By Leslee Thompson

Health care organizations across Ontario have noted that despite significant challenges brought on by the recent COVID-19 pandemic, upholding standards and continuing with external evaluations of quality of care remains a top priority. Even in the chaos of a pandemic, organizations were keen to utilize new tools and methods to help them continue their quality improvement journey.

In response to the COVID-19 pandemic, Accreditation Canada (AC) and their many surveyors pivoted to offering accreditation surveys utilizing both virtual and on-site assessment approaches to help clients continue their accreditation work even in the most challenging time. Other resources were released such as toolkits for Infection Prevention and Control Practices Virtual Care, webinars and COVID-related Leading Practices.

Sean Molloy, Director of Patient and Family Centered Care and Care Transitions at North York General Hospital said the accreditation process is “extremely important” even during the COVID-19 pandemic. “It’s extremely important for organizations to continue their accreditation process, as the standards are integral to patient safety, quality and family-centred care,” he said. “The pandemic has changed what we need to do every day, but it hasn’t changed the fact that we need to deliver care in a safe way.”

Utilizing AC’s temporary hybrid, virtual and on-site survey model – born out of COVID-19 – North York General was able to continue its accreditation work through the pandemic.

Stephanie Robinson, Manager, Quality and Service Innovation at North York General, noted that the hybrid experience “worked well” for the organization. “It needs to be highly facilitated, organized and planned but moving forward, we would have no hesitancy in doing it again,” Robinson said.

She added the hybrid survey was a positive experience as it allowed more people to connect without everyone having to be in the same room. “We would definitely continue,” Robinson said. “That’s one of the benefits of the pandemic requiring our hospitals to rapidly become more virtual. It’s been wonderful to connect with people wherever they are.”

In the face of COVID-19, the Children’s Hospital of Eastern Ontario (CHEO) also had to move towards more virtual care delivery.

The organization credits the accreditation process with keeping its systems and practices “at their best,” allowing it to adapt to change quickly. “Our continuous focus on safety, supported by Accreditation Canada’s rigorous process, ensures we are ready to quickly and safely adapt to any situation, even one as all-encompassing as the COVID-19 pandemic,” said Dr. Ken Farion, Medical Director of Strategy, Quality and Systems Improvement at CHEO. 

Like most health organizations in Canada, CHEO was forced to suspend most in-person appointments when COVID-19 began. Dr. Farion adds that with the emergence of COVID, CHEO’s ER, which is one of the busiest ERs in Canada, saw a significant drop in patients. “It suddenly went quiet, and we realized that we needed to reach these families and reassure them and ensure they were getting the care they might need,” he said.

He noted that as the accreditation process required CHEO to have best practices and processes in place, the organization was able to quickly mobilize a virtual ER department. “Providing virtual care is not new to CHEO, but the pandemic increased the need, seemingly overnight, to be able to provide safe online care,” Dr. Farion said.

For AC and HSO, the COVID-19 pandemic has only reinforced the need for high-quality standards and for vigilance on maintaining safe, reliable, person-centred care that can withstand unexpected disruptions such as outbreaks, another pandemic or other disasters.

As quality improvement is an ongoing process, moving forward from COVID-19, AC is working to establish a continuous assessment model. Under OnboardQi, AC and HSO clients will be able to access new assessment methodologies that include virtual surveys, as well as new survey instruments and new, revised and existing standards.

Like North York General and CHEO, Toronto-based Safehaven also credits its early COVID-19 success to AC’s accreditation process, which helped to refine the organization’s health and safety protocols.

Susan Bisaillon, CEO of Safehaven, noted that as the organization was accredited prior to the pandemic in June 2018, they were provided with a sustainable framework for all their policies and procedures during regular operations, as well as in a scenario that required them to manage an outbreak such as COVID-19.

“Even though no one wants to think about dealing with a pandemic, we knew we were prepared,” she said. “When there were challenges and barriers, the thing that kept us grounded was the framework we adopted from Accreditation Canada. We knew that we were in a good place.”

Safehaven offers residential, respite and recreational programs. In the summer of 2020, the organization remained COVID-free. “The measures we put in place because of accreditation actually kept us out of outbreak,” Bisaillon said.

Leslee Thompson is the CEO of Accreditation Canada.