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

  • Toronto and Peel were moved into lockdown by the Government of Ontario – effective today on Nov. 23. News release available here. This difficult decision reflects the very concerning situation we are in with COVID-19. It’s more important than ever that we practice all parts of our COVID prevention strategy (e.g. masking, physical distancing, hand hygiene, avoiding in-person gathering) – it is also important we practice compassion. Please take advantage of UHN’s mental health resources (Corporate Intranet > COVID-19 Preparedness > Mental Health Supports). Thank you for your help.   
  • Cloth masks are no longer permitted at UHN – effective today on Nov 23. Read about why this change is being made in this previous communication (Corporate Intranet > COVID-19 Preparedness > Internal Communications > “Revision to previous communication…”).
  • Access for Essential Care Partners is moving to Phase 1 with modifications at UHN – effective today on Nov 23. This difficult change is being made in alignment with Toronto region hospitals. Learn more under the “COVID-19 update” in the Executive Leadership Forum meeting recap below.
  • week to nominate colleagues for UHN’s 2020 Local Impact Awards – Toronto General is leading with the most number of nominations for its site (43%)! Help a colleague get some well-deserved recognition. Learn about the categories this year and submit your nomination by Nov. 30. (SurveyMonkey form here // Learn more via “Corporate Intranet > Right side bar navigation > Nominate your colleagues…”)

Overview of last week

1. COVID-19 Incident Management System (IMS) table created for Greater Toronto Area (GTA) Hospitals   

  • Background: Toronto is reporting an average of 500 new COVID-19 cases per day and Ontario is reporting 1,500. Scarborough and Peel are seeing especially high case numbers. The GTA hospitals want to ensure we have an effective mechanism for responding with the system as a whole and offer safe, effective and coordinated care. 
  • What happened last week? The Toronto Region has now created a GTA Hospitals IMS table that reports up through Ontario Health. The purpose is to create a single hospital network during this time. Many UHN colleagues now sit at this table including Susy Hota (Medical Director, Infection Prevention & Control (IPAC)) for IPAC, Marnie Escaf (Vice President, Clinical) as dyad lead for downtown hospitals with Tom Parker from Unity Health, Rebecca Repa (Executive Vice President, Clinical Support and Performance) for logistics, and Lucas Chartier (Medical Director, Quality and Safety) for Emergency Departments.   
  • What do I need to know? The GTA Hospitals IMS table is a welcome response to a very concerning situation. If a hospital needs help managing its volumes – whether its related to COVID-19, non-COVID or specialized services – the GTA Hospitals IMS table is now available to assist with transfers between hospitals. Equitable distribution is vital for ensuring that patients and providers have the safest experience possible and that no hospital is needlessly burdened. 

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 Nov. 19, 2020.

COVID-19 Update

  • Background and why this was brought to ELF: Due to the increasing rate of community transmission, access for Essential Care Partners is going back to Phase 1 at UHN with modifications. This change is necessary for infection prevention but concerning as family caregivers are essential for patient well-being. The members of ELF discussed the implications of this policy and the viability of testing acute/non-acute caregivers with the same frequency as long-term care caregivers.
  • Who presented? Susy Hota (Medical Director, IPAC)
  • What do I need to know? While there is capacity for additional testing across Ontario, this will likely reach its limits soon. The province is planning to increase the frequency of testing for long-term care staff (every five days instead of every two weeks) and Toronto Public Health is resuming contact tracing, which means more people will be coming forward for testing. The Toronto Region COVID-19 Operations Table is discussing how to maximize the use of our remaining testing capacity.

Working to evolve UHN’s model for committee structures

  • Background and why this was brought to ELF: In June 2020, we announced a refined organizational structure – one that is centered on the journey of patients, clients and consumers of our services at UHN. To help ensure a successful implementation of this structure, we created working groups focused on four work streams including committee structures.
  • Who presented? Rebecca Repa (Executive Vice President, Clinical Support and Programs)
  • What do I need to know? It is in our collective interest to move away from individual site-based approaches and think more about our resources as a whole across UHN. We’re stronger when we work together. The members of ELF were presented with a high-level model for committee structures which was created in response to this and your feedback. We’ve heard there is a desire to minimize redundancy and duplicated efforts across committees, and a need for more clarity around decision-making. The members of ELF agreed with the proposed model in principle, which includes organizing existing committees into three streams: Quality, Operations and Strategy. Each stream would be managed by an Executive Council. The Council will help set agendas and priorities for the respective committees. A refined model based on ELF feedback will be brought forward for approval.

Altum Health, Connected Care and International Program update

  • Background and why this was brought to ELF: In June 2020, Altum Health, Connected Care and International Business were brought together under one portfolio led by Shiran Isaacksz (Vice President, Business Development & Altum Health). The focus of this new portfolio is to support the design and delivery of new models of care – and generate much-needed revenue for UHN to support patient care. A high-level overview of the business development portion of this new portfolio was provided, which will focus on identifying opportunities locally, nationally and internationally.  
  • Who presented? Shiran Isaacksz, Justin Young (Director, Business Development)
  • What do I need to know? This team serves as a UHN-wide resource to both cultivate new revenue opportunities and provide business support to the organization, as required. Given our need to maximize resources and protect bandwidth across UHN, we will be evaluating opportunities with increased scrutiny to ensure the required capacity is in place and ensure alignment with UHN and Canadian values.

