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

  • You are strongly encouraged get your first dose of the COVID-19 vaccine if you haven't already. Vaccination is an important tool in combatting Wave 3 – alongside masking, physical distancing, avoiding in-person gathering etc. – and will help keep patients and TeamUHN safe.
    • If you haven't been vaccinated, please do so now. Here is the link to UHN's Vaccine Registry (Corporate Intranet > COVID-19 Preparedness Page > Vaccine).  
    • If you have been vaccinated, please remember to notify Health Services after receiving each dose by completing this form.
  • Working with the College of Nurses of Ontario and beyond to address staffing challenges across the health system for Wave 3: At UHN, we are looking at team-based models of care, adjustments to staffing ratios where it is safe, and our previous acuity based staffing work (as reported in the previous weekly update). The College of Nurses of Ontario is aware of our move to team-based models of care and approved the framework. They agree we must do all we can to prevent an overwhelmed health system. We are in the process of communicating with the other colleges for the other professions as well. Read more about the collective action we are taking under "What happened at the Executive COVID-19 IMS Table" below.  
  • Thank you to all teams who continue to step up during these trying times. Every member of TeamUHN plays a vital role in this response, but we extend our sincerest gratitude to the teams who are managing exceptional pressures including our Emergency Department, Critical Care and General Internal Medicine colleagues – as well as IPAC (Infection Prevention & Control), Health Services, Laboratory Medicine and Environmental Services. They have been at the forefront since Wave 1 and are currently facing exceptional pressures with limited capacity and overcrowding.

 

What happened at the Executive COVID-19 IMS Table

In response to 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.

Urgent need to create additional clinical capacity across the health system

  • Background: We are facing unprecedented demands on the health system with Wave 3, which means that UHN, Women's College Hospital, Sinai Health System – along with our partners at SickKids – must increasingly respond as an integrated health service provider. For those who missed it, SickKids recently opened 8 adult ICU beds in support. While we do have the GTA (Greater Toronto Area) IMS Table which directs transfers across the region, we need a highly coordinated approach downtown. As such, the aforementioned hospitals are working together to explore the best use of beds and ambulatory environments, which will maximize flow and expand capacity. These are extremely challenging times so we are considering all options and trying to brainstorm unconventional solutions. Time is of the essence so we are discussing ideas early this week.
  • Who presented? Marnie Escaf (Vice President, Clinical), Fayez Quereshy (Vice President, Clinical), Janet Newton (Vice President, Clinical), Kathryn Tinckam (Physician-in-Chief), Shaf Keshavjee (Surgeon-in-Chief)
  • What do I need to know? The good news is that COVID-19 has introduced unprecedented levels of collaboration and teamwork across the health system. Staffing remains our biggest challenge – which means it's more important than ever that we support one another's physical and mental health. Get vaccinated if you haven't and continue to follow public health measures (e.g. masking, physical distancing), even if you've been fully vaccinated. In terms of your mental health, please use UHN's mental health resources (see "Closing notes" at the bottom of this update for the links) and work with your Manager/Principal Investigator if you require special accommodations. If you are unable to secure the supports you need, please contact Human Resources (Corporate Intranet > Departments > Human Resources > HR Contacts).   
  •  

    Vaccine update: Targeting COVID-19 hot spots in Toronto

    • Background: Last week, Toronto Public Health announced that vaccine bookings are available for people 50-years-old and over from 53 postal codes identified as COVID-19 hot spots, as of April 9. People who are 18-years-old and over will soon be eligible in those zones as well. UHN, alongside many other hospital and community partners, will be taking an inter-OHT (Ontario Health Team) approach to ensure capacity across the health system is fully leveraged. This approach will see primary and community care leaders, supported by Toronto hospitals, working together to support community vaccination days.
    • Who presented? Shiran Isaacksz (Vice President, Connected Care and Altum Health), Emily Musing (Vice President, Clinical; Chief Patient Safety Officer)
    • What do I need to know?  One of the first collaborations to take a broad postal code approach is with the Mid-West and North West OHT hospitals – including UHN, Sinai Health System, Women's College Hospital and Humber River Regional – as well as local primary and community partners (Black Creek and Unison Community Health Centres, LOFT). This collaboration will ensure that those most at risk in the northwest of the city are protected. These efforts have been accelerated for Ontario with the development of a comprehensive, community-led vaccination playbook thanks to Tania Carlyle (Program Lead, Connected Care), Sané Dube (Manager, Community and Policy – Social Medicine), Luwam Ogbaselassie (Implementation Lead – Social Medicine), Melissa Chang (Senior Program Director, Connected Care), and Andrew Boozary (Executive Director, Social Medicine and Population Health). This work was done in partnership with Angela Robertson from Parkdale Queen West Community Health Centre and seven other community health centres, as well as the Ontario Health – Black Health Plan Working Group. This will enhance our collective ability to provide low-barrier care to marginalized individuals, and will be used in parallel to vaccination strategies organized by hospitals and municipalities.

      

    Overview of last week

    Peter Munk Scientific Advisory Board meeting: Using research and innovation to overcome the challenges brought on by COVID-19 for cardiovascular patients

    • Background: The Peter Munk Scientific Advisory Board (SAB) oversees research activity at UHN's Peter Munk Cardiac Centre and is chaired by Victor Dzau (President of the U.S. National Academy of Medicine). Barry Rubin (Medical Director, Peter Munk Cardiac Centre) and many contributing scientists provided updates to the external members of the SAB. Brad Wouters (Executive Vice President, Science & Research) and I take part in these meetings – in this case a two-day virtual meeting. Highlights of the discussion included the integration of physical and mental health, use of remote patient monitoring to promote care outside the hospital, artificial intelligence and data to help drive research and improve care, and strengthening our relationships with the Nishnawbe Aski Nation and Weeneebayko Area Health Authority (led by Heather Ross (Division Head, Cardiology) and Lisa Richardson (Internist; Co-Chair, Indigenous Health Program)).
    • What happened last week? While many projects were discussed, one of the underlying themes was how we are using research and innovation to overcome the challenges that have been brought on (or further exacerbated) by COVID-19. For example, we know that mental and physical health are inextricably linked, which is especially concerning as the pandemic continues to exact a serious mental health toll on patients and providers. Our colleagues at Peter Munk Cardiac Centre have been focused on integrating physical and mental health for quite some time, and now plan on screening all patients for anxiety and depression if they are scheduled to undergo a cardiovascular procedure. This confidential information will be integrated into Peter Munk's Digital Health Platform – and into Synapse when it goes live – so we can identify patients for appropriate mental health treatment, and explore the relationship between mental health disorders and cardiovascular disease.
    • What do I need to know? Thanks to our colleagues at the Peter Munk Cardiac Centre for advancing A Healthier World. In addition to leveraging the strength of UHN Research, our colleagues are collaborating with industry partners including Apple and Phillips, as well as the Vector Institute and Kings College London, to amplify our efforts.  

     

    Closing notes

    • Please use the mental health supports we have available at UHN. In addition to the demands of our pandemic response, many colleagues are managing a variety of additional pressures. Use the UHN Cares program (Corporate Intranet > COVID-19 Preparedness > Mental Health Supports). It provides great mental health resources. Share widely and check in with one another often. We will get through this together.
    • Reminder: Consider pausing non-essential meetings so we can increase our focus on our COVID-19 response. Information sharing and communication remain vital to our pandemic response – so ensure that everyone knows how to escalate issues as needed and leverage the existing meetings that will remain in place.

     

    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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