By: Leah Green, Knowledge Broker, Northwest Region, Provincial Systems Support Program (PSSP) - Centre for Addiction and Mental Health
The COVID-19 Pandemic has posed many challenges to our healthcare system. It has amplified existing system gaps and vulnerabilities, but has also sparked incredible partnerships between hospitals, community mental health & addictions agencies, and a host of other service sectors. These partnerships have been the foundation for a successful system response.
A strong example of this partnership is the Ontario Health North Hospital Diversion & Community Capacity Pandemic Response Table's Mental Health and Addiction Working group that has been meeting regularly throughout the pandemic to coordinate planning efforts, identify challenges, and share a variety of service innovations. Hospitals in North Bay, Sudbury, and Thunder Bay have been busy building new service pathways and partnerships in order to improve patient access and care, and meet the emerging needs in their respective communities. Below, we've featured a few of these innovations.
Increased demand for ED care
In North Bay's Regional Health Centre, for example, the hospital anticipated an increased demand for emergency department (ED) services related to the pandemic. They developed a way to reduce mental health visits within the ED by adopting a triage tool to determine low-risk patients who can be diverted away from the ED and assessed by a crisis team at a different location within the hospital. This innovation provides enhanced privacy for patients, reduced risk of cross-contamination, and improved timeliness of assessments. It has also expedited the process for patients returning for psychiatric visits. Staff have benefited from the seamless transfer of accountability, increased communication, and collaboration. The greater number of PSW and Protective Services staff have been beneficial to assist with care in the ED when not with patients in crisis. View this innovation here.
Addressing longer admission times
Elsewhere, in Sudbury, Health Sciences North was seeing longer admission times for Acute Inpatient Psychiatry due to closure of treatment centers and difficulty in securing housing in the community. This was making it difficult for inpatients and staff to maintain a safe social distance. Meanwhile, Monarch Recovery Services had closed their residential treatment home due to COVID-19, which provided an opportunity for the two organizations to form a unique partnership. Monarch offered their available beds to HSN, and staff were leveraged from both organizations to support a new "Flex-Unit". Patients waiting for housing or treatment beds were supported in this unit, where they continued to receive Psychiatric and Primary Care virtually as they approached discharge and transition out of inpatient care. View this innovation here.
Supporting individuals experiencing homelessness
In Thunder Bay, St. Joseph's Care Group (SJCG) and 11 partner organizations who work with vulnerable populations, quickly recognized that those experiencing homelessness are especially at risk in a pandemic situation, as they have nowhere to self-isolate. The community saw the need to screen and create spaces for potential, probable, or confirmed COVID-19 cases. To do this, they implemented a two-pronged approach: 1) increase surveillance for those with any illness in a space designated as the "illness shelter", where those who were experiencing any non-COVID illness could be housed and monitored, and 2) provide a separate space designated as the "isolation shelter", located in a hotel with individual rooms set aside for potential or suspected COVID-19 cases. Medical teams from both SJCG and NorWest CHC provided care to both locations, and the initiative now showcases a successful collaborative effort to address this unmet need in the community. View this innovation here.
"The pandemic has provided an opportunity to clearly demonstrate what can be achieved through cooperation and collaboration" says Nancy Black from St. Joseph's Care Group in Thunder Bay. "It has been truly inspirational to witness the care, compassion and commitment of community leaders who have effectively and efficiently responded to urgent and emerging community needs."