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 amd updates

  • This pandemic has shown us how interdependent our health system is. As our admission volumes remain high, the system as a whole is struggling with capacity. It is more important than ever for us to focus as a team on the timely discharge of patients to home or their next level of care in order to liberate space for the incoming patients who are in the acute phase of their illness and need our care and attention. While we know that transitions in care always carry a degree of risk, we need to recognize the importance of balancing the needs of the patients in front of us, with those who are awaiting care. We ask all teams to work collaboratively to mitigate and minimize risks while facilitating early, safe transitions in care.
  • I want to again convey how thankful I am for everyone who has gone the extra mile to be flexible and come together to meet the needs of our patients in these difficult times. I also want to sincerely thank everyone found a way to make it into our units during last week's massive snowstorm. With so much already on your plate, Mother Nature decided to make things even more challenging. True to form, the committed professionals on TeamUHN rose to meet the moment.
  • Health Canada has approved Pfizer's COVID-19 Paxlovid antiviral treatment for adults over 18. As many know, I have been publicly advocating for this for weeks because I believe that a therapy that can be taken by patients at home can be a game-changer in reducing hospitalizations. While questions about the rollout remain, the federal government has made an initial order of one million treatment courses.
  • Virtual Open Forum on COVID-19 this week – Thursday, January 27, 11:00 a.m. to 12:00 p.m.
    • A link to submit COVID-related questions and vote on them will be sent on: Tuesday, January 25th. Reminder to please include your full name in order to have your question accepted.
    • Livestream link here (Chrome or Firefox only).

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.

Return to work for those exposed or previously positive COVID-19

  • Background: Staff shortages in light of the Omicron wave have required health organizations to consider adjusting practices to permit some staff who have been recently COVID positive or exposed to return to work from isolation sooner.
  • Who presented? John Granton (Interim Medical Director, Health Services and Respirologist / Intensivist, UHN)
  • What do I need to know? Following discussions with other ELF members, it was recommended that UHN switch to the approach of allowing staff who tested positive to return after seven days of isolation instead of ten, and those with high-risk exposures to return after five days after a break in exposure. If they cannot break exposure from a household member, they remain off for an additional five days rather than an additional ten days.
    • Shortening the period of isolation is still a cautious and safe approach that is more conservative than what peer hospitals have already implemented. Our approach is consistent with provincial recommendations and acceptable to Health Services and IPAC. There will be enhanced safety strategies put in place to support this approach. Staff will be instructed on how and when to obtain a PCR test, Rapid antigen testing and advised on how to isolate while at work as they complete their period of isolation while at work.
    • Individuals may be contacted by their managers or Health Services to adjust their return to work based on previous instructions given prior to January 24, 2022. PCR results do not go directly to Health Services. Team UHN members are required to inform Health Services using this link.

Omicron subvariant being watched closely

  • Background: A sister version of Omicron, known as BA.2, has become the dominant variant in Denmark and has also increased in prevalence in India, Singapore, and the United Kingdom.
  • Who presented? Brad Wouters (Executive Vice President, Science & Research)
  • What do I need to know? While the first sub-lineage of Omicron, BA.1, has been dominating the world, we saw a few cases of BA.2 last week. Not much is known about BA.2 from a biological perspective, but researchers have found it has 28 different mutations from BA.1. UHN has given samples to the CIHR Variant Network COVARR-NET for further study.

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 January 20, 2022.

Synapse update

  • Background and why this was brought to ELF: The Synapse project to transition to a new health information system (HIS) powered by Epic is on track to go live on June 4, 2022. Over the remaining months until go-live, there is a dual focus: ensuring the system, devices, and data are ready, and ensuring the readiness of the more than 16,000 TeamUHN members who will use the new system. An update and a risk analysis on the project were presented to ELF.
  • Who Presented? Sarah Muttitt (Vice President, Chief Information Officer) and Robert Slepin (Sr. Project Director, HIS)
  • What do I need to know: Despite challenges, the Synapse project has seen incredible achievements this month, including the Epic playground environments opened for early adoption by a pilot group of physicians and a successful workshop for building templates for appointment scheduling. Today, the first cohort of 83 Credentialed Trainers will start – most of whom are from TeamUHN – a major milestone. The second cohort of 28 will start no later than February 7, a delay that is due to clinical demands. This will help us ease the staffing shortage due to Omicron and address the needs of our units. Key risks that the team is mitigating include timely completion of testing and interface workstreams, and registration of users for training classes. Training will be a huge focus in the next month, as the Synapse team works with managers to register staff by March 18. The 120-Day Go-Live Readiness Assessment (GLRA) – a stem-to-stern review of project risks and mitigation strategies – will be held on February 2 and attended by ELF members.

Closing notes

Training Essential Care Partners (ECPs) for voluntary bedside support. The current staffing shortages have been very challenging, but have also provided an opportunity to find creative ways to ensure continuity in the support of our patients' care and safety. Colleagues in Patient Education and Collaborative Academic Practice (CAP) have developed resources for TeamUHN to educate and provide the necessary training to Essential Care Partners (ECPs) who wish to provide bedside support to their loved one for care activities such as meal support or positioning and mobility. This additional support is not only helpful for a patient's stay, but also prepares them for discharge and can prevent readmissions. An added benefit is the time patients and ECPs get to spend together as limiting ECP access during the many stages of the pandemic has been difficult for patients, families and TeamUHN. More information is available at the ECP Training Hub.

UHN has once again been ranked the top research hospital in Canada. Research Infosource Inc.'s annual ranking of the country's top 40 research hospitals has kept UHN in its top spot – a position we've held since the list began in 2011. It's no surprise, as UHN continues to blaze new paths in health research. As Dr. Brad Wouters, UHN's Executive Vice President of Science and Research, told UHN News, none of this is possible without the incredible generosity of the foundations – The Princess Margaret Cancer Foundation and UHN Foundation.

Yesterday marked the 100th anniversary of the first clinical use of insulin, something 14-year-old Leonard Thompson became the first person in the world to receive at Toronto General Hospital on Jan. 23, 1922. The discovery of insulin by Frederick Banting and Charles Best at the University of Toronto saved the lives of millions of people living with diabetes. As Dr. Minna Woo, Director of the Division of Endocrinology and Metabolism at UHN and Sinai Health, told UHN News, "insulin is truly a gift to the world."

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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