COVID-19 Pathway May 5, 2020 Healthy People, Healthy Saskatchewan - - PowerPoint PPT Presentation

Healthy People, Healthy Saskatchewan

The Saskatchewan Health Authority works in the spirit of truth and reconciliation, acknowledging Saskatchewan as the traditional territory of First Nations and Métis People.

May 5, 2020

COVID-19 Pathway

Introduction

COVID-19 Pathway

• In preparation for the anticipated demand on healthcare

services for COVID-19, physicians and administrative leaders within the SHA have created a COVID-19 Pathway that outlines a framework for how patients (COVID-19 and non-COVID-19) best access and flow through the healthcare system at a local and provincial level.

• The COVID-19 Pathway framework includes the flow of

patients through acute care, community services and focus points for vulnerable populations.

Scope

COVID-19 Pathway

• The COVID-19 Pathway is a provincial roadmap that
• utlines the care journey for patients (COVID-19 and non-

COVID-19) from the time they seek medical advice (e.g., 811, 911, family physician, emergency department) through the community or acute care and back home.

• The pathway:
• Outlines the optimal flow for patients
• Identifies provider and system roles
• Builds supports required at each step of the patient’s journey.

Goal

COVID-19 Pathway

The goal of the pathway is to:

• Ensure patient and provider safety during the pandemic.
• Improve teamwork and interdisciplinary collaboration.
• Improve practitioner awareness and understanding of their role

and the interdependency of their role, as well as system supports available and how these supports contribute to the patient journey.

• Improve the alignment, coordination and efficiency in our

response to COVID-19.

Key Supporting Initiatives

COVID-19 Pathway

Resource Coordination

Links to strategies and processes for population health, primary care and palliative care to ensure coordinated entry and exit from acute care.

Clinical Standards Support

Standardization of clinical documents such as order sets, work standards, algorithms and other tools to support consistent practice throughout the SHA.

Clinical Training and Practice Resources

Resources for clinical training and practice for advanced airway management will be available shortly. Skill lists to identify individual competency gaps and teams with the necessary capabilities are available on the COVID-19 website. An inventory

• f learning resources to support training is in development.

Evidence Support Think Tank

Link academic and clinical expertise to establish a repository and to synthesize new and emerging evidence based on the COVID-19 pandemic.

How It Relates to Connected Care

COVID-19 Pathway

Connected Care for the People of Saskatchewan is the SHA’s service delivery model. Throughout COVID-19 pandemic planning, the SHA continues to mobilize in a way to ensure we meet the objectives of our pandemic planning strategy: detect, contain and mitigate while maintaining the foundation of our healthcare system: Connected Care.

How to Use the Pathway

COVID-19 Pathway

Use the COVID-19 Pathway to:

• Create service connections for patients by providing a visual

representation of seamless service alignment through consistent processes and coordinated use of resources.

• Provide the framework for provincial standardization of related processes,

tools, order sets and required training to mitigate risk from variation. Consistency supports patient and staff safety, improved outcomes and patient satisfaction.

• Improve practitioner awareness and understanding of their role and the

interdependency of their role, as well as system supports available and how these supports contribute to the patient journey.

Your Role

COVID-19 Pathway

As a leader, your role is to:

• Continue to identify and communicate gaps where processes are

not clear.

• Collaborate in the development and promote the usage of

standardized clinical documents to help manage and improve the process.

• Incorporate new best practices based on sound evidence during

the COVID-19 pandemic.

Acute Care Pathway

Purpose

Acute Care Pathway

• To streamline the entry and exit points of all patients flowing through acute

care.

• To serve patients suspected of or diagnosed with COVID-19 requiring in-patient

medical care due to trauma and/or medical conditions unrelated to COVID-19, non-threatening COVID-related symptoms or COVID-related acute respiratory distress.

• To identify designated COVID intubation sites that will provide airway

management for patients diagnosed or suspected of COVID-19. The highest level of safety for medical staff and patients is achieved by ensuring that an airway team is present, skilled and trained for these events.

Goals

Acute Care Pathway

• Mobilize specialized expertise to support providers throughout the

province.

