Strategic planning during a pandemic

By Dr. Naveed Mohammad
As hospital administrators, we’re constantly evolving our services and models of care in response to changing health care needs and to further enhance quality and patient safety. But how does this strategic planning come into play when facing a global pandemic that hits close to home?

William Osler Health System’s (Osler) hospitals have been operating within two of the province’s biggest hot spots for COVID-19 – Brampton and North Etobicoke – placing unprecedented pressures on our emergency departments, critical care and inpatient units.

During Wave 1, we treated more patients for COVID-19 than any other hospital system in Ontario. At the time I’m writing this, our testing centres have seen tremendous volumes, leading the province with more than 275,000 tests to date. Since the resurgence of COVID-19 over the past weeks, our current test positivity rate has risen and with high numbers of COVID-19 patient admissions, hospital capacity challenges have emerged.

Like all hospitals, we faced many unknowns when COVID-19 landed on our doorstep, challenging us to think differently about how we sustain access to services, while addressing the resource-intensive needs of patients requiring specialized care.

Rather than taking a step back, we streamlined select action plans aligned with our strategic priorities – quality excellence, organizational effectiveness, health system leadership, and people and culture – accelerating those plans that would best support our teams at the point of care, with a particular focus on technology, partnerships and innovation.


Leveraging technology

Every day, our teams face the difficult task of finding appropriate beds for patients with, and under investigation for COVID-19. The logistics of placing the right patient in the right bed often calls for a herculean effort on the part of several teams. With the onset of COVID-19, we accelerated planning for our Operational Command Centres to facilitate this process.

These physical and virtual ‘hubs’ at each hospital offer teams a 24/7 birds-eye view of where every inpatient is from admission at the Emergency Department to an inpatient bed. They were designed to help reduce patient gridlock, enhance quality and patient safety, and support an improved patient and staff experience. As we move through this second wave of COVID-19 and cold and flu season, we’re fully utilizing our Operational Command Centres to help us manage demand.

At the outset of the pandemic we also advanced our existing virtual care technologies to connect with older patients and those with complex health conditions who are most vulnerable to contracting infections and/or who are isolated, or who face barriers due to distance, transportation and travel/parking costs. To date, we have successfully grown our virtual care program to include more than 30 outpatient clinics.


Strengthening partnerships

While Osler has enjoyed a long history of working closely with government, health care and community partners, these partnerships have never been more crucial than they are today.

Given ours is a voice among many, we have stepped up our relationships with elected officials and public servants. Locally, this includes regular meetings with municipal leaders, Public Health, the Ministry of Health, and provincial and federal representatives.

These efforts helped to increase awareness of our needs and we were pleased to receive support through the province’s recent decision to invest in 87 additional beds at Osler to help manage COVID-19, the flu season and anticipated winter surge. This capacity investment not only helps improve access to care for our patients and communities, but also boosts the morale of our leaders, staff, physicians and volunteers who have been working tirelessly to deliver safe, quality care under often difficult circumstances.

Faced with significant capacity pressures, we’re also grateful to the many Greater Toronto Area hospitals who accepted patient transfers so that we could continue to provide safe, quality care to patients arriving in our emergency departments and admit them onto our units.

Pre-pandemic and beyond, members of the Brampton Etobicoke Ontario Health Team (OHT) solidified a strong partnership that has been instrumental to our region’s pandemic response. From working together to support care and safety in long-term care facilities, to working with the Region of Peel on availability and distribution of PPE, to addressing the needs of vulnerable populations and helping expand options for COVID-19 testing, our joint efforts have proven invaluable.

Advancing innovation

Last, but certainly not least, we have adopted some innovative strategies to help further improve access to care. Among them is the creation of one of Ontario’s first COVID-19, Cold and Flu Clinics. In a bid to keep mild and moderate cases of influenza and COVID-19 out of our emergency departments, we opened the clinic at Osler’s Peel Memorial Centre for Integrated Health and Wellness so residents can get timely access to a COVID-19 test and undergo a medical assessment.

While we’re optimistic these strategies will help address some of the ongoing pressures created by the pandemic, we will continue to encourage our communities to adopt the basic public health measures designed to minimize spread. It’s only in working together as individuals, communities, health systems and a province, that we will truly minimize the impacts of COVID-19 on our hospitals, our patients, and our dedicated health care workers.

Dr. Naveed Mohammad is President & CEO, William Osler Health System.