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

  • I want to begin by reiterating that my thoughts are with those members of TeamUHN who are of Ukrainian heritage, as well as TeamUHN members of Russian descent who are disgusted by the Russian military invasion of Ukraine. As we all hope for a peaceful resolution, I continue to ask that you show kindness and compassion for each other and our patients and staff who because of their connections to those in danger are feeling the sorrow of this war on a deeper level.
  • Tomorrow – March 1 – we will begin distributing Rapid Antigen Test (RAT) kits to all TeamUHN members working on site. Those on-site this week will receive one RAT kit containing five tests. This process is in line with how the provincial government is distributing kits at grocery stores and pharmacies. All managers will be given access to kits by March 4. You can see videos on how to use your test kit here. Reminder: a positive result from any member of your household must be reported to Health Services, which will provide more instructions about PCR testing and return to work.
  • Today, the Government of Canada is lifting its advisory against non-essential international travel as part of a phased loosening of other border measures. Fully vaccinated travellers will no longer need a negative molecular test to enter Canada, and can instead opt for a Rapid Antigen Test administered by a lab or health care provider 24 hours before a flight or arrival at a land border. Learn more about the changes on the government website.
  • The Province of Ontario will lift its requirements for proof of vaccination against COVID-19 tomorrow. But other settings and business can choose to continue to require proof of vaccination. As I mentioned last week, UHN is not changing its policy of mandatory vaccinations for staff and visitors. Protecting the health and safety of our patients and staff, especially those who are immune-compromised or immune-suppressed, remains of paramount importance.
  • Last Thursday, Health Canada approved a sixth COVID-19 vaccine, Medicago's two-dose Covifenz, for adults between the ages of 18 to 64. It's the first COVID vaccine approved by a Canadian company and the first to be made with plant-based technology. According to Health Canada, clinical trials showed the vaccine, administered 21 days apart, was 71 per cent effective against symptomatic infection and 100 per cent effective against severe disease caused by COVID-19.

What happened at the Executive COVID-19 IMS Table

In response to COVID-19, UHN has re-activated its Executive COVID-19 IMS (Incident Management System) table and we are meeting on a daily basis. Membership includes our Executive Leadership Forum and other members of COVID-19 work streams. This is a snapshot of the discussions this past week.

Guidance regarding Essential Care Partners

  • Background: Ontario Health and the Toronto Region are changing their guidance on Essential Care Partners (ECP) having access to hospitals, effective March 1. ECPs are support persons who are considered essential to the safety and well-being of patients while they are in hospital.
  • Who presented? Marnie Escaf (Vice President, Clinical)
  • What do I need to know? With the changes, all patients will be eligible for an ECP upon admission. Currently, an ECP is approved if a patient is staying in the hospital for more than seven days, unless the patient meets certain criteria such as a significant language barrier or intellectual disability. It is recommended hospitals expand from one ECP to two ECPs per day for inpatients, and that all emergency department patients and outpatients be eligible to have one ECP with them, presently something only permitted for vulnerable patients. UHN still expects ECPs to show proof of vaccination against COVID-19. The names will continue to be provided to door screeners for inpatients only. UHN recognizes and values how important ECPs can be for a patient's care journey. All changes are reflected in the ECP Staff Tip Sheet.

What happened at the Senior Management Forum meeting

UHN's Senior Management Forum (SMF) represents a broad range of voices and skill sets from across the organization and provides direction and oversight in service of patients, TeamUHN and our vision of A Healthier World. SMF meets monthly. The last SMF meeting was held on February 24, 2022.

Synapse update

  • Background and why this was brought to SMF: The Synapse project is our clinical transformation of the care experience for patients and providers and it includes transitioning to a new health information system (HIS) from Epic on June 4, 2022. The Synapse Team is continuing with system and user readiness activities across UHN. Project leads provided an update to the Senior Management Forum on the Technical Dress Rehearsal (TDR), training registration, the Epic Playground, and appointment conversion and cutover.
  • Who presented? Chelsea King (Change Management and Benefit Realizations Lead), Ivanka Hanley (Sr. Manager, Training & Education) and Jennifer Hope (Project Director, End User Devices)
  • What do I need to know? TDR, which involves testing every non-medical device used with Epic (for example workstations and barcode scanners), will continue across UHN until June 1. Supply chain issues have caused delays in the delivery of some devices and forced some testing to be re-scheduled. Testing progress and device deployment are being tracked weekly on the End User Device Readiness Dashboard. Managers are contacted by email 2-3 weeks ahead of their scheduled TDR date to confirm the timing won't interfere with patient care.
    • The deadline to register for Epic training is March 18. Super User training begins on March 21. Training is virtual for all users (with the exception of EVS and Transport) and individuals are expected to ensure the computer where they'll be taking training (at home or work) meets the technical requirements. A limited number of workstations are available at each site for those without access to a computer. More information is here.
    • The Epic Playground pilot group has 520 users and expected to grow to 4,000 users by March 21. Users are able to explore and navigate through a copy of the training environment using "scavenger hunt" exercises.
    • The conversion of all future-dated patient appointments takes place May 14-15 ahead of the Scheduling Go-Live on May 16. This week, managers will be asked to identify staff to help with appointment conversion.
    • The manual conversion into Epic of patient information for in-hospital patients takes place 48 hours before go-live on June 4. This week, managers will be asked to identify staff to help with cutover.

