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 Jan. 26 (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 or enter #UHNCOVID-19x37 on Slido.com. Livestream here (Chrome/Firefox).
  • Link to UHN's Vaccine Registry will be sent later this week – stay tuned. The registration process will place you in one of our vaccine groupings (Group A to E) and allow us to understand the demand for vaccine within each group. To see the updated criteria for Groups A to E and for more information about the Vaccine Registry, see this all-users message sent on Jan. 22. (Corporate Intranet > COVID-19 Preparedness > Internal Communications > "Vaccine Registry Coming…")

What happened at the Executive COVID-19 IMS Table

In response to the concerning state of 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.

COVID-19 Vaccine update

  • Background: Canada will not be receiving any Pfizer vaccines this week due to manufacturing disruptions at the Pfizer facility in Belgium. Last week, hospital CEOs (including myself) had emergency meetings with Toronto Public Health and the Ministry of Health to discuss the implications of this delay in supply. We are told this will impact us for up to three weeks. Our main concerns are continuing to ensure the most vulnerable citizens in long-term care are vaccinated and getting second doses into the arms of those who have already received their first dose.
  • Who presented? Emily Musing (Vice President, Clinical; Chief Patient Safety Officer)  
  • What do I need to know? Starting this week, it appears likely we will need to re-schedule second-dose appointments from 21 to 28 days. If you fall into this category, you will be notified ASAP. I know how frustrating it is for the many staff awaiting the vaccine and we are using all efforts to support the various levels of Government to secure more vaccine ASAP. We anticipate an update in the next day or two on supply.

Capacity and redeployment

  • Background: Our health system is strained and facing capacity pressures. In response, we have put forward requests to the Ministry of Health and Ontario Health for additional surge capacity beds (ICU-levels II and III and rehab beds to permit flow). We are working to maintain our non-COVID clinical work for as long as appropriate. Due to increasing staff shortages across the GTA, the Executive COVID-19 IMS Table made the decision to re-open UHN's Redeployment Centre effective Jan. 22.
  • Who presented? Marnie Escaf (Vice President, Clinical), Diana Elder (Vice President, Human Resources), Niall Ferguson (Head, Critical Care)   
  • What do I need to know? Given that we are in a state of emergency in Ontario, you may be asked to use your expertise where and when it is most required. That will mean, for some, being asked to work in a different setting. When considering who to redeploy, leaders will be using the following guidelines for nursing and other positions. Every effort will be made to maintain current schedules where possible. We are working to make the best possible decisions to promote patient and TeamUHN safety. For more information, please see our Redeployment Overview and Redeployment Principles. You can also visit the Human Resources COVID-19 Information page (Corporate Intranet > COVID-19 Preparedness > HR Redeployment).

National surveillance needed for COVID-19 variants

  • Background: Although Ontario case numbers have fallen in recent days, there is increasing evidence of the arrival and spread of concerning variant strains. As such, Canada needs a more comprehensive surveillance strategy and detection strategy for identifying and responding to variants of concern – including B.1.1.7 (first detected in the U.K.), B.1.351 (first detected in South Africa), and P.1 (first detected in Brazil). To illustrate the potential impact of these variants, look to Israel where B.1.1.7 has rapidly risen to account for at least 40% of new infections. While we do have some national surveillance strategies thanks to Genome Canada, who launched CanCOGeN (Canadian COVID-19 Genomics Network) as a cross-agency network for large-scale COVID-19 sequencing, we need a more comprehensive strategy to identify and respond to the variants rolled out across the country ASAP. UHN is aggressively advocating for this important practice.
  • Who presented? Brad Wouters (Executive Vice President, Science & Research)    
  • What do I need to know? We should be developing a comprehensive strategy to systematically test positive COVID-19 samples for variants of concern on a routine basis with a turnaround that will allow public health to respond. We discussed this last week with the Federal and Provincial government and are working with peers to advance best practices in the tracking and prevention of variant cases.

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.caThe last ELF meeting was held on Jan. 21, 2021.

2021/22 financial planning update

  • Background and why this was brought to ELF: UHN Finance will be presenting to the Finance & Audit Committee of the Board on Feb. 8. They will be bringing forward our proposed budget and multi-year financial strategy for discussion. Current financial risks at UHN include: Program deficits (i.e. projected financial performance and costs), the need to fund approved investments, COVID-related costs, and our capital needs (i.e. physical infrastructure, equipment). Our strategies for mitigating these risks include helping UHN portfolios address non-COVID pressures, working with the Ministry of Health, and capturing all COVID-19 financial impacts at UHN.
  • Who presented? Kelly Enair (Deputy Chief Financial Officer), Darlene Dasent (Chief Financial Officer)
  • What do I need to know? In order to ensure sufficient cash flow to meet UHN's needs, it is essential we understand our financial position and achieve our financial targets. Therefore, we've decided to move forward with our budgeting process, but will adapt it to the degree possible due to the pressures on TeamUHN. We are anticipating inflationary pressures in the next fiscal year and discussing this with the Ministry of Health.

