-old and over – plus clarity on the extended dose interval 

  • Background: After launching our Vaccine Registry last week for people 80-years-old and over, we now have more than 10,000 people signed up. Approximately 17% of those individuals indicated they require further assistance with registration and booking via phone call. As part of our commitment to delivering a client-focused experience, Diana Elder (Vice President, Human Resources) is working with our colleagues in Human Resources to set up staffing in support of these individuals. In addition, we have significantly customized our clinical processes for this older population which includes expanding our space for accessibility, allocating more time for each booking, and supporting the presence of Essential Care Providers. On March 15, the Ministry of Health is expected to launch its own Vaccine Registry for people 80-years-old and over. We will work to connect our Registries. 
  • Who presented? Emily Musing (Vice President, Clinical; Chief Patient Safety Officer), Janet Newton (Vice President, Clinical)  
  • What do I need to know? As per the direction of Ontario’s COVID-19 Vaccine Task Force, dose intervals have been extended from 35 days to four months (16 weeks). This includes people 80-years-old and over if they are not a long-term care or retirement home resident. We sent a message about this disappointing change to TeamUHN on March 5 and discussed this at our Open Forum (Corporate Intranet > COVID-19 Preparedness > Internal Communications > “Ontario is intending to…”). The exceptions to this are very limited and clearly defined by the Task Force: Long-term care residents, retirement home residents, and remote and isolated First Nation communities (further discussion on dose intervals for Indigenous communities is underway). 

GTA and broader region: Monitoring the growth rate for Variants of Concern

  • Background: The number of non-variant COVID-19 cases versus Variant of Concern (VOC) cases are moving along separate trajectories. Last Thursday, Ontario’s COVID-19 science advisory table reported a reproduction value of 0.9 for non-variant cases whereas VOCs are at 1.24. The table also reported that VOCs are representing 42% of new daily cases in the province. While these numbers were not yet published at the time of the UHN’s Executive IMS meeting, the members discussed numbers in this range and emphasized the need for rapid rollout of vaccination.
  • Who presented? Susy Hota (Medical Director, Infection Prevention & Control) and Niall Ferguson (Head, Critical Care) 
  • What do I need to know? Across the province, we are starting to see a Wave 3 with Humber, Richmond Hill and Brampton being especially impacted. Help save lives and accelerate our collective return to normalcy by masking, physically distancing and not gathering unnecessarily with people outside your household and registering for your COVID-19 vaccine (Corporate Intranet > COVID-19 Preparedness > Vaccines).

Clinical capacity at UHN: Creating more flexibility in our COVID-19 response 

  • Background: Last summer, we developed a COVID-19 Care Plan at UHN to help prepare for different scenarios and volumes. Up until now, we have opened and maintained dedicated COVID-19 units in response to the number of cases. We are now reaching a point in the pandemic where more flexibility is required, given the contrast between an increasing number of vaccinated individuals and the concerning trajectory for Variants of Concerns (as discussed above). In response, we are preparing to implement a more flexible phase of the Care Plan – which means that when COVID-19 case numbers drop below a certain threshold at our acute sites, we will look to integrate those patients within our GIM (General Internal Medicine) units. When they exceed that threshold, we will open a dedicated COVID-19 unit.
  • Who presented? Marnie Escaf (Vice President) and Fayez Quereshy (Vice President, Clinical)  
  • What do I need to know? We are working closely with GIM and IPAC (Infection Prevention & Control) to finalize logistics and details for this phase of the Care Plan. For the time being, we will continue to maintain COVID-19 units at each acute site (Toronto General and Toronto Western).

Overview of last week

1. Discussing research competitiveness and measuring impact at the Research Committee of the Board meeting    

  • Background: UHN's Research Committee of the Board is responsible for monitoring and evaluating UHN’s discovery, translational and clinical research enterprise. It makes recommendations for UHN’s Board of Trustees and is chaired by Lawrence Pentland (UHN Trustee).
  • What happened last week? The Committee convened for its quarterly meeting to discuss a number of items, including updates on finance, risk and operations, as well as the development of approaches to address the mid- and long-term consequences of COVID-19 with respect to research competitiveness. UHN has remained resilient in the short-term; however, several risks may arise as a result of decreases in available funding, such as conservatism (i.e. researchers may be hesitant to undertake high-risk, high-reward research) and loss in momentum of research activity. An update on the initiatives of our Strategic Research Plan was also presented, including the development of key performance indicators led by our working group of Heather Cole, Michael Hoffman, Tuula Kalliomaki, Valeria Rac and Azadeh Yadollahi. This group is making recommendations on the final set of indicators that we will use to measure and benchmark our research impact. Part of their selection process includes a series of stakeholder engagement seminars, featuring external experts in the area of evaluating academic hospitals. You can watch them here. Finally, the Committee discussed ongoing work by Mark Taylor and team to develop a new strategic plan for commercialization.
  • What do I need to know? We are being proactive to mitigate the risks associated with the pandemic on UHN Research. This includes working with the Research Institute Directors to develop strategies for redirecting existing funding and supports. It also includes exploring the creation of new support mechanisms.

2. UHN shows its support for Waterfront Toronto as it explores the development of an inclusive mixed-use, multigenerational community where people can age in place 

  • Background: Quayside is one of the last undeveloped expanses in downtown Toronto and presents an incredible opportunity to transform the lives of many people. The City and governing body for the area, Waterfront Toronto, plan to use this land to deliver an inclusive mixed-use, multigenerational community where people can age in place. The community will include new affordable and market rate housing, and commits to delivering the conditions for a diversity of businesses to succeed. 
  • What happened last week? Waterfront Toronto launched an international competition to secure a development partner for this project. We support this initiative at UHN as it directly aligns with our vision of A Healthier World. Our endorsement was reflected in the official release
  • What do I need to know? There is a backlog of more than 5,700 people waiting for long-term care in the Central Toronto region. It is important we support new models of care for aging populations, whether it’s at UHN or through our partners across the health system and beyond. 

Closing notes

  • Last week was the inaugural Canadian Woman Physicians Day! We are privileged to work with and learn from many remarkable women physicians at UHN. With the recent launch of UHNWomen – which aligns with UHN’s Strategic Priority Empower and invest in a diverse TeamUHN – our goal is to create a more supportive environment for these valued colleagues, in addition to women across all professions here. Help shape the future of UHNWomen by filling out this survey and see the Steering Committee members who will guide the way. Everyone is encouraged to provide input.

Feedback?

Your feedback is welcome and valued. Please reply directly to me or leave anonymous feedback here

Have a good week,

Kevin 

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