CTU Redeployment Orientation - January 15, 2021
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CTU Redeployment
Orientation
January 15, 2021
Objectives 1. Redeployment schedule and expected activation 2. Shared COVID protocols 3. Site Specific Orientation 4. Questions
Principles of Redeployment • 7 day redeployment block • Monday to Monday • JMR lists • all PG residents except most medicine subspecialties • SMR lists • shared with Critical Care • from medicine subspecialties and those with critical care skills • 2 categories of redeployment – Gap and Surge Coverage • subject to a change in assigned category, depending on service needs
Principles of Redeployment • Internal Medicine • residents are also recruited and placed on the redeployment list • residency workforce resources are utilized before Postgrad redeployment is activated • We anticipate that you will require orientation to the assigned clinical area • This can also be provided by the SMR or CMR on the first day of your redeployment • Red Book • Please feel empowered to request supervision when needed, and to decline a delegated task if you are uncomfortable performing without direct supervision • Residents who have been redeployed once will be placed at the bottom of the list to be considered for the next request for a redeployment.
DOM Faculty Response to the Pandemic – Awesome!
Gap Coverage • Coverage of individual nighttime call gaps due to COVID related attrition/absenteeism • Usually notified by 1000 am same day • Released from call for that specific night, only if no request by 1700 pm • Maximum of 2 calls shifts, not more than one 24-hour shift • Weekday call - 1700 – 1000 • Weekend call – 0900 – 0900 https://pgme.mcmaster.ca/home/coronavirus-updates/redeployment-details/
Surge Coverage
• Coverage of service gaps activated when hospitals reach critical
threshold of patient numbers
• Assume the regular duties of a resident assigned to the CTU
• daytime ward rounding and nighttime calls roughly consistent with roster of
resident being replaced
• Notified prior to 1700 on the Sunday before redeployment week
• released from call for that specific week, only if no request by Sunday 1700
• Maximum of
• 5 daytime weekday ward duty – 0800 – 1700, plus
• 2 call shifts, not more than one 24-hour shift
https://pgme.mcmaster.ca/home/coronavirus-updates/redeployment-details/Activation and Release
• You will hear from the following by phone or pager if activated (please provide to
PGME):
• SJH: Dr. Andrew Cheung
• JH: Dr. Samir Raza
• HGH: Dr. Marianne Talman
• For Gap Coverage
• requests usually come mid morning on same day night call is required
• if you have not heard by 1700, you are released for that specific night
• For Surge Coverage
• requests may come a few days in advance or on the day before redeployment week (Sunday)
• if you have not heard by 1700 on Sunday night, you are released for that specific weekShared Protocols Across Sites
COVID Outbreak Wards • HHS • ED • 5W • Short Stay Medical Unit • Juravinski • E3 • St. Joseph’s • CTU West • Tracking for contact tracing • personal log for ward movements – time and motion • charting on each patient
Protected Code Blues
• Occurring at all sites
• Specific Differences:
• N95, shield and impermeable gown is required before any AGMP (bagging,
intubation)
• Minimize movement in and out of rooms
• Most senior provider intubates
• SMRs are asked to attend codes as a member of the team, even during the
rollout of Protected Code Blue TeamsCOVID specifics: Entrances • SJH: Fontbonne Entrance, Roof deck entrance (off St. Joseph’s Drive); James street south entrance, Juravinski Tower Level 0. • *Will be provided 2 masks • JH: Between Cancer Center and Main Hospital (beside Breast Assessment Center) or Emergency Department • *Bring a mask or enter at the front doors • HGH: Parking ramp, entrance off Copeland near McMaster Wing • *Bring a mask or enter at the front doors
Self-Screening SJH HHS
Universal Masking
• Wear a Shield for all patients in the ER
• Wear a mask while in clinical spaces
• If you are removing your mask to eat, ensure you are greater than 6ft from others