Synapse update: Beginning "Phase 1" in early February

  • Background and why this was brought to ELF: The Synapse team will be presenting to the Quality and Safety Committee and Finance & Audit Committee of the Board, today (Jan. 25) and Feb. 8 respectively. Synapse represents UHN's clinical transformation journey which will be supercharged by a new Health Information System (HIS). Epic is our HIS vendor of choice and ensuring its successful implementation requires the hard work of many people. "Phase 0 – Prework" of the Synapse project will be ending in January. "Phase 1 – Workflow Walkthrough and System Configuration" will begin in early February and will involve deep engagement with TeamUHN. This includes many stakeholder engagement sessions during Workflow Walkthrough Days (Feb. 9-11), when Epic will demonstrate the HIS software to Synapse Champions (i.e. appointed ambassadors for clinical transformation), Subject Matter Experts, project team members, HIS educators, and Epic Application Managers. I know many of you are anxious about the workload of Project Synapse, in addition to our COVID-19 challenges, and we will be monitoring this very carefully.
  • Who presented? Robert Slepin (Senior Project Director, HIS), Sarah Muttitt (Chief Information Officer)
  • What do I need to know? The timing of Synapse is not ideal but we must push forward in an effort to realize a modern infrastructure. The number one request I received when I joined UHN in 2018 was the desire for clinical transformation and a new HIS. We look forward to bringing Synapse online.

KPMG Internal Audit Plan for 2021/22

  • Background and why this was brought to ELF: KPMG performs an ongoing internal audit of UHN to ensure we are operating as effectively as possible. The 2020/21 audit is now complete and will be presented to the Finance & Audit Committee of the Board on Feb. 8. In addition, KPMG consulted the members of ELF and asked them to suggest areas of focus for the 2021/22 internal audit. The Finance & Audit Committee will be reviewing the shortlisted ideas. Again, the pressures of COVID-19 are being considered as we make these choices.  
  • Who presented? Libby Duckworth (KPMG), Nick Rolfe (KPMG)
  • What do I need to know? We are very mindful of TeamUHN bandwidth and doing everything we can to protect against burnout. When deciding the areas of focus for the 2021/22 Internal Audit Plan, the Finance & Audit Committee of the Board will be taking organizational capacity into consideration.

Ontario's Specialized Care Centre supporting long-term care residents

  • Background and why this was brought to ELF: In December 2020, the Province announced the opening of a new Specialized Care Centre. Several long-term care homes across the GTA are struggling as they manage COVID-19 outbreaks, crowding, staffing shortages etc. The Specialized Care Centre allows residents to be temporarily relocated depending on their individual needs and the status of their long-term care home. The Centre is located in the Toronto Congress Centre and operates as a temporary extension of Toronto Grace Health Centre. Toronto Grace and UHN are co-leading this initiative with the following partners: Chester Village, Emergency Medical Assistance Team, Ministry of Health, Ministry of Finance, Infrastructure Ontario, and the Ministry of Long-Term Care. Marnie Weber (Executive Director, Strategic Developments) is the Chair of the Specialized Care Centre Steering Committee. 
  • Who presented? Marnie Weber, Jake Tran (President & CEO, Toronto Grace Health Centre)
  • What do I need to know? The Specialized Care Centre is a welcome safety net for long-term care homes in crisis. The goal is to staff and operate 90 beds as soon as possible. The first 30 beds began accepting residents on Dec. 28, 2020. Residents do not have to be COVID-positive to be eligible. The remaining 60 beds will open in 20 bed increments starting Feb. 15.

Closing notes

  • Underserved people in the Toronto Region will now have better access to essential health and harm reduction services thanks to joint effort with Parkdale Queen West Mobile Health Clinic. The clinic on wheels is powered by Parkdale Queen West Community Health Centre, TELUS Health and UHN's Social Medicine Program. For more information, see the TELUS release.
  • Bell Let's Talk Day is coming on Jan. 28 – supporting our mental health and fostering resilience is more important than ever. Later this week, UHN News will publish a story including a video with Susan Abbey (Psychiatrist-in-Chief), who will lead us through a brief exercise that can help when we're feeling overwhelmed. Different mental health supports will work for different people; the hope is to equip TeamUHN with a variety of supports so they can assemble a personalized 'tool box' of effective strategies. For additional mental health support, please consider using the UHN Cares program (Corporate Intranet > COVID-19 Preparedness > Mental Health Supports) or speak with your primary care provider.  

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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