Quality improvement still important, even amid pandemic response, says CEO of Muskoka Algonquin Healthcare

November 25, 2020

Accreditation allows health organizations to showcase the excellent work they are doing, even during the COVID-19 pandemic, says Natalie Bubela, Chief Executive Officer (CEO) at Muskoka Algonquin Healthcare (MAHC).

“I think that through a pandemic, it’s important to continue to ensure the focus isn’t just on pandemic response, but also on continuing to achieve quality in an organization,” Bubela says.

Natalie Bubela, CEO of Muskoka Algonquin Healthcare and Surveyor for Accreditation Canada.
Natalie Bubela, CEO of Muskoka Algonquin Healthcare and Surveyor for Accreditation Canada.

Bubela, who has been a surveyor for Accreditation Canada (AC) for nearly 20 years, notes that accreditation is an opportunity for an organization “to showcase and validate” the quality of care being provided.

“Though it could be seen by some as a distraction, given that there are limited resources in hospitals right now, the accreditation process ensures standards are being met and quality care is being provided.”

Bubela adds “there is no question” that surveying, even during a pandemic, is important. “The accreditation process really helps peer hospitals and other organizations be the best they can be,” she says. “I also think that it’s a great motivator for staff who through the process, are recognized for what they’ve been able to accomplish.”

Bubela notes that in the face of COVID-19, MAHC – like all Ontario hospitals, had to ensure it was ready to deal with a possible worst-case scenario.

“It was a very busy time for us at the beginning of the pandemic,” she says. “We had to look at all of our policies and protocols. We had to look at how to manage visitors and make exceptions. We had to figure out how to ensure our staff, physicians and patients were safe and protected.”

MAHC provides emergency services and inpatient care at two acute care sites in Huntsville and Bracebridge, Ont. To date, MAHC has cared for eight COVID-positive inpatients, 11 COVID-positive emergency department patients and performed 3,605 swabs to test for COVID.

Two surgical nurses at MAHC.
Two surgical nurses at MAHC.

Additionally, Bubela says MAHC operates in older facilities, which can be a challenge in itself during a pandemic. “For example, we had minimal negative pressure isolation capacity and needed to increase that quickly,” she says. “In addition, we needed to understand what the patient flow within the organization would be and how to manage aerosol generating procedures. Our Command Structure facilitated these decisions and the safe implementation.”

Though Bubela currently holds an administrative position, she was previously a Clinical Nurse Specialist in cancer care. She notes that at the time, AC was looking for surveyors with experience in cancer care and she was encouraged to apply. “At the very beginning, most of my surveys were more cancer centre-related and then, they became broader.”

Bubela shares that what she enjoys about being a surveyor is the ongoing learning that takes place. “It’s seeing an organization that’s doing really well and how they’ve achieved that,” she said. “Some of that knowledge has been brought back to my organization.”

She notes that one of her most memorable surveys was in Edmonton, Alta., while she was surveying an intensive care unit (ICU). Bubela shares that the ICU team was discussing the issue of ‘no codes,’ which is related to whether or not a person should be resuscitated.

Rather than discussing whether it was a code or no code situation, Bubela says the ICU team discussed the different levels of care that would need to occur around a potential end of life situation. “Many physicians and staff endorsed this approach,” she says. “The physicians talked about how important this approach was and how it led to more comfortable conversations with families.”

In terms of the ongoing pandemic, Bubela says it’s important to be vigilant and continue to follow Public Health guidelines. “It’s important to follow guidelines around physical distancing, wearing your mask, staying in your bubble, washing your hands – it’s all of those things,” she says.

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