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

  • On the subject of second doses of vaccine for healthcare workers, we continue to advocate daily with decision makers and I think we may be making some progress. Stay tuned! See more in the message sent to TeamUHN on May 5 (Corporate Intranet > COVID-19 Preparedness > Internal Communications > "Decisions around…").
  • Thanks again to the UHN Foundation and The Princess Margaret Cancer Foundation for providing TeamUHN with greatly appreciated wellness supports. Many of you expressed your deep appreciation for the $100 transportation credit issued last week on May 6, the Rest Safe program [Editor's Note: Link is no longer available] (which offers hotel supports to those residing with high-risk family members), and also the food vouchers which are now back. We're very fortunate to have the support of extraordinary donors at UHN.
  • Show your colleagues some gratitude and recognition on the #ThanksUHN page on Slido.com. We all benefit when we are good to one another. Shout out a colleague or team here or go to Slido.com and enter #ThanksUHN. A selection of comments will be read at our Open Forums. Please include your full name to have your comment posted.

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.

Staffing: Pandemic models of care and supporting TeamUHN through the changes

  • Background: In response to staffing shortages across the health system, we have moved to a predominantly team-based model of care (i.e. Yellow Phase Pandemic Model of Care in UHN's Pandemic Playbook – see page 6). This was communicated to managers and staff on May 4 and 5, then summarized in the COVID-19 Update sent on Friday, May 7. Due to the significance of this topic, it was also discussed at UHN's Executive COVID-19 IMS Table. Many thanks to all who are working in new models of care in order to meet the needs of patients and families.
  • Who presented? Joy Richards (Vice President, Patient Experience; Chief Health Professions)
  • What do I need to know? The College of Nurses, Allied Health regulatory colleges, and all of us at UHN want to assure you that Pandemic Models of Care are only meant for temporary emergency use. We know these models differ from our preferred and usual standards and will carefully monitor outcomes and the impact of these measures. We will revert back to the staffing ratios and care standards that we all support as soon as possible. In terms of supporting a successful team-based approach, the literature – as well as colleagues familiar with implementing these models – tells us that trust and mutual respect are essential, which is echoed in UHN's Pandemic Playbook. Thank you to everyone who has been doubling down on these values.

What happened at the Executive Leadership Forum meeting

UHN's Executive Leadership Forum (ELF) 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. See the full membership on UHN.ca. The last ELF meeting was held on May 6, 2021.

Finance: 2020/21 preliminary operating results and planning ahead

  • Background and why this was brought to ELF: Thanks to your efforts and support from the Provincial and Federal government, we met our financial targets at UHN and balanced our operating and research budget for 2020/21. Great news. Ontario's hospitals received a significant amount of COVID-related funding over the past year which was essential for keeping everyone afloat. The Ministry of Health is working to provide COVID-19 funding to hospitals as needed, and we are discussing the pressures we face – including the fact that our historical funding hasn't kept up with inflation over the past few years. Our colleagues in Finance updated the members of ELF on our preliminary 2020/21 operating results, as well as our operating and capital plans for 2021/22, in advance of their presentation to UHN's Finance & Audit Committee at the May 12 meeting.
  • Who presented? Darlene Dasent (Chief Financial Officer), Kelly Enair (Deputy Chief Financial Officer)
  • What do I need to know? Before the pandemic, leaders across UHN developed plans to address our financial deficits with support from our colleagues in Finance. With organizational capacity top of mind, we will start reassessing these plans in phases so we can support UHN in the following ways: Repair our aging physical infrastructure, bring Synapse to life, and create a workplace where people can grow and develop as world-class professionals. Our 2022/23 financial planning will begin this Fall.

Research: UHN's 2021-26 commercialization strategic plan – "Commercialization lives here"

  • Background and why this was brought to ELF: One of UHN's Strategic Priorities is "Elevate Canada as a world destination for commercialization and discovery." Through commercialization, we can diversify our economy, help create high-quality jobs, and become an international hub for producing world firsts with tangible societal benefits. Our colleagues at UHN's Technology Development & Commercialization (TDC) office are preparing to launch our 2021-26 commercialization strategic plan – titled "Commercialization lives here" – in support of this priority. TDC was created in 2000 to help protect Intellectual Property (IP) at UHN, and has since evolved into a full-fledged office that enables us to launch start-ups, partner with industry for sponsored research, develop IP and manage funds. Our colleagues in Research and the Technology Development & Commercialization office will be presenting on UHN's commercialization work at the May 19 Board meeting. They brought their presentation to ELF in advance for feedback and input.
  • Who presented? Brad Wouters (Executive Vice President, Science & Research) Mark Taylor (Director, Technology Development & Commercialization)
  • What do I need to know? UHN is now leading the country in commercialization revenue (among universities and hospitals) because of this evolution and has generated $68M in commercialization revenue over the past three years. This revenue creates value for patients and is made possible thanks to sponsorship from government, our Foundations, and private sector.

