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ESHC TO POSTPONE ALL NON-URGENT SURGERIES AND REDUCE DIAGNOSTIC IMAGING TESTS BEGINNING MONDAY, JANUARY 4th, 2021.

December 30, 2020

With in-hospital admissions of patients with COVID-19 continuing to rise at an alarming rate and a potential shortage of available acute care beds, Erie Shores HealthCare has made the difficult but necessary decision to postpone ALL non-urgent, pre-scheduled elective surgeries and reducing diagnostic imaging testing for an indefinite period, effective January 4th, 2021. 

 

ESHC will continue to perform surgeries for emergencies and urgent surgeries deemed priorities by the surgical team. Cancer surgeries will continue to be prioritized. Surgeons will review the elective cases that they had booked from January 4th and onwards to contact patients to inform them of their postponements.
Erie Shores HealthCare is working with our regional hospital partners to assess decanting options as needed over the coming days and week(s).

 

The decision was made to address not only bed capacity within the hospital as COVID cases continue to rise but to ensure human resources to support staff as well as bed utilization. Starting immediately, Erie Shores HealthCare will move to a 24-hour onsite leadership coverage to support frontline staff, as well.

 

“Windsor-Essex currently has the highest per capita rate of COVID cases in Ontario. As a result, we have seen an increase in related pressures on our Hospital over the past month and we anticipate these pressures will continue or increase over the coming 6-8 weeks. In order to be available to provide care to the sickest patients in our Community, we now need to again prioritize procedures and surgeries and postpone any elective procedures until this surge is over.”

– Dr. Ross Moncur, Chief of Staff

 

“ESHC is greatly appreciative of the abundance of support from our regional Hospital and EMS partners during this most challenging time. It truly highlights the collaborative approach to the delivery of care across Erie St. Clair.“

- Kristin Kennedy, CEO

 

For more information on how ESHC is working to protect the public from the unnecessary transmission of COVID-19, including COVID-19 Assessment Centre and visitor restrictions, please visit www.erieshoreshealthcare.ca and follow Erie Shores HealthCare on Facebook, Twitter, Instagram for the latest updates.

 

ESHC Pandemic Response Stage 2 – Summary of Service Level Descriptions

DIAGNOSTIC IMAGING

Mammography

All screening studies will be deferred. Diagnostic studies (for patients in whom there is a newly suspected breast malignancy) will be booked on a priority basis.

CT Scan

Only Urgent/emergent outpatient tests will be booked. Priority 3 (Semi urgent) requests will be deferred.

Ultrasound

Only urgent exams will be performed: Paracentesis, Thoracentesis, Biopsies, Obstetrical. All requests will be triaged by radiologist.

Nuclear Medicine

Only outpatient urgent and emergent scans: urgent/oncological bone scans and MUGA scans, urgent lung scans, urgent MIBI scans, GI bleed and urgent Hida scans will be performed. All other urgent scan requests will be triaged by the NM physician.

Gastric

All outpatient gastric exams will be deferred.

X-ray

All outpatient requests will be scheduled on a priority basis (no walk-in service). Maximum 1 patient in waiting room.

CARDIOPULMONARY

PFT

Only pre-operative urgent surgical requests will be booked.

Echocardiogram

Non-urgent outpatient requests will be deferred.

Stress

Non-urgent outpatient requests will be deferred.

OUTPATIENT CLINICS

General Surgery Clinic

Closure of clinic except for one day per week shared among all General Surgeons. MRPs to cancel any patient with non-oncologic or non-urgent need. Max 1 person in waiting area.

Pain & Injection Clinics

All non-urgent pain clinics will be deferred.

AMBULATORY CARE

Ambulatory Care Clinic

(Blood Transfusions, IVIG and IV Venofer) Clinic will be reduced to two (2) days per week to accommodate patients with urgent care needs. Criteria for inclusion will be monitored by IM physicians and administration. Iron infusions will be redirected to the community whenever possible.

 

OTN visits

All OTN services will be postponed or relocated within the community.

INR

Clinic All INR consultations or follow ups will be done in the community.