Social Medicine Program update

  • Background and why this was brought to SMF: UHN's Gattuso Centre for Social Medicine is focused on how social determinants of health, such as food security and housing, should be integrated into care delivery for marginalized people. The team works alongside community organizations, clinicians, marginalized populations, patients, and all levels of policymaking, to co-design, evaluate, and scale innovative solutions that lead to better health. An update was given to SMF on UHN Social Medicine's recent initiatives during the pandemic, as well as ideas for future collaborations.
  • Who presented? Andrew Boozary (Executive Director, Population Health and Social Medicine)
  • What do I need to know: The Centre for Social Medicine works with patients who have complex medical and social needs but face barriers in accessing care. These patients' challenges have only been exacerbated by the pandemic. Some recent highlights from that important work include:
    • Partnering with The Neighbourhood Group and the UHN Equity team to bring six peer workers from the COVID hotel recovery site for people who are homeless into the Emergency Departments at Toronto General and Toronto Western. (Funded by the Gattuso Foundation) Clinicians have responded positively to these efforts.
    • Enrolling more than 200 families in the FoodRX program, with almost 5,000 Good Food boxes delivered and more than 1,600 phone calls made to reduce social isolation.
    • Implementing one of just five mobile health clinics in Canada, which initially focused on vaccination at shelters but is transitioning to primary care and harm reduction.
    • Bringing in the first community health worker to the UHN Toronto Centre for Liver Disease to address unmet social needs, including mental health, addictions, housing and food insecurity.
    • Partnering with the Indigenous Health Program to hire a harm reduction lead amid the overdose crisis and launching an advisory committee of people with lived experience in harm reduction.
    • Securing a $40-million investment from the Government of Canada and City of Toronto to build supportive housing by mid-2022 in partnership with United Way Greater Toronto. The referral process will be through UHN.
    • Partnering with community groups to ensure vaccine access for neglected neighbourhoods and providing policy analysis, highlighting and addressing existing inequities.
    • Working with teams across UHN to integrate health equity data with Synapse.
    • Securing partnerships with Ontario Health and City of Toronto to scale the Social Medicine Care Model to focus on top 1,000 under-served UHN patients, with complex medical and social needs.

Closing notes

February 28 is International Rare Diseases Day. Nearly 3 million Canadians are afflicted with a rare disease, and more than 7,000 rare diseases have already been identified with new ones emerging every year. Here at UHN, we have world-class clinics and programs that support those with Ehlers-Danlos Syndrome, Malignant Hyperthermia, and Thalassemia, just to name a few of the rare diseases that collectively impact millions worldwide. Both research and clinical care are critical to the well-being of our patients and I am grateful for all those members of TeamUHN who work in these areas.

A series of confidential, virtual focus groups, led by the Nursing Workforce Planning Committee, has been launched to ask nurses what matters to them and what can make working at UHN better. To register for one of these sessions over the coming weeks, visit the Nurse Engagement Site or email engagement@uhn.ca to learn more.

In celebration of International Women's Day on March 8, UHNWomen is hosting a free virtual event on March 7 from 1 to 2 p.m. REGISTER HERE. All members of TeamUHN are invited to join me for an empowering hour of honest conversation, community-building, and collaborative inspiration. Hear from keynote speaker Dr. Chika Stacy Oriuwa, an accomplished physician, spoken word poet, and advocate for racialized and marginalized populations. Dive into one of four breakout sessions: UHNMoms: Juggles and Struggles; Intersectionality: Being You; Burnout & Boundaries; and Allyship & Action.

Feedback?

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Have a good week,
Kevin

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