General Internal Medicine team
(L to R) Drs. David Frost, Rodrigo Cavalcanti and Shail Rawal are part of the General Internal Medicine team at Toronto Western Hospital, which authored the piece for CMAJ. (Photos: UHN)

How do you prepare hospital units to safely care for many patients with a new disease?

As COVID-19 made its way across the globe to Canada, hospitals across the country started to prepare their response for an influx of patients and how to approach treating an unfamiliar illness.

As part of that planning, the General Internal Medicine (GIM) team at Toronto Western Hospital (TWH) began collecting available information to develop an approach to treating COVID-19 patients admitted to their units in a way that supports both staff and patient safety.

That approach, based on the COVID experience in Madrid, Spain and other existing medical literature, includes the use of dedicated COVID units with designated risk zones, infection control protocols, and reconfiguring medical care teams and protocols to provide robust, patient-centred care.

"Principles for clinical care of patients with COVID-19 on medical units" was published Wednesday in CMAJ (The Canadian Medical Association Journal) in an effort to provide hospitals around the world with tools to safely care for their patients with COVID-19, as subsequent waves of the illness are likely.

"GIM units traditionally treat patients with a variety of needs and illnesses and we expected that our teams and units would play a major role in caring for patients with COVID-19, which required several fundamental changes to unit structure and function," says Dr. David Frost, Site and Clinical Teaching Unit Director, GIM, TWH, and one of the paper's co-authors, along with along with Dr. Rodrigo Cavalcanti and Dr. Shail Rawal, general internists from the hospital's GIM Division.

"Having created and used this approach locally at UHN, we want to share it with healthcare colleagues across the globe, just as we learned from the experience of other settings in designing our system."

"The ability to rapidly disseminate information, repeat protocols, and collaborate with physicians across the world will continue to be important through subsequent pandemic waves," says Dr. Cavalcanti.

"We would also like to highlight the critical roles that the nurse managers of our two COVID dedicated units, Janet Pilgrim and Kevin White, had in implementing these principles locally, as well as the incredible interprofessional team we have the privilege to work with on these units," adds Dr. Rawal.  

The approach is also available through an open access website: www.torontocovidcollective.com

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