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

  • Next week, we are changing the date of our Virtual Open Forum to support TeamUHN well-being. Our next session will be held on Thursday, April 8 at 1:00 p.m. (instead of Tuesday, April 6 at noon) in an effort to help TeamUHN unplug over the Easter long weekend.
  • Keep masking, physically distancing and not gathering unnecessarily with people outside your household. This is important even when you are fully vaccinated. Vaccination complements public health measures – it does not replace them.

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.

Wave 3: Clinical capacity across UHN and the Greater Toronto Area (GTA)

  • Background: Ontario is now reporting COVID-19 case counts over 2,300 and the numbers are still rising, fuelled by the increasing rate of Variants of Concern. Across the Toronto Region, we are noticing significant differences with Wave 3 compared to Waves 1 and 2. For example, UHN is now transferring patients out through the GTA IMS Table, whereas we previously only received transfers (the GTA IMS Table directs transfers between hospitals across the Toronto Region to preserve equitable access to care). In response, we are scaling back non-emergent activity at UHN and opened a third COVID-19 unit to create more capacity. Across the region, we are also seeing a difference in case demographics. For example, while we largely saw a population of people 60+ in our ICUs during Wave 1 and 2, we are now seeing a younger population of people in their 40s and 50s. At UHN, we are also now managing our highest number of ECMO (extracorporeal membrane oxygenation) referrals; ECMO is used as the last line of defense for a patient when a ventilator is no longer able to support them.
  • Who presented? Susy Hota (Medical Director, Infection Prevention & Control), Marnie Escaf (Vice President, Clinical), Niall Ferguson (Head, Critical Care), Brian Hodges (Executive Vice President, Education; Chief Medical Officer), Shaf Keshavjee (Surgeon-in-Chief), Fayez Quereshy (Vice President, Clinical)
  • What do I need to know? Challenging times call for creative solutions and we are fortunate to have the talent and determination to deliver those solutions at UHN. During Wave 1, our colleagues at The Michener Institute of Education worked to safely accelerate the graduation of senior students so they could jump in and support our COVID-19 response. Given our increasing critical care needs, we are seeing if we can mobilize senior students to support UHN's work. In addition, we will continue to work with our partners across the GTA IMS Table and follow the principles of UHN's Clinical Activity Ramp Down Blueprint.

Vaccinating as many people as possible as Variants of Concern continue to spread

  • Background: In Toronto, more than 65% of patients with COVID-19 are testing positive for Variants of Concern which are known to be more contagious. And since there is a reporting lag with Public Health Ontario data, we suspect that the rate is closer to 80% – which means we need to get everyone vaccinated as quickly as possible. Last week, I sent out a special request for members of TeamUHN to get their first dose; I am glad to know that approximately 1,000 people signed up in response (Corporate Intranet > COVID-19 Preparedness > Internal Communications > "A special request…"). This means we now have the vast majority of TeamUHN vaccinated with their first dose (or registered to receive their first dose). With the majority of TeamUHN covered, we will now focus on building vaccine confidence among those remaining. UHN's Vaccine Confidence Call Centre will launch this week, where people can call and safely discuss their concerns. Details coming soon. We must consider what our responsibility is to patients and all members of TeamUHN and I will be writing to you later this week with some ideas for discussion.
  • Who presented? Emily Musing (Vice President, Clinical; Chief Patient Safety Officer), Susy Hota (Medical Director, Infection Prevention & Control), John Granton (Interim Medical Director, Health Services)
  • What do I need to know?Register for your COVID-19 vaccine if you are in Group A, B, C or D and haven't already (Corporate Intranet > COVID-19 Preparedness > Vaccines). We are moving through our TeamUHN-facing Vaccine Registry quickly so this is the best time to sign up. Continue to mask, physically distance and follow all public health measures even after you are vaccinated.

Overview of last week

UHN's Executive Council on Quality and Safety: Discussing the future and next steps

  • Background: UHN's Executive Council on Quality and Safety was created to provide a clear line of sight on high-priority quality and safety risks at UHN, and complements existing structures including our Quality of Care Committees. Council membership includes Patricia Murphy, Joy Richards, Emily Musing, Kathryn Tinckam, Brian Hodges, Lucas Chartier, Shaf Keshavjee and Ed Cole.
  • What happened last week? The Council convened to discuss the quality structures across UHN (e.g. the current state of our reporting mechanisms) and how we can advance the necessary cultural change needed for quality and safety to be at the forefront of every interaction at UHN. While we have made very fine progress in fostering a learning culture around safety events at UHN, we need to continue to improve our timeliness in changing behaviours and processes. As we have been on our quality and safety journey for the past four years, it's time to undertake an external evaluation of our progress. We have invited Jack Kitts (former President & CEO, The Ottawa Hospital) to lead a review of UHN's current quality and safety progress and future opportunities. Jack is respected across the health system for his extensive quality and safety experience. We look forward to the insights and recommendations.
  • What do I need to know? Synapse, which will be powered by a new Health Information System (HIS), also presents a huge opportunity for us to advance quality and safety at UHN. As we move forward and make critical decisions about how we want to configure our HIS, we will need to think about the metrics we want to track – and most importantly, the ones patients and funders wish to explore – and how we can support teams so they can confidently embrace a sense of ownership.

Closing notes

  • Watch our Anti-Racism and Anti-Black Racism virtual roundtable on Wednesday, March 31 at 12:00 p.m. (Microsoft Teams Live Event link) – presented in partnership by UHN and Urban Alliance on Race Relations, a non-profit organization focused on dismantling institutional racism. Andrew Boozary (Executive Director, Social Medicine and Population Health) will be giving opening remarks and Sheila O'Brien (Executive Vice President, People, Culture and Community) will be giving closing remarks. This is an opportunity to learn and expand our minds in service of A Healthier World. A recording will be made available.
  • April is Be A Donor Month: Almost 1,600 Ontarians are waiting for a lifesaving organ transplant, and every three days, someone will die waiting. UHN's Ajmera Transplant Centre is Canada's largest transplant program. Thanks to the generosity of organ donors, they perform more than 600 transplants every year. Help make a life-saving difference and consider registering for organ donation at BeADonor.ca/TeamUHN and wear green on April 7 for Green Shirt Day. Follow the Ajmera Transplant Centre on Twitter, Facebook and LinkedIn and use #GreenShirtDay on April 7.
  • April is also Parkinson's Awareness Month: More than 100,000 Canadians are currently living with Parkinson's today, with more than 6,500 new cases diagnosed each year. Through an interdisciplinary approach, beginning with advanced research all the way through to drug discovery and exceptional clinical care, the Movement Disorders team at UHN's Krembil Brain Institute is dedicated to finding new treatments and developing innovative technologies to help patients gain mobility and reach their full potential. Learn more.
  • Finally, April is Irritable Bowel Syndrome (IBS) Awareness Month: Millions of Canadians live with Irritable Bowel Syndrome and the economic burden alone is $6.5 B annually. People of any age can suffer from this illness which can be debilitating and hard to discuss with others. UHN's Centre for Digestive Health and Gastroenterology is the leading centre for digestive health disorders in Canada and we are proud to help support and empower patients facing this chronic condition.

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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