Northumberland Hills Hospital has issued an update on its continuing transition to a new normal following the COVID-19 pandemic, including the non-urgent surgeries, procedures and tests that have begun to resume in accordance with regional approval received late last month.
Over the past two weeks – in a staged plan developed by the hospital's Service Continuity and Working Group – these have included colonoscopies, cataract surgery, hernia repairs, certain gynecological procedures, a small number of in-person ambulatory-care clinic appointments, selected diagnostic-imaging procedures (like CT scans and ultrasounds) and a limited number of in-person community mental health appointments (at the walk-in counselling clinic at 1011 Elgin St. W., Cobourg).
The update reminded everyone that the government of Ontario invoked the Emergency Management and Civil Protection Act to direct acute-care hospitals on March 19 to ramp down elective and non-urgent services like these in order to preserve system capacity for an effective response to the pandemic. As a result, for almost three months, NHH has performed only emergency and high-priority surgeries and imaging exams. Hundreds of other tests, appointments and procedures, meanwhile, were either postponed or (if appropriate) provided virtually.
Vice-president of Patient Services and Chief Nursing Executive Susan Walsh said ramping down was a new experience for much of her team.
“This was a challenging time for both patients and NHH staff and physicians alike, as we had to adapt swiftly to the risks of a virus we are still learning about,” Walsh said.
“Safety has continued to remain our guidepost and number-one priority and, to that end, I'm very pleased we are now at the point in our region where we can begin to resume non-urgent hospital services.”
NHH is moving forward in two-week increments, the announcement said, resuming a service (or a portion of a service), monitoring patient flow to ensure conditions required for a safe ramp-up remain in place (such as adequate personal protective equipment supplies, for example) and bottlenecks do not occur that could threaten the necessary physical-distancing requirements.
All of this is done within the context of COVID-19, ensuring safe pathways of care for all – and without the benefit of volunteers, who have not yet been permitted to return to hospital duties (in part because of the need to minimize the number of individuals in the hospital in order to ensure safe management of patient flow and physical distancing).
As of this week – the second stage in the NHH plan – the third and final operating-room suite resumes operation and further diagnostic-imaging and ambulatory-care clinic procedures will begin to be scheduled, including X-ray, mammography, nuclear medicine and interventional radiology procedures (specifically, joint injections and pain management).
Those awaiting surgery are being advised by the referring physicians to arrange pre-operative COVID-19 screening, if required. Diagnostic-imaging tests will be scheduled directly by the hospital. IN all cases, pre-screening will also be conducted by hospital staff (by phone) to review a standard set of COVID-19 questions, provide logistical details and answer any questions.
The NHH press release offered a few other details of where things stand.
Accessing COVID-19 testing
The COVID-19 Assessment Centre continues to see high volumes of patients, with demand expected to continue through 2020-21. To date, the centre has supported more than 7,400 virtual and in-person visits, 1.973 of which were completed in collaboration with Northumberland Paramedics at a range of locations, from local retirement homes and long-term-care facilities to Alderville First Nation's Health and Social Services. In these visits, swabs to test for COVID-19 were completed on more than 4,400 individuals.
Relocated within NHH earlier this month from the front entrance to the former IM care offices within the emergency department, the centre is open daily from 8 a.m .to 4 p.m. While walk-ins are accepted, it is strongly recommended individuals call ahead (905-377-7783) to schedule an assessment. This helps minimize wait times for all in support of physical-distancing requirements.
As always, if symptoms are severe, call 911 and alert the dispatcher of the potential concern regarding COVID-19 so responders can prepare appropriately.
Masks
Universal masking continues throughout NHH. Anyone coming into the hospital for an appointment or to the emergency department who has a cloth mask in good, clean condition is asked to bring it along and plan to wear it throughout his or her visit. If worn properly, cloth masks help cover the hose and mouth to prevent respiratory droplets from contaminating other people or surfaces nearby.
Cloth masks (also referred to as a non-medial mask) are recommended in any place where physical distancing of two metres or six feet is difficult, and this includes NHH.
If you do not have a cloth mask, NHH will provide one that you can keep and reuse. The blue non-medical masks distributed this way are generously sewn by a small team of local volunteers using a material designed for the sterilization of medical equipment. Thanks to these Blue Mask Volunteers, many medical-grade masks have been preserved for use by front-line health-care providers.
No mask is useful, however, unless it is worn and removed properly. The Government of Canada has a video with information on the proper wearing of a non-medical mask or face covering to continue to limit the spread of COVID-19.
The Ontario Health Team of Northumberland has also issued a call to local volunteers to sew additional cloth masks for distribution through health and social-service agencies throughout the county.
Food and drink restrictions
Anyone coming into the hospital for an appointment or to the emergency department is asked not to bring food and drink. NHH requires masks to be work by anyone able to tolerate them, so food and drink cannot be safety consumed.
Hand hygiene
Whether at NHH or out and about in the community, washing your hands often is one of the best ways to minimize the spread of potentially dangerous germs. Wash your hands frequently preferably with soap and water. If that is not an option use an alcohol-based hand sanitizer.
For the latest news on COVID-19 and links to useful local, regional and provincial resources, visit www.nhh.ca/covid-19.