• Ask patients to mask during direct contact, if feasible. If not feasible, health care
worker must have shield
Donning and Doffing
https://pgme.mcmaster.ca/home/coronavirus-updates/ppe-information/Donning
Doffing
Site Specific Details
SJH Handover • Handover occurs at 8 am each morning in our designated handover areas • Team A - CTU West Conference Room • Team B – 6GI Conference Room • Team C - CTU North Nursing Station 2 • Team D - CTU North Nursing Station 1 • Team E - ED Consult Room/Page Staff • Team F - CTU Central Nursing Station • Team G - CTU West Nursing Station • Report for call to CTU West Conference Room at 5 pm, where you will meet with the SMR and rest of the call team
Special Wards/Units
• COVID Unit
• All confirmed COVID-positive patients will be admitted under the MD-based Team F MRP
• Medicine residents will be responsible for admitting any COVID-positive patients overnight
• Other services (e.g., nephrology, surgery, psychiatry) will admit their own COVID-positive patients under the Team F
MRP
• JMRs will be expected to cover the Team F pager overnight and are able to address overnight issues -- JMRs and
SMRs should receive handover daily from Team F PA/MRP and SMRs will be available to support you
• Warm Unit
• All patients under investigation (PUI) for suspected COVID will be admitted to the "Warm Unit” on CTU West
• These are often patients who may have a negative NPS but high clinical suspicion (i.e., clinical syndrome or from
breakout setting) -- they may require repeat NPS and/or sputum PCR to rule-out COVID infection
• GIM teams may have patients admitted here and you are responsible for rounding on them and covering them
overnight
• MSCCU
• Step down unit for medicine patients and level-two ICU, manages everything short of intubated patients
• Teams A/B/C/D often have patients who are admitted here and JMRs are responsible for rounding on these patients
during the day as well as covering them overnightSJH Sick/Absence Notification • Please email the following people if you are unwell: Dr. Andrew Cheung (CTU Director): andrew.cheung@medportal.ca Chief Residents: CMR@stjosham.on.ca Your Staff Person EHS: 905-522-1155 x 36131 (COVID) ; 33344 (non-COVID)
Juravinski Hospital Handover • Team Handover Spaces • B3 charting room • F3 charting room • E3/F3 conference room • If you are unsure where to go, there will be an SMR during the daytime in the ER consult room. • On weekdays, report for call to the E3/F3 conference room at 5pm
Special Wards/Units
• 2 COVID units at JH
• M3 – low acuity COVID pts, Team F
• F5 – higher acuity COVID pts, Team X
• Medicine residents will be responsible for admitting any COVID-positive patients
overnight
• residents will assist with overnight coverage of these patients, but will not be
expected to round on these patients day to day
• Currently in outbreak - you will not be assigned to outbreak wards for
daytime rounding
• Observation UnitJH Sick Notification • Please email the following people if you are unwell: Dr. Samir Raza (CTU Director): samir.raza@medportal.ca Dr. Leslie Martin (Dep PD): leslie.martin@medportal.ca Chief Residents: juravinski.chiefs@gmail.com Your Staff Person EHS: 905-521-2100 x 42200 (COVID) ; 42314 (non-COVID)
HGH Handover • Day 1: Everyone will meet in the 8N conference room • Team Rooms • Team A: Thornton conference room • Team B: 8N teaching • Team C: 5N teaching • If you are unsure where to go, there will be an SMR during the daytime in the consult room. • Report for call to the ER consult room at 5pm
Special Wards/Units
• COVID unit is on 5W
• COVID + patients are admitted to the MD based Team X
• Medicine residents will be responsible for admitting any COVID-positive
patients overnight
• Similar to SJH, residents will assist with overnight coverage of these patients,
but will not be expected to round on these patients day to day
• Step Down Unit on 8SHGH Sick Notification • Please email the following people if you are unwell: Dr. Marianne Talman (CTU Director): talmanm@mcmaster.ca Chief Residents: hghcmr@gmail.com Your Staff Person EHS: 905-521-2100 x 42200 (COVID) ; 46307 (Non-COVID)
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