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

  • Tomorrow on Tuesday, June 1 (12:00 p.m. to 1:00 p.m.) – Virtual Open Forum on COVID-19.
    • Read answers to FAQs here – updated regularly (Corporate Intranet > COVID-19 Preparedness > Virtual Open Forum (top right box) > Open Forum FAQ).
    • Submit questions here including your full name or enter #UHNCOVID-19x47 on Slido.com. Including your full name will help support transparency and collegiality at UHN.
    • Livestream link here (Chrome/Firefox).
  • Second Doses for TeamUHN – Colleagues in Groups A and B who work on the COVID-19 units, in the Emergency Departments, on the General Internal Medicine floors, ICUs, or clinicians who perform aerosolizing procedures have all been offered second doses and, as vaccine supplies allow, we will offer to remaining on-site staff at UHN, Mount Sinai, Toronto Grace, SickKids, and Women's College. Please report your vaccination status [Editor's Note: Link is no longer available] to Health Services (formerly Occupational Health). The UHN Registration site remains open for first doses, which will largely be new employees or individuals who have not yet registered.
  • Safety on UHN sites – Last week we had two separate safety incidents across the organization. One incident was a tragic accident at the Murray Street entrance of Princess Margaret, which resulted in an individual being pinned between two cars. They later very sadly died as a result of their injuries, which is an incredible tragedy. Our thoughts are with the family at this terrible time. The second incident involved two staff members who were approached by a man who exposed himself to them. The individual responsible was arrested last week by Toronto Police Services, which was enabled by video footage from the cameras in the underground parking lot. We're all very upset by this occurring to members of TeamUHN and we will work to support the individuals affected. These are reminders that we must think about our safety and the safety of others at all times. UHN Security has reminded me that we have the Walk Safe and Call Safe Programs – the first was introduced to provide staff with added security while walking between their vehicle and work, at any time of the day. The Call Safe program provides a safety call service on a scheduled basis for staff upon request. For more information please visit here.

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 discussions.

Critical care, Extra Corporeal Lung Support (ECLS) and Returning Redeployed Staff

  • Background: Three items are on the agenda at the Executive COVID-19 IMS table: The pressures on Critical Care, including the high level of patients on Extra Corporeal Lung Support (ECLS); the stress and burnout experienced by staff; and the pressure to return to scheduled care for procedures and surgeries. There is recognition by all at the table that these three areas represent a difficult balance and that achieving 'normal' levels of scheduled care comes with a price on the staff who have gone above and beyond throughout the pandemic, particularly in the ICUs, the COVID GIM units and in the Emergency Departments. There is also recognition that the reduction in scheduled care has impacted patients waiting for care and the people who provide it.
  • Who presented? Marnie Escaf (Vice President, Clinical), Joy Richards (Vice President, Patient Experience; Chief Health Professions), Fayez Quereshy (Vice President, Clinical), Niall Ferguson (Head, Critical Care)
  • What do I need to know? There will be several forums for the staff in the ICUs to discuss their experiences during the past two months and make suggestions on how best to balance the needs of staff and the needs of patients. With ECLS in particular, there is recognition that this will require supporting more centres to provide this level of care, with additional RNs and perfusionists trained in this area, and the guidance from UHN to make this happen. Part of our ability to start offering scheduled care again rests on returning redeployed staff from the areas of need identified in Wave 3 (ICUs, COVID units, Dialysis and the Emergency Departments) to their regular work. The planning to return staff to their home units is underway, but repatriation will take time – we opened additional ICU beds to manage COVID cases during Wave 3, and the patients in those beds remain with us for a longer period of time before discharge.

