A System Approach

The COVID-19 pandemic has put Canada’s healthcare system to the test. In Ontario, the entire system has had to flex and find new ways to create capacity and respond to surging demand. For Women’s College Hospital, as our partners across the region were pushed to the brink, we quickly pivoted and reached beyond our ambulatory model of care and stepped into roles – both within the organization and beyond.

Early in the first wave, Women’s created a temporary in-patient surgical unit. By December 2020, with the second wave showing no signs of slowing, new solutions were needed. As hospitals worked together to manage patient flow and balance capacity, Women’s College Hospital saw an opportunity to provide some relief through the creation a temporary 12-person alternate level of care (ALC) inpatient unit. By transferring COVID-negative low-acuity patients out of partner hospitals to Women’s, it would create more system capacity for more acutely ill patients. 

With time of the essence, #TeamWCH created an in-patient unit in just a few weeks. From training and creating a multi-disciplinary model of care, to acquiring the needed equipment and developing operational procedures, opening a new unit in such a short time frame was unprecedented. 

Cris Barrett, director of specialized medicine & mental health, patient care & ambulatory innovation, said the endeavour truly took a village. “The complexity of creating this unit lay in the consultation of our subspecialty services, as well as with other hospitals to support the transfer of patients from their institution to Women’s College.” 

As the unit began accepting its first patients on December 23, team members from outpatients, OR and pre-admission departments stepped up to provide round the clock care. Registered dieticians led the food services in the unit, environmental services was reassigned, and every team from IM/IT to finance to human resources was called upon to support the creation of the unit. And the passion and commitment made an impact.

“At Women’s, our nurses and health disciplines quickly and efficiently developed and nurtured relationships with patients, family members and other members of our care teams working in both traditional and non-traditional roles,” said Jennifer Price, chief nursing and professional practice executive. “This truly worked to our advantage during the COVID-19 pandemic as we had to pivot to meet the demands of the system and open first an in-patient surgical unit and then the ALC unit.”

Between December and the end of  May when the last patient transition into long-term care, the unit cared for 15 people. Barrett describes her experience with the ALC unit as beyond extraordinary as the team witnessed how their patients’ health significantly improved thanks to the care provided. “It was a privilege to have cared for such remarkable individuals.” 

When the third wave once again threatened to overwhelm the health system, health discipline teams from across the organization stepped up again. This time, teams of nurses, nurse practitioners, physiotherapists, pharmacists and social workers worked in pre-admission and general internal medicine units at the University Health Network and Mount Sinai Hospital. Physicians also shared their expertise at hospitals across the region. 

Debbie Childerhose, physiotherapist in the cardiac rehab program and manager of professional practice of health disciplines at Women’s College Hospital, reflected on her redeployment experience saying, “It was nice to see all these hospitals stepping up to provide care and watching people raise their hands to help wherever needed.” 

This was a theme seen not only at Women’s but across the entire health system. By working together as a system, we are demonstrating that together we are, indeed, stronger. This level of collaboration will help carry us through not just the pandemic but well into the future.