This note provides a summary of Canadian and international experiences with re-opening non-COVID- 19 activities in hospitals.
*The full version of the Briefing Note including Supporting Evidence and the Appendix can be accessed in the PDF file at the top of the page*
- Approaches Being Used:
- Canada: Most provinces and territories have resumed elective and non-urgent surgeries, as well as other specialized services in hospitals (e.g., oncology, medical imaging activities). A few provinces have made publicly available detailed strategies and frameworks to move forward (notably British Columbia, Ontario, and Quebec). These plans usually detail infection prevention and control measures, as well as other changes to delivery arrangements to ensure optimal and safe care for both patients and staff. These plans to resume non-COVID-19 activities in hospitals have often been flagged in provincial economic and social response plans as the first stage to re-emerge from COVID-19 shutdown.
- International (Australia, China, New Zealand, South Korea, Sweden, and the United Kingdom): Australia and New Zealand have developed publicly available strategies to move forward with the re-opening of non-COVID-19 activities in their hospitals. The findings from other countries focus particularly on the prioritization of elective procedures once services resume.
- Innovative Approaches: Approaches include scaling up/down emergency room capacity and ‘bypassing’ hospitals and providing services in other locations, as well as implementing surge-management models, triage protocols for services and personal protective equipment, infection prevention and control measures, and virtual visits by dedicated ‘internet hospitals’.
- Potential Pitfalls to Avoid:
- Service planning for COVID-19 treatment: Avoid overlap in roles and responsibilities among those coordinating changes in the hospital, determine early on which staff members are ‘deployment ready’ for potential COVID-19 activities, and do not underestimate the importance of orientation and instructions related to infection prevention and control measures.
- Service planning for the ongoing management of other conditions: Do not compromise the prognosis of cancer patients by deviating from department guideline-recommended radiotherapy practices, and reduce patient travel to receive health services.
- Workforce planning: Avoid any form of discrimination against frontline health workers and their family members.
The COVID-19 Evidence Synthesis Network is comprised of groups specializing in evidence synthesis and knowledge translation. The group has committed to provide their expertise to provide high-quality, relevant, and timely synthesized research evidence about COVID-19 to inform decision makers as the pandemic continues. The following members of the Network provided evidence synthesis products that were used to develop this Evidence Synthesis Briefing Note:
- McMaster Health Forum/Rapid-Improvement Support and Exchange. May 13, 2020. COVID-19 Rapid Evidence Profile #7: What are the international lessons learned from re-opening non-COVID-19 activities in hospitals?
- Ontario Health (Quality). May 8, 2020. Ambulatory and Primary Care Services Ramp-Up Planning to Inform the COVID-19 Response Effort: A Jurisdictional Scan.
- The Ontario Medical Association. May 11, 2020. Reopening Ontario to a ‘New Normal’: Five Public Health Pillars for a Safe Return.