Regional planning: Post-COVID and long-COVID care

  • Background: Given the evidence that the after-effects of a COVID-19 infection may continue for a long time in some cases, planning work for the care of these individuals continues. There is also recognition that new infections of COVID-19 will continue and that there will be ongoing requirement for hospitalization for some individuals despite the current vaccination campaigns. Care planning for this patient group is happening at UHN and within the Toronto Region.
  • Who presented? Marnie Escaf (Vice President, Clinical), Brian Hodges (Executive Vice President, Education; Chief Medical Officer) and myself.
  • What do I need to know? Post-COVID and long-COVID care will require acute, specialized rehab and post-acute programs. As the executive co-leads of Ontario's Critical Command Table, Barb Collins (President & CEO, Humber River Hospital) and I were asked by Ontario Health to start thinking about a process to craft a regional response for post-pandemic COVID care and long COVID services.

Report from the Vaccine Team

  • Background: The efforts of the Vaccine Team – within the hospital collaborative and Team Vaccine across the GTA – has been stellar with thanks to the work of Emily Musing, Michael Caesar, Shiran Isaacksz, Camille Lemieux, Leanna Graham, Jin Huh, Melissa Chang, and Lori Seeton – to name just the leaders of the effort. Over 225,000 vaccine doses have been delivered within UHN clinics and by volunteer teams throughout the City of Toronto.
  • Who presented? Emily Musing (Vice President, Clinical).
  • What do I need to know? The efforts of the team continue, and I am very grateful to all the members of TeamUHN who have volunteered to support the clinics that have been happening throughout the City of Toronto. UHN plans to continue providing vaccinations to everyone who has registered with us. Once this is achieved, we will continue to offer vaccinations to new staff, and patients who are eligible, and will consider how long clinics may be required. However, it is our intention to move away from offering large vaccination clinics, while continuing to encourage individual members of TeamUHN to contribute to the City's efforts through Team Vaccine. The Board of Trustees and Executive Team are immensely proud of the work done in this area to move the City of Toronto to such a high rate of vaccination and to ensure that those most at risk – such as residents of long-term care (LTC) and those in Hotspots – continue to be offered the opportunity consistently.

Overview of last week

Senior Management Forum Meeting

  • Background: Senior Management Forum is made up of ELF, Program Medical Directors, the Directors of the Research Institutes and Executive Directors. The meetings have been on hiatus as we worked through the pandemic but, last week, we met virtually and began to talk about our plans for the future.
  • What happened last week? The meeting had a number of presentations including:
    • Remote Work Policy
    • Discussion of the stresses and burnout of staff
    • Summary of redeployment during this time
    • Overview of Master Planning and the projects ahead
    • Summary of the efforts to enable UHN in its vision to be the 'greenest' hospital it can be
    • Summary of how we will return to normal operations as soon as our response to the pandemic allows
    • Look at our financial health last year and what's ahead
  • What do I need to know? In the weeks ahead, there will be a number of presentations on UHN's Remote Work Policy, information about redeployment over the period of the pandemic and what is ahead in the area of redeployment.

Closing notes

Congratulations to Patricia (Pat) McNama on her retirement after 41 years at UHN! Dr. McNama joined the staff at Toronto General in 1980 after completing medical school and an anesthesia speciality at the University of Toronto. During her career, she has held numerous leadership roles and is the recipient of two teaching awards: the Award for Excellence in Undergraduate teaching (2010) and the John Bradley Award for Excellence in Teaching (2018). She is a highly respected clinician whose exemplary patient-focused care has inspired medical students, anesthesia trainees, fellows and colleagues for generations. Thank you Dr. McNama for your dedication to excellence in anesthesia care for UHN patients!

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.

Saturday, June 5 is World Environment Day: Thanks to our Facilities Management – Planning, Redevelopment & Operations (FM-PRO) colleagues on the Energy & Environment Team for delivering planet-centred care, research and education across our sites every day. Climate change is a major threat to health and we're grateful for their efforts in addressing pressing environmental issues, as well as fostering a strong culture of sustainability at UHN. In 2020 alone, they cut greenhouse gas emissions by 3,619-tonnes and reduced water use by 19 per cent. They've also grown the Green Team to 731 members strong. Learn more at their annual report here and connect with the team at green@uhn.ca.

Feedback?

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Have a good week,

Kevin

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