Digital Multi-Year Road Map Update

  • Background and why this was brought to ELF: UHN Digital is developing a multi-year road map and working with colleagues across UHN to identify high-priority projects. As mentioned above, we have an organizational need to maximize resources and must be strategic about what we take on. 
  • Who presented? Sarah Muttitt (Chief Information Officer), David Wiljer (Executive Director, Education, Technology & Innovation), Tanzina Chowdhury (Clinical & Corporate Lead, Technology & Innovation).
  • What do I need to know? Some of our top Digital priorities in the coming years include Synapse and our Clinical Transformation journey, UHN’s Virtual Care strategy, optimizing our financial reporting systems, cyber security and beyond. While our Digital capacity is very limited since the majority of it has been allocated to Synapse, UHN Digital has a Digital Demand Management (DDM) process so that we have a mechanism for hearing and escalating urgent and emergent needs. To learn more, visit the DDM Hub.

Virtual Care (Accessing Care Everywhere) update

  • Background and why this was brought to ELF: While the speed of our virtual care ramp up at UHN was amazing (250 visits to 7,000 visits during the peak of Wave 1), our colleagues leading virtual care at UHN have identified the need for a better and more sustainable approach. Current virtual solutions at UHN do not support the clinical experience from end-to-end, which means that providers are taking on a tremendous amount of inefficient, manual work just to make the virtual appointments possible. We need a better way.  
  • Who presented? Catherine Wang (Vice President, Clinical)
  • What do I need to know? UHN is launching a long-term virtual care strategy under the name “Accessing Care Everywhere.” This is alignment with our strategic work to deliver tomorrow’s care. First, we’ll need to lay the groundwork and create our clinical guiding principles to determine the patient groups that are appropriate for virtual care. Different populations will also have varying degrees of comfort with (and access to) different forms of technology. In addition, we need to evaluate our progress which comes with corresponding data and implementation science needs. Finally, we need the right technology – one that supports the full patient journey. We are considering a number of third-party platforms and focusing on solutions that integrate with our technologies including Microsoft Teams and Epic (which we call “Synapse” at UHN as part of our Clinical Transformation journey).

Working from home – future directions

  • Background and why this was brought to ELF: We are encouraging members of TeamUHN to work remotely if they demonstrate they can do so without compromising their responsibility to patients and colleagues. In response, we assembled a Remote Work Task Team co-led by Venita Indewey (Senior Director, Organization & Employee Development) and Michael Caesar (Executive Director, Data & Implementation Science) to support individuals, teams and leaders with sustainable remote work processes. Several large teams who are working remotely are testing and providing input on tools, as well as a comprehensive Guide to Remote Work. This work supports the flexibility required for TeamUHN during COVID-19 and lays the groundwork for beyond the pandemic.     
  • Who presented? Diana Elder (Interim Vice President, Human Resources)
  • What do I need to know? The goal is to launch enhanced remote work processes and supporting tools to all teams by the end of January 2021. Through the Virtual Open Forums, we have heard the desire for more consistency in terms of who is permitted to work from home. In response, the Remote Work Task Force has created a transparent decision-making model which includes an escalation process. We are all accountable for continuity of service across care, research and education; the tools are designed to facilitate open and collaborative conversations between leaders and teams. Lastly, we are completing a high-level scan to identify what roles are suitable for the various degrees of remote work. This will help us understand and plan around the barriers we may face due to remote work over time.     

Closing notes

  • National Physician Assistant (PA) Day is on Nov. 27: This week, please join me in thanking PAs at UHN for the valued services they provide across multiple programs. PAs are highly skilled professionals who can work in any clinical setting to extend physician services and improve access to care for patients. They perform assessments, histories and physical exams; order and interpret labs and diagnostic tests; review and order medications; coordinate care and transitions between hospitals; perform procedures and assist in the operating room and clinic. Stay tuned for a great UHN News story on these colleagues – it will be published on Thursday, Nov. 26.
  • University of Toronto named one of the top 10 in the world across many Departments on the U.S. News and World Report Global Ranking: #4 for Surgery, #4 in Oncology, #5 in Clinical Medicine, #5 in endocrinology and metabolism, #6 for Cardiac and Cardiovascular Systems, #8 in Psychiatry/Psychology, #9 Gastroenterology and Hepatology, #9 in Radiology, Nuclear Medicine and Medical Imaging, #10 in Biology and Biochemistry and #10 in Cell Biology. The Department’s faculty members are the physicians, surgeons, scientists and educators of the affiliated hospitals – including UHN – and all play an important role in achieving this ranking.

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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