Dear Colleagues, we have reasons to be optimistic this week.

Wave 3 continues to challenge us – but Canadian healthcare workers are stepping up and fighting back. On Wednesday, six RNs and three physicians will be arriving from Newfoundland and Labrador to help in our ICUs (Intensive Care Units) and COVID-19 units for at least three weeks. This is extraordinarily generous of these professionals and was arranged through Ontario's Ministry of Health and Ontario Health, as well as the Premiers of both provinces.

In addition, we have received six perfusionists from other centres, as well as nursing colleagues from Women's College Hospital who were deployed to our Toronto General GIM (General Internal Medicine) Unit. We also thank and recognize the 15 Allied Health colleagues from Toronto Rehab who have been redeployed to our acute sites this week.

In the face of daunting numbers, this is inspiring news and I hope you will join me in celebrating it. This show of dedication and selflessness is what ties everyone in healthcare together, whether you are patient-facing or not. So, as we start the week ahead, I hope you share my strong sense of optimism, knowing that we as Canadians will always stand up to help our fellow citizens. Our deepest thanks to all the colleagues at UHN who are supporting these deployments.

Key reminders and updates

  • Thanks to UHN's generous donors, members of TeamUHN now have access to additional wellness supports:
    • Thanks to the UHN Foundation, the Hotel Respite Program and food vouchers are available once again. More details here (see item 5) (Corporate Intranet > COVID-19 > Internal Communications > "UHN COVID-19 Latest updates 23 April…")
    • Thanks to The Princess Margaret Cancer Foundation, a one-time $100 Transportation Credit will be made available for each member of TeamUHN – you will receive the credit through payroll on May 6 (special run date). We are offering the credit as it is more inclusive than free parking, which only supports colleagues who drive and park. More details here (see item 5) (Corporate Intranet > COVID-19 > Internal Communications > "UHN COVID-19 Latest updates 23 April…")
  • 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. 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.

GTA (Greater Toronto Area) IMS Table: Transferring 200+ patients across the region

  • Background: Last week, under directive from the Province, the GTA IMS Table transferred approximately 200 patients across the province to alleviate pressures at hard-hit hospitals including William Osler Health System. While the volumes remain challenging, these highly effective moves speak to the strength and value of the GTA IMS Table coupled with Provinical support. Further capacity has been made available with pediatric admissions largely being directed to SickKids from GTA hospitals in order to make room for adult patients. SickKids is also contributing adult critical care capacity by converting eight beds for adults under 40-years-old.
  • Who presented? Marnie Escaf (Vice President, Clinical)
  • What do I need to know? We are likely to see a similar number of transfers across the region this week. Through the GTA IMS Table, downtown hospitals including UHN are playing a critical role in alleviating pressures within the system.

Staffing and redeployment across the health system

  • Background: These are radical times so the health system is working to maximize the resources we have, including health care workers as mentioned in the opening of this update. This involves looking at team-based models of care, adjustments to staffing ratios where it is safe, and our pre-pandemic acuity-based staffing work. Last week, the College of Nurses of Ontario sent a statement to all members acknowledging the uncertainty and stress of these times and asked members to comply with workplace policies and procedures – including evolving standards of care – given the dynamic nature of the pandemic. 
  • Who presented? Joy Richards (Vice President, Patient Experience; Chief Health Professions), Diana Elder (Vice President, Human Resources), Rebecca Repa (Executive Vice President, Clinical Support and Performance), Janet Newton (Vice President, Clinical)
  • What do I need to know? We are meeting with Sunnybrook, Trillium Health Partners and Sinai Health System to compare models of care and see if there are learnings we can share. Michael Caesar (Executive Director, Data & Implementation Science) was also asked by the Province to help build an HR Registry where available healthcare workers across Ontario can sign up and offer to help hard-hit hospitals. They are hoping to launch the portal early this week.