Overview of last week

Medical Advisory Committee meeting: Discussing the impact of deferred scheduled care and surgical ramp down

  • Background: UHN's Medical Advisory Committee (MAC) is chaired by Patricia Murphy (Chair, MAC) and includes representation from all departments, divisions and programs. On behalf of UHN's Board of Trustees, its role is to oversee quality of care at UHN and address issues that impact patients, as well as physicians within the broader context of TeamUHN.
  • What happened last week? On May 6, the MAC convened to discuss a number of topics related to our COVID-19 response, including the impacts of deferred care. This important topic is the focus of the next Enterprise Risk Management report we are sending to UHN's Board of Trustees.
  • What do I need to know? In addition to following UHN's Recovery Plan and Ramp Down Plan (which enables us to adjust clinical activity levels rapidly), we have many other risk mitigation strategies that are designed to offset the negative impacts of deferred patient care. These include:
    • Use of an Accountability for Reasonableness ethical framework to help clinical programs optimally use available resources.
    • Partnering with other hospitals including Women's College Hospitals to complete out-patient surgical cases.
    • Continued emphasis on the use of virtual care.
    • Redeploying health care staff to areas where they can best support patient care, such as in the ICU.
    • Review planned surgical care and procedures on a weekly basis and ensuring care for patients with life, limb or vision threatening diseases, in line with the most recent directive from Ontario Health.

    Thanks to all colleagues involved in this work, including the Clinical Activity Recovery Team co-chaired by Barry Rubin (Medical Director, Peter Munk Cardiac Centre) – who presented on this at the MAC meeting – and Terri Stuart-McEwan (Executive Director, Sprott Department of Surgery). Fayez Quereshy (Vice President, Clinical) is the Executive sponsor.

Closing notes

  • Happy Mother's Day and Mothering Sunday, which we celebrated yesterday. We also acknowledge maternal bonds and the aunts who care selflessly for many, kin or not. Thanks for your amazing work, especially those with school-aged children who are managing unique pressures during the pandemic. UHNWomen, a new program designed to create equal opportunity for all, is working to introduce supports for mothers at our organization. This includes the creation of lactation rooms (with the help of UHN's Accessibility Committee, FM-PRO, Diversity and Mediation Services and beyond) and a mentorship program for mothers coming back to work. While both offerings are still in their early stages, these ideas came from a number of passionate colleagues across UHN who have proactively offered solutions. If you have solutions you'd like to suggest, including ones for nonparents since motherhood is one facet of many, please message UHNWomen Executive co-sponsors Catherine Wang and Brian Hodges who will share them with the highly engaged UHNWomen Steering Committee.
  • Last week was Palliative Care Week: Thanks to our colleagues in Palliative Care who play an essential role in supporting patients and families when facing a life-limiting illness. They work to prevent and ease suffering, offer psychosocial and spiritual support, as well as advance care planning and end-of-life care. UHN's Palliative Care program is led by Camilla Zimmermann and includes physicians, nurses, social workers, spiritual care professionals, physical and occupational therapists, and other interdisciplinary team members. Together, they support patients across Princess Margaret, Toronto General, Toronto Western, Toronto Rehab – as well as Kensington Hospice.
  • May 10 is World Lupus Day: Thanks to our colleagues at UHN's Lupus Clinic at Toronto Western for the remarkable work they do across care, research and education. The clinic is co-led by Murray Urowitz and Dafna Gladman and home to the first and largest lupus database in North America. As part of the Schroeder Arthritis Institute, it has also expanded into one of the world's largest centres for specialized lupus care and research with more than 2,100 patients and has become a leader in lupus medical education, training more than 140 fellows from Canada around the world. 50 years ago, the 5-year survival rate for lupus was 50%. Today, the 20-year survival rate is approaching 90%.

Feedback?

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Have a good week,

Kevin

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