Hospitals in Waterloo Wellington are collaborating to plan for gradual resumption of scheduled surgeries and procedures that were paused in March because of COVID-19. The ability of hospitals to do so depends on meeting certain conditions as outlined in the Province’s framework for resuming scheduled care.
This framework outlines conditions that are key to regional planning for resuming scheduled surgeries and procedures. The timeline is to be determined by these factors, which include:
• Current capacity within hospitals to care for patients, including those with COVID-19.
• Having adequate supplies of personal protective equipment.
• Having adequate supplies of drugs for surgeries.
• The ability to take activity down quickly should there be a re-emergence of multiple cases of COVID-19 positive patients.
• Evaluation and use of different approaches to care, and the potential for having patients and their care team travel for care.
A multi-disciplinary committee of experts created this framework based on the best available evidence to guide all hospitals - and the health care system at-large - in this next phase of care in Ontario. The framework is critical to regional planning and allows for the implementation of carefully thought-out resumption of scheduled cases. A great deal of work is underway in each of Waterloo Wellington’s hospitals to ensure patient and staff safety and the priority sequencing of services.
“We acknowledge that there are many people in our community who have been waiting for these procedures and services, and thank them for their patience as we’ve worked through this challenging time,” said Lee Fairclough (photo), President of St. Mary’s General Hospital and Hospital Lead for the Waterloo Wellington hospitals’ pandemic response, in coordination with Ontario Health. Throughout the pandemic, hospitals have been delivering urgent and emergent care, with clinicians constantly evaluating the care needs of people who are waiting, and moving individuals into the urgent and emergent categories as needed. Given the status of COVID-19 in Waterloo Wellington, the actual ramp up of more elective surgeries will take many weeks, when you consider the need for pre-operative care that has been on hold. Patients will be contacted about re-booking their procedures and do not need to reach out to their doctor’s offices. Many of the conditions currently in place at hospitals will continue, such as the restricted visitor policy and the need for patients to wear masks.
Resuming scheduled hospital-based care for patients waiting for treatment is necessary and has to be very carefully weighed with the overriding need to ensure Ontario hospitals can maintain capacity to be ready for any surge in COVID-19 patients. For example, the current situation in Long-Term Care and Retirement homes involves hospitals working closely with homes to provide support. Sometimes this requires hospital staff to be re-deployed to work in a facility, or transitioning residents to hospital for care. In addition, hospitals will be collaborating with home care, primary and community care providers to determine the potential impact of increasing service and what this will mean for necessary care following a procedure.
“One of the important considerations is the current local status of COVID-19,” said Dr. Hsiu-Li Wang, Acting Medical Officer of Health for Waterloo Region. “As a region that continues to see community cases, and continues to manage outbreaks in congregate care settings, we will be monitoring the situation closely and working with hospitals to determine when it will be safe to proceed. Though we feel things are stabilizing, our gains are still precarious and COVID-19 is still a significant threat. The number of cases and outbreaks can rise again very quickly if we are not careful,” Dr. Wang said.
Each hospital will be developing a plan, and is also committed to working together across Waterloo Wellington to determine how to best collectively meet health needs in an equitable way across the region through Ontario Health regional planning COVID-19 tables. The plan will require approvals, as part of a province-wide approach, executed on a regional basis and based on local context.
Hospitals will be collaborating as a group to optimize the use of resources in order to support the resumption of services. This collaboration has served the hospitals well to date in managing through COVID-19, and will be equally important at this next important and complex stage.
“We want to thank our community for its continued efforts in dealing with this pandemic,” said Ms. Fairclough. “By following Public Health guidelines to date you have flattened the curve and helped control the situation so as not to overwhelm our health system, as well as allowed it to support the long-term care and retirement home sector. We will move forward thoughtfully to respond to the need to increase our services and continue to provide safe care to our community.”