Code Orange exercise
Participants from multiple departments huddle around a floor map of the Toronto General Hospital Emergency Department in a mock Code Orange exercise. This was one of the first 10 Code Orange training workshops led by Emergency Preparedness. (Photo: UHN)

The next wave of the UHN Emergency Preparedness team's Code Orange training workshops is underway.

This week, members of clinical units at Princess Margaret Cancer Centre (PM) and Toronto Rehab (TR), as well as non-clinical teams across UHN, began attending the interactive sessions. The workshops began last month with Toronto General (TG) and Toronto Western (TW).

The workshops come as part of a plan to improve UHN's existing Code Orange mass casualty incident response – an area of focus the organization has turned to in light of tragic events in the city last year, including the van attack on Yonge St. and the Danforth shooting.

"It's not a case of 'if,' but 'when' something happens and we have to respond – how do we become comfortable in dealing with the situation as a team?" says Paul Beverley, Manager of UHN's Emergency Preparedness team.

"The more you can participate and learn how our departments work together, the more confident we will be."

The first 10 workshops gathered 233 staff and physicians over the course of a month. Participants were taken through the detailed timeline of a Code Orange incident and how patient flow operates at UHN's acute care sites.

They then worked in teams to identify solutions and gaps in a simulated Code Orange event – the aftermath of an attack at Queen's Park.

The end goal, Paul explains, is a robust, unified plan which incorporates each departments' individual Code Orange protocols. An e-learning module for all staff is in the works, along with a UHN-wide drill scheduled for June 2019.

Layli Sanaee
Emergency physician Layli Sanaee (centre) worked during a Code Orange response in Ottawa following a tragic bus-train crash in 2013. She says UHN’s training workshop was "incredibly insightful."" (Photo: UHN)

Dr. Layli Sanaee, an emergency physician at UHN, recalls when she was a resident emergency physician at The Ottawa Hospital's General Campus when a Via Rail train crashed into a commuter bus in 2013. The hospital went into a Code Orange response as more than 30 injured were sent to four hospitals in the area.

"In that moment, I was thankful for the careful planning and training exercises we had received beforehand," she says.

Dr. Sanaee last month attended Code Orange workshops at TG and TW with her colleagues in the ED, Medical Imaging, Pharmacy, Respiratory Therapy, Patient Flow and Laboratory Medicine.

She says the workshops at TG and TW "were incredibly helpful​"

"It helped me realize the importance of strong collaboration between departments and disciplines in a place as complex as UHN," she says.

"Had we not all been together in the same room, many areas for improvement may not have come to light."

What's next?

The next round of interactive Code Orange workshops began earlier this week and runs until the end of February. It includes teams at PM, TR and non-clinical departments such as Housekeeping, Public Affairs and Security.

By the end of the workshops, the groups will have a deeper understanding of the impact of a mass casualty incident on hospital operations, as well as their specific roles in a Code Orange response.

"Thanks to the dedication and team effort of everyone involved, we're making steps to ensure the Code Orange drill in June is a success," says Janet Newton, VP and Site Lead, TW. She co-chairs the Code Orange Improvement Steering Committee together with Dr. Sam Sabbah, Assistant Director of Emergency Medicine, UHN.

"It's a complex task, but we're confident that we'll be better prepared than ever by the end of it," Dr. Sabbah says.

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