• Ensure that COVID-19 patients with medical needs receive timely,

standardized best practice care that is informed by current evidence.

• Coordinate and standardize the transportation of patients.
• Utilize hospital capacity in a coordinated way to meet current and

future demand.

Key Supporting Initiatives

Acute Care Pathway

Coordinated Patient Flow Plans Includes role descriptions of COVID-19 ready facilities and EMS Bypass Protocols. System Flow Coordination Centre (SFCC) Provides centralized support to inform decision-making in primary care and small hospitals, as well as administrative support for decisions about patient disposition and transport destinations. COVID-19 Order Sets Critical Care, Medicine and Emergency order sets have been developed. Other COVID-19 related order sets have been created or are in development for Maternal Children’s, Palliative and Long-Term Care. Clinical Standards Standards will be supported by training for advanced airway management and COVID Physician Access Line personnel. Designated Intubation Hubs Identify and support through training and simulation designated sites that will serve as intubation hubs throughout the province.

System Flow Coordination Centre (SFCC)

Acute Care Pathway

What is it? A single, system-wide Physician Access Line and provincial bed flow coordination service. All patient admissions and transfers (COVID-19 and non-COVID-19) will be coordinated through the SFCC. It will enable us to see all patients and bed capacity, and work together as a province to meet and care for patients in the right place, at the right time, as close to home as possible.

Visual

Acute Care Pathway

INCLUDE VISUAL OF PATHWAY

Located at www.saskatchewan.ca/COVID19 in Information for Health Care Providers > Clinical Practice Resources > COVID-19 Pathway

Community Care Pathway

Purpose

Community Care Pathway

• To follow the patient experience (both COVID-19 and non-COVID-19)

through the primary healthcare system.

• To follow patients seen at Assessment and Treatment Sites for both

COVID and non-COVID-related health concerns.

• To follow patients transitioning from the community into acute care

and from acute care into the community, including post-acute supports and services.

• To serve as a communications tool to help providers understand how

and where to assess COVID-19 and non-COVID-19 patients.

Goal

Community Care Pathway

To connect the following system access points to support the patient journey:

• Screening, Public Health, Testing Sites, Assessment and Treatment

Sites

• Primary Care Clinics
• Family Physician Offices
• Virtual Care
• Vulnerable Populations
• Intermediate Care
• Continuing Care

Visual

Community Care Pathway

INCLUDE VISUAL OF PATHWAY

Located at www.saskatchewan.ca/COVID19 in Information for Health Care Providers > Clinical Practice Resources > COVID-19 Pathway

Supports and Services

Vulnerable Populations

• Working in partnership with other organizations and communities,

individuals without financial and social means will be supported to safely and effectively self-isolate as directed by the provincial public health order.

• A standard approach to assisted self-isolation sites (ASIS) will be

developed provincially and implemented locally based on local resources and preferences (e.g., hotels, schools, churches). We will also develop an integrated system for active case finding, monitoring, sentinel surveillance and public health reporting.

Virtual Care

How Virtual Care Will Support the Pathways

Virtual Care

• Provider to patient videoconferencing (PexIP)
• Decreasing exposure while providing care
• Assessment and Treatment Sites, Inpatient Virtual Care, Long-Term Care
• Decreasing visits to emergency rooms and minor emergency clinics
• 811 – Second level physician triage
• Online medical control for “Treat and Release”
• Ongoing remote assessments
• Virtual Care Medicine Clinic
• Virtual Critical Care Clinic
• In-home and hotel-based community care
• Home health monitoring
• Improving and ensuring information flow as a foundation for Virtual Care

Next Steps

COVID-19 Pathway

We will continue to advance this work by:

• Identifying intermediate care requirements and resources to address

needs.

• Engaging in post-acute care planning for continuing care residents who

may require acute care services.

• Establishing deeper connection points for contact tracing and monitoring

to prevent the spread of the virus.

• Incorporating linkages with pathology for management of the deceased if

demand exceeds capacity.

• Linking it to the Connected Care strategy.

Questions?