Reduced surgical services and preparing for possible critical care expansion at UHN

  • Background: UHN is a provincial resource for many specialized services including transplant, cancer, cardiac and neuro. Last week, we received a modified Directive #2 from Ontario Health, which means we will provide care in cases of potential loss of life, limb, or vision if not treated within 14 days. We are morally distressed and challenged at the thought of further delaying procedures for patients in need – and working hard across the system to preserve as much care as possible. I want you to know we are extremely focused on this work and committed to addressing the most urgent cases. Unfortunately, we are expecting to see a sustained demand for ICU capacity across the GTA and Ontario based on current projections. In response, a multidisciplinary team at UHN is working on a possible critical care expansion so we are able to support as many patients as possible. The scale of the expansion may evolve depending on organizational, regional and provincial needs, and will be driven by directives from the GTA IMS Table (which reports up to Ontario Health).
  • Who presented? Fayez Quereshy (Vice President, Clinical)
  • What do I need to know? During Wave 1 of the pandemic, Ontario's ICU triage protocol was created in case we are in the position of having a greater number of critical care patients than available beds across the health system. You will have read in the news that there are discussions about whether this protocol will need to be enacted – and I know this causes all of us serious concern. We are preparing for a possible critical care expansion and working aggressively across the health system to transfer patients so we do not end up in that situation. Please know your distress is understandable and that we share it.

Overview of last week

Met with UHN's Senior Management Forum to discuss Synapse and Critical Care

  • Background: The Senior Management Forum (SMF) is an advisory committee to ELF and includes UHN's Program Medical Directors, Research Directors, Education Senior Leadership, Chair of the Medical Advisory Committee – as well as the members of ELF themselves.
  • What happened last week? SMF meetings were temporarily paused at the onset of the pandemic to clear schedules but we met to discuss two urgent priorities: Synapse and the possible critical care expansion (discussed above). In terms of Synapse, we continue to do our very best to realize a Spring 2022 go-live but recognize that we may have to alter some of our processes in order to keep this schedule. We are activating a variety of risk mitigation and contingency measures to keep the work on track, including streamlining decision-making processes and holding time-boxed discussions. Synapse project team members are not being redeployed at this time but the team is preparing for that possibility.
  • What do I need to know? As discussed in the "COVID-19 IMS Table" section above, the Province is accumulating a significant backlog of care which will be felt by Ontarians well past the pandemic. Synapse – our Clinical Transformation powered by a new Health Information System – will allow us to minimize negative impacts. It's also an investment that brings us hope for the future as we transform care, research, education and work life at UHN.

UHN Board of Trustees Retreat: A Healthier World

  • Background: Every year, UHN's Board of Trustees meets for an all-day annual retreat which supports strategic planning, team building, and education – all so that our Trustees can further support the goals of this organization. This year, we held a condensed virtual retreat that included presentations on UHN's Strategic Priorities: Tomorrow's Care; TeamUHN; Convergence of Care, Research and Education; Technology and Innovation; and Commercialization and Discovery.
  • What happened last week? Thank you to our presenters Shiran Isaacksz (Integrated Care), Sheila O'Brien (Talent Development, Retention and Culture), Brian Hodges (The Michener Institute of Education), Catherine Wang (Virtual Care) and Brad Wouters (Research Commercialization), as well as Megha Bhavsar (Corporate Planner) for organizing a meaningful and fulfilling retreat.
  • What do I need to know? UHN's Board sends its deepest and most sincere appreciation to all of you, the members of TeamUHN. They commented on the incredible work you are all doing in service of patients and providers and thank you for continuing to go above and beyond during this pandemic. They support our future directions and how they will help UHN navigate a post-pandemic world.

Closing notes

  • Please use the mental health supports we have available at UHN. We need to remain regimented about caring for our mental health. Use the UHN Cares program (Corporate Intranet > COVID-19 Preparedness > Mental Health Supports). It provides a range of confidential mental health supports, self-management strategies and individual/group therapy.

Feedback?

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

Have a good week,

Kevin

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