Accreditation supports quick, safe change in face of COVID-19: CHEO

August 14, 2020

“Having just been accredited with Exemplary Standing in December 2019, CHEO was well prepared to adapt quickly and safely when the COVID-19 pandemic arrived in March,” said Dr. Ken Farion, Medical Director of Strategy, Quality and Systems Improvement at CHEO. “The accreditation process and its accompanying standards supports us, keeping our systems and practices at their best.”

When COVID-19 began in Canada this spring and health care organizations were forced to temporarily suspend non-urgent care, CHEO had to quickly adapt its procedures. Like most health care organizations, CHEO was forced to suspend most in-person appointments.

CHEO in Ottawa, Ont.

Farion noted that even one day in a child’s development can be critical. “Not only were we forced to suspend most ambulatory care appointments, but we also saw a huge drop in attendance in our Emergency Department (ED),” Farion said. “Our ED is among the busiest in Canada, but it suddenly went quiet. We realized that we needed to reach these families to reassure them and ensure they were getting any urgent care they might need.”

Farion said CHEO mobilized a virtual ED and was the first pediatric hospital in Canada to do so. He said a system of daily online ED appointments was arranged — powered by Epic, CHEO’s electronic health records system, and an information-secure Zoom application.

By the beginning of May, up to 24 patients and families per day were meeting virtually with CHEO ED physicians and other health care professionals. With this new system in place, CHEO was able to see patients who might otherwise have stayed away.

“Providing virtual care is not new to CHEO, but the pandemic increased the need, seemingly overnight, to be able to provide safe online care,” Farion said. “This keeps children, youth and families safe and our staff and physicians safe.”

Farion said virtual care was extended to other areas of the hospital too. To reduce traffic through inpatient units and minimize the risk of infection, daily medical rounds were moved online. “Instead of physicians, nurses, and other health care professionals moving from room to room, the care team now meets remotely with patients and families who are staying in hospital,” he said.

To minimize the number of people coming into the hospital, Farion noted that CHEO extended virtual care to in-person appointments, allowing children and youth to safely access the care they need. Since May, approximately 50 per cent of ambulatory appointments at CHEO have been virtual.

“Our continuous focus on safety, supported by the rigorous Accreditation Canada process, ensures we are ready to quickly and safely adapt to any situation, even one as all-encompassing as the COVID-19 pandemic,” Farion said.

CHEO staff members wearing masks.

Farion adds CHEO is now focussed on moving to the “new normal.” He noted that many of the new virtual care measures will remain and be continuously improved, in partnership with patients, families and staff.

Soon, for example, family members who are essential partners in the care team will be able to participate in daily medical rounds from home, overcoming the limit of a single, family caregiver at the bedside being able to participate.

“Focusing on what matters to families and putting safety first has enabled CHEO to implement these changes at COVID-speed,” Farion said. “It has been remarkable to see how quickly we have been able to expand our care and safely adapt our procedures.”