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

  • Deepest thanks to all managers, Patient Flow, and staff working to support expanded capacity. I have profound gratitude to the staff and managers across our sites who are showing so much grace under the constant pressure of the pandemic. I know that all of you are making complex staffing decisions each and every hour as we work through the staffing shortages as our colleagues fall ill or must isolate at home. To those in our Toronto General and Toronto Western Emergency Departments dealing with a relentless flow of patients – all day, each day – it is clear that all of you and your colleagues on the units are working to ensure that we not leave patients in our EDs any longer than necessary. To everyone at Toronto Rehab and Princess Margaret who have been working to assist the movement of patients, I thank you for your flexibility and for helping by working with colleagues in the EDs and at the acute sites. Across UHN you are all talking on more patients to distribute the pressures and as we head into more weeks of difficult decisions and stressful circumstances, I want you to know how deeply appreciative I am of your professionalism.
  • UHN partnership means more virtual emergency visits for Torontonians. UHN has partnered with Unity Health Toronto and Sunnybrook Health Sciences Centre to offer even more virtual appointments for Torontonians dealing with urgent, but non-life-threatening, medical conditions. Toronto's Virtual Emergency Department – which builds on each institution's pilot program to unify Emergency Medicine staff and resources between the organizations – makes it possible for patients over the age of 18 to have same-day consultations with ED doctors from any partner organization all from the comfort of their home. For more on virtual hours, FAQs, and information on how to book at an appointment, visit UHN's website.
  • Please join me in welcoming Pam Hubley to TeamUHN as the Interim Chief Nursing Executive (CNE). Pam is joining UHN as we begin a national search for Joy Richards' permanent replacement in the position. Pam is cross-appointed to UHN from SickKids Hospital, where she serves as the Vice President of Education and Academic Practice and the Chief of International Nursing.

What happened at the Executive COVID-19 IMS Table

In response to COVID-19, UHN has re-activated its Executive COVID-19 IMS (Incident Management System) table and we are meeting on a daily basis. Membership includes our Executive Leadership Forum and other members of COVID-19 work streams. This is a snapshot of the discussions this past week.

Redeployment and Additional Staff Resources at UHN

  • Background: In light of staff shortages due to TeamUHN members becoming ill or having to self-isolate due to an exposure to COVID-19, work is being done expeditiously to both bring additional personnel resources into the hospital, and deploy non-clinical staff to help support clinical programs.
  • Who presented? Diana Elder (Vice President, People & Culture)
  • What do I need to know? Four streams of activity have been initiated to provide more support for the current challenges:
    1. Employee volunteers: Seventeen staff who volunteered for redeployment were deployed last Friday and 26 more are set to deploy this week. Of those deployed last week, eight went to Toronto General, four to Toronto Western, two to Princess Margaret as Hospital Support Aides (HSAs), and three to our vaccine clinics.
    2. Recruitment from job postings has already produced six hires whom UHN aims to deploy this week.
    3. Ontario's Ministry of Health Resident Support Aide (RSA) initiative has resulted in the training of 10 Hospital Support Aides, with more coming down in the weeks ahead.
    4. Nurses who retired from UHN returning to work: Conversations are continuing with nurses who retired over the last 24 months to come back to provide support, most likely to areas from which they retired.

Reduction in Scheduled Surgeries

  • Background: The Chief Medical Officer of Health (CMOH) reissued Directive #2 earlier this month, instructing hospitals to pause scheduled surgeries to preserve critical-care capacity.
  • Who presented? Fayez Quereshy (Vice President, Clinical; Executive Sponsor, Clinical Activity Recovery Team)
  • What do I need to know? Omicron continues to drive increased inpatient admissions and staff shortages, requiring UHN to move to CART Phase B – reducing surgical activity to about 54 per cent. We continue to perform urgent surgeries and will increase activity as soon as it is feasible to do so.

Closing notes

Congratulations to researchers at the Ajmera Transplant Centre and Toronto General Hospital Research Institute for having been awarded the $24-million, New Frontiers in Research Fund (NFRF) - Transformation grant from the Government of Canada. The funding will support a groundbreaking project, led by Dr. Shaf Keshavjee, Director, Toronto Lung Transplant Program, to accelerate ex vivo technology to repair and rebuild organs with the ultimate, transformational goal of eliminating the transplant wait list. As Dr. Shaf Keshavjee told UHN News, "we now have the opportunity to take ex vivo technology to the next level." Just seven projects from across Canada were awarded the funding.

January marks #Alzheimers Awareness Month in Canada. 500,000+ Canadians are currently living with Alzheimer's or another related dementia, a number that is expected to double by 2035. At UHN, the Krembil Brain Institute's multi-disciplinary team of researchers, neurologists, neurosurgeons, neuropsychologists, chemists, and support staff are pioneering new ways of diagnosing Alzheimer's earlier, developing new treatment modalities such as deep brain stimulation (DBS) to re-circuit the brain and restore memory, and identify molecules that may one day lead to new treatments. Public education and outreach are top priorities for our team, as well as effectively communicating our discoveries to promote support for research. On Toronto Rehab's Specialized Dementia Unit, patients with advanced dementia are admitted because the severity of their illness has progressed to a point where it cannot be managed in the community. The team takes a person-centred approach to care, innovating around non-pharmacological approaches to improving the quality and safety of care for all patients with dementia. One of the consequences of dementia is a high risk of falling, as the disease attacks the motor system and memory. Geriatric psychiatrist Dr. Andrea Iaboni and her team at The KITE Research Institute are using new technology such as artificial intelligence to predict and prevent falls before they happen.

Transition of UHN's Tele-Monitoring Program from the Nursing Resource Team (NRT) to Altum Health. Tele-monitoring is a service used across all sites and units at UHN, allowing multiple patients, each of who would normally require a bed-sitter, to be monitored remotely by a trained technician. Tele-Monitoring provides UHN with an alternative to 1:1 bedside sitters when appropriate, and has proven to be a cost-effective and safe resource for many UHN patients that require constant observation. Under the direction of Dr. Shaf Keshavjee (Tele-Monitoring Medical Director) and Marijana Zubrinic (Executive Clinical Lead for Tele-Monitoring), UHN is exploring the adoption of the program at numerous hospitals across Ontario and Canada. To this end, the program has transitioned from the Nursing Resource Team (NRT) to Altum Health to support and drive the external expansion of UHN's Tele-Monitoring program. The organization is grateful for the leadership of April Guthrie and Brenda Kenefick for the operational growth of this program at UHN.

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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