Pediatric Clinics

All pediatric clinics will be postponed or relocated within the community.

Infant Hearing

All infant hearing clinics will be postponed or relocated within the community.

PERIOPERATIVE

Operating Room

Waiting area closed.

PASC

Closed.

Operating Room

Procedures(General Surgery, Gynecology, Plastic Surgery, Orthopedic Surgery, Dental Surgery, Endoscopy).

Operating Room will be scheduled to allow redeployment of staff to needed areas within the hospital. An average of one (1) room per day will be booked for all services to allow for patient booking on a priority basis with pre-assessment within the Surgical Patient Prioritization Framework (appendix 5). Emphasis will be on patients with the following:

  • Life threatening conditions;
  • Conditions at risk of severe complications resulting in need for surgery within 4 weeks;
  • Aggressive malignancy.

 
Obstetrics

Unchanged.

OTHER

Physician Offices and St Elizabeth’s Clinic Schedule in-person appointments in accordance with Ontario Health recommendations; all patients/visitors subject to screening at entry to building.

 

ESHC Pandemic Response Stage 2 – Questions & Answers

Q. What is a “Pandemic Response Stage”?

 

A. Erie Shores HealthCare has developed a “Deferral of Non-Pandemic Services Policy” which has guided our service offerings throughout the Pandemic. Due to a need to focus our resources on Pandemic services during periods of surge, it has been necessary to delay other procedures. In some cases, for example, staff who normally work in one department may need to be redeployed to another department due to increased patient volumes or reduced staff availability.
Depending on the situation, various “Stages” in the Policy dictate which services will be offered, and at what volumes.

 

Q. What guides the decision to move up and down the stages?

 

A. Various criteria, including the availability of human resources, PPE, community spread, and the level of disease burden within our patients and staff all contribute to decision-making. In addition, our Pandemic Response Stages are tied to the Provincial Public Health Response Categories.
A multidisciplinary team including clinicians and administration at ESHC meet regularly to review the criteria and make consensus decisions regarding changes to the Policy and Stages.

 

Q. What is “Stage 2”?

A. Our Policy describes Stage 2 as appropriate when there is “Confirmed presence of infectious agent within ESHC patients’ geographic region with patients presenting to hospital for diagnosis and treatment and significant burden on hospital resources.” Stage 2 allows for “Services for urgent life-threatening conditions will be maintained as long as resources are available, if severe adverse health consequences are anticipated from delay.”

 

Q. When we will see a move back to Stage 1?

 

A. The multidisciplinary committee will continue to meet regularly and re-evaluate the criteria. As soon as the burden of the Pandemic-related illness is no longer requiring
 

Q. Should we expect to go to Stage 3?

 

A. It is possible that a move to Stage 3 will be required if there is further impact on the ability for the Hospital to care for acute care patients. This could occur if there is a surge in patient volumes, or if there is a significant shortage of human resources.

Stage 3 would limit services to life-threatening conditions only.

Q. What happens to surgical patients who are already booked for surgery?

A. The Perioperative team will be contacting patients who are currently booked for surgery to confirm or postpone their surgical dates. Surgeons will work to prioritize their patients based on acuity of condition. We will continue to perform surgery for patients with the following:
  • Life threatening conditions;
  • Conditions at risk of severe complications resulting in need for surgery within 4 weeks;
  • Aggressive malignancy.
Q. What happens to Diagnostic Imaging and Cardiopulmonary patients?
 

A. The Hospital will be contacting patients who are currently booked for tests to confirm or postpone their appointment dates.


Q. Should referring clinicians stop making referrals for Diagnostic Imaging and Cardiopulmonary procedures?

A. At this time, we request that referring clinicians NOT make referrals that do not fit into the current Pandemic Response Stage 2. All referrals will be reviewed, and those that do not appear to meet the Stage 2 criteria will be returned to the clinician. We will not hold these requests for later booking.

Q. What if a referring clinician thinks that a patient needs a service urgently but they do not fit into the criteria?
 

A. Clinicians are encouraged to contact the relevant Hospital department if they require clarification on criteria, or if they have a particular case which needs individual review.