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Patient and caregiver on stairs
With elevators not working due to a Code Grey, patient Brooke Gilbert (R) climbed stairs for the first time in rehab, with the support of her physiotherapist, Trish Stapleford. (Photo: UHN)

Brooke Gilbert found light in the darkness, in the most unexpected of ways.

Toronto Rehab's Lyndhurst Centre recently declared a Code Grey, as all inpatient units, and most service areas, lost power and network connectivity when an on-site construction crew drilled through cement in an area that enabled water to flow into – and ultimately damage – electrical panels. 

The lights went out in many areas. There were no patient phones, no access to the Electronic Patient Record (EPR), no call bells. And, the elevators stopped, which posed a particular challenge for Lyndhurst's spinal cord injured patient population, who rely on them to move freely between floors.

In all, the Code Grey lasted 30 hours, challenging all TeamUHN members – from frontline clinicians and support staff to research staff and students – at both Lyndhurst and University Centre.

"Thanks to the coordinated teamwork across UHN, and the resiliency of staff at Lyndhurst, this Code Grey had minimal impact on our patients, and no serious safety events were reported," says Sue Jewell, Senior Vice President and Executive Lead, Toronto Rehab.

But for Brooke, 21, who had been admitted to Lyndhurst with a diagnosis of transverse myelitis – an inflammation of her spinal cord, which caused her to lose sensation in her arms and legs – the code call proved to be a milestone on her goal of walking out of rehab without the aid of any mobility devices.

At first, Brooke didn't give much thought to the Code Grey when it was called at 10:30 a.m. on March 11. She had spent most of the morning in the gym, which was located on the ground floor and still had electricity.

It wasn't until it was time to rest that the impact of the power outage hit Brooke: if she wanted to get to her room on the second floor, the only way up was the stairs.

It was time for Brooke to test her limits.

staff wearing hair nets
Regardless of their roles, staff pitched in to deliver lunch trays to patients (Photo: UHN)

'If anything happens, Trish is right here to help me'  

"When Trish, my physiotherapist, asked if I wanted to try the stairs, I was totally on board," says Brooke.

"It would be the first time I had climbed a set of stairs since my diagnosis and I thought it was a good physio opportunity."

Although trust in herself was still building, Brooke had total trust in Trish.

"She put a chair on the first landing, my walker at the top, and encouraged me to go at my own pace," Brooke recalls.

"It was reassuring, knowing that I was trying something new, but that she was there for support and encouragement. I thought, 'ok, if anything happens, Trish is right here to help me.'"

Rehab is about regaining independence and maximizing what patients are able to do for themselves back in their communities. Building trust between a patient and their care providers is an essential part of that journey.

"It's important to build a rapport, so while you're trying new things, and talking through challenging situations, your patients know your focus is on them and what they can do," explains Trish Stapleford, Brooke's physiotherapist.

"Because Brooke and I had been working together, I knew her level of ability. I thought, 'what better time to challenge her, than out of necessity,' because that's part of life, too."

So, up the stairs they went.

One step turned into two, and two turned into 20 – and before Brooke knew it, she had reached the second floor.

"I felt so accomplished, when I got to the top," she says. "It told me a lot about how much I should trust myself.

LYNDHURST CODE GREY BY THE NUMBERS

0 serious safety events (SSEs) reported

2 command centres established

6 hours without emergency power

6 hours without network access

30 hours without regular power​

"I don't think I would have considered stairs, had the power not gone out. But it became part of another success in my recovery journey."

Taking control of the Code Grey

Meanwhile, behind the scenes, command centres had swiftly been set up at both Lyndhurst and University Centre, to take control of the Code Grey.

The top priority was the safety of both patients and staff, says Incident Commander Joanne Zee, who is also the Clinical Director, Brain and Spinal Cord Rehab Program & Business Development.

While facilities staff focused on restoring power, clinical sweeps were initiated to identify high-risk patients and situations, flashlights were distributed, updates were shared regularly via overhead paging systems, additional security, staff, and pharmacy team members were deployed.  

 "We had just practiced the Code Grey – Information Systems plan, so we were able to draw the same algorithm to guide us, along with the tools from our emergency preparedness toolkit."

But staff in the command centre weren't the only ones taking ownership of the code.

On the frontline, students, clinical, and research staff pitched in to deliver food trays, while therapists transferred individuals up and down stairs in their wheelchairs, and continued to provide therapy to patients on the second floor, either in their rooms or elsewhere on the unit.

"It felt like a strong team approach," says Trish.

"At all times, we had clear leadership, and knew the command centres were moving things forward. That allowed the rest of us to focus on establishing a sense of normalcy for patients."

Within six hours of the Code Grey call, emergency power and network connectivity had been restored. But it was not until the next afternoon, more than 30 hours after it was called, regular electricity resumed, and the code was declared all clear.

According to Joanne, teamwork was the key to keeping everyone safe.

"The leaders, training, culture, and laser focus we all shared, on caring for our patients and each other, helped us overcome any obstacles the power outage brought our way," she says.

"I'm so proud to be part of the team."​

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