By Raj Kohli and Dr. Roger Goldstein

West Park’s newly expanded Long-Term Ventilation Unit (LTV) comes at a time when Intensive Care Unit (ICU) resources could become scarce in acute care centres, especially as they prepare for a potential second wave of COVID-19.

A great deal of the concern around a potential second wave is that the vast majority of people across Canada are still susceptible to the disease and that it could coincide with what is typically influenza season.

During the first wave of the COVID-19 pandemic, the Toronto Region requested that West Park expand bed capacity rapidly and our team acted fast, adding 23 beds to support intensive care units.

West Park is also using its experience as the provincial LTV Centre of Excellence to take a lead role in moving medically stable ventilated patients out of the Greater Toronto Area ICUs into newly expanded LTV beds not only at West Park, but in partnership with two other Toronto hospitals. West Park and our partner hospitals are caring for patients who are invasively ventilated and occupying an ICU bed but could be moved to an alternative care setting, freeing up much needed ventilators and ensuring that ICUs are being used to their maximum benefit t should there a surge of COVID-19 cases arise.

LTV beds in post-acute care settings are in high demand, typically have a long waitlist, and serve those who have had an acute trauma or severe illness such as ALS. During a pandemic, there is additional pressure  to free up acute care space and the additional beds at West Park have allowed acute care partners to do just that.

West Park’s expertise in long-term ventilation and rehabilitation makes it an ideal partner in the effort to free up acute care ICU beds. Decision makers across the system realized some years ago that as people in an ICU become stable some still depend on a ventilator for life support and continue to occupy these beds without requiring ICU level of care.   Transferring these patients is not only good from a system perspective; it improves the quality of life for these patients.   West Park provides an environment enriched with recreational therapy, access to the outdoors and the ability for families and caregivers to be active members of the care team.

For some of our patients, we provide comprehensive training to caregivers on mechanical ventilation, medication and personal care. This is complemented with therapy to optimize their physical, cognitive and emotional well-being. West Park collaborates with its external partners to follow the patients as they transition back to the community.

While we were pleased to be able to expand and contribute in wave one, the true benefit of West Park’s leadership and the expanded bed capacity will be during wave two. If that second wave hits differently and we do end up having packed ICUs, West Park will be ready to assume its role.

Raj Kohli is the RRT Clinical Practice Leader- Respiratory Therapy  Clinical Coordinator, Long-Term Ventilation Strategy and Dr. Roger Goldstein is  Specialist, Respiratory Medicine and Senior Scientist at West Park Healthcare Centre.