Read new visiting guidelines and other COVID-19 updates here.

Staff COVID-19 Updates

This page is for HHS STAFF and will be updated regularly.

We would like to thank our staff for the ongoing efforts throughout this unprecedented time. Please check this page or The Hub regularly for any COVID-19 updates. If you have questions that aren’t addressed here, please email staff-covid19@hhsc.ca.

Select a topic below to learn more.

Today's Daily Dispatch: What you need to know

March 31

What you need to know

• In addition to the visitor guidelines that came into effect on March 20, we want to provide you with updated information regarding families dropping off personal items for patients, the email-a-patient service and WiFi access.

• As of April 2, staff and physicians are required to complete online screening before reporting to work. The self-screening tool is a quick and convenient way for you to screen for any symptoms of COVID-19 prior to your shift. Access the tool by visiting staffscreen.hhsc.ca. Copy and paste the address into your browser either inside or outside Citrix. Please note: If you are a physician or other healthcare professional without an HHS ID number, enter zero in the ID field and proceed to the screen questions.

• Tomorrow, patient meals are changing. The Nutrition Services team has put in place a phased planning approach in response to the challenges that the COVID-19 pandemic is expected to bring to our sites. This staged response ensures we can be prudent with staffing and resources while accommodating an expected increase in patient volumes and resource requirements. Read the full memo.

• Read how updates to healthcare worker testing criteria will impact you if you have symptoms.

• The Ministry of Health has established a new, temporary process for billing for uninsured patients. Understand how these changes affect patient billing at HHS.

What you need to do

• Watch today’s all-staff webinar with some of our leaders addressing your COVID-19 related questions, now available on our YouTube page. All COVID-19 webinars are posted to The Hub and our Staff COVID-19 page on the external website.

• The Ontario Hospital Association (OHA) is asking hospital staff to take a few minutes to reinforce the message that Ontarians need to stay home to reduce the spread of COVID-19 and to protect our hospitals from being overwhelmed. They launched a new social media campaign and are asking hospital staff to help by recording a quick video, on your phone, telling Ontarians to stay home. Click this link and follow the instructions. It’s important for Ontarians to see the faces of the people behind their care, and to hear authentic messages of how important it is that they stay home. OHA is committed to getting these video messages in front of tens of thousands of Ontarians to flatten the curve!

What is happening elsewhere

VIDEO: Empowering and protecting your family during the COVID-19 pandemic

PPE Conservation

The COVID-19 pandemic has created substantial demands on personal protective equipment and the entire world is experiencing production and logistics disruptions. Conservation measures and practices must be followed by everyone across HHS to ensure products are available for the safety of our patients and our care providers—we are all in this together. Please refer to the resources for what HHS is doing to make the best use of our PPE resources, what departments need to do as a collective, and what you, the individual, can do to help.

PPE Decision Making – Staged Approach memo  (March 30)
PPE Conservation Quick Reference
Isolation Room Checklist
PPE Conservation Checklist
PPE Conservation -Process Observation Cards
PPE Conservation Workflow Redesign Team Action Plan
PPE Re-Use and Extended Use Guidelines
PPE Re-Use Step-by-Step Instructions

Emergency Government Order | Redeployment

Update on staff redeployment and alternate work arrangements (March 28)

The provincial government announced that a temporary order had been issued under the Emergency Management and Civil Protection Act (EMCPA) that would facilitate the ability of hospitals to implement redeployment plans to respond to the COVID-19 pandemic.

Under this temporary order, issued on March 21, hospitals will be able to respond to, prevent and alleviate an outbreak of COVID-19 by carrying out measures such as:

• Redeploying staff within different locations in (or between) facilities of the hospital;
• Redeploying staff to work in COVID-19 assessment centres;
• Changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work;
• Changing the scheduling of work or shift assignments;
• Deferring or cancelling vacations, absences or other leaves, regardless of whether such vacations, absences or leaves are established by statute, regulation, agreement or otherwise;
• Employing extra part-time or temporary staff or contractors, including for the purpose of performing bargaining unit work;
• Using volunteers to perform work, including to perform bargaining unit work; and
• Providing appropriate training or education as needed to staff and volunteers to achieve the purposes of a redeployment plan.

Under the temporary order, these redeployment plans temporarily supersede the provisions of a collective agreement, including lay-off, seniority/service or bumping provisions. Other collective agreement and HHS policies provisions continue to be in effect.

HHS has created a Central Redeployment Centre which is responsible for coordinating staff redeployment to ensure adequate staffing levels are maintained to new service areas and service areas experiencing volume pressure. Our hospital staff are the most important resource in supporting patients.

The temporary measures are necessary to ensure the Hospital is able to effectively redeploy staff to where help and support is needed most. This time-limited order is valid for 14 days unless revoked or renewed in accordance with the Emergency Management and Civil Protection Act.
Further communication will be coming shortly around the redeployment initiatives and next steps.

We recognize that information continues to change rapidly. We are continuing to work closely with our union partners to ensure everyone is receiving regular updates and to answer questions in a proactive and collaborative way.
We appreciate your co-operation and understanding as we work to support a safe and healthy work and patient care environment.

Michele Leroux – VP, Human Resources

Screening, Testing, & Reporting

Criteria for COVID-19 testing of healthcare workers

Effective March 31, 2020, the criteria for healthcare worker COVID-19 testing at HHS have changed:

  1. Healthcare workers who have a fever of 38 or higher, or new onset or worsening of cough, or difficulty breathing need to contact Employee Health Services (EHS) at covidforms@hhsc.ca or ext. 42200 to be referred for COVID-19 testing. They must not come to work until cleared to do so by EHS.
  2. Healthcare workers who are experiencing any two of the following minor symptoms, unexplained runny nose, sore throat, headache, muscle aches, nausea, anosmia (loss of smell) *new or diarrhea need to contact Employee Health Services (EHS) at covidforms@hhsc.ca or ext. 42200 to be referred for COVID-19 testing. They must not come to work until cleared to do so by EHS.
  3. *New Healthcare workers who are experiencing only one of the above minor symptoms, need to contact Employee Health Services (EHS) at covidforms@hhsc.ca or ext. 42200 to be referred for COVID-19 testing. They are allowed to continue working, wearing a mask, while awaiting their test result.

Self-screening

As of April 2, staff and physicians are required to complete online screening before reporting to work. The self-screening tool is a quick and convenient way for you to screen for any symptoms of COVID-19 prior to your shift. Access the tool by visiting staffscreen.hhsc.ca. Copy and paste the address into your browser either inside or outside Citrix. Please note: If you are a physician or other healthcare professional without an HHS ID number, enter zero in the ID field and proceed to the screen questions. Read our FAQs for more information.

Resources for staff and physicians

Managing asymptomatic patients who are in self-isolation following international travel (March 17, 2020)

Clinical direction is provided in this document.

Screening questions for staff and physicians interacting with patients (updated March 6, 2020)

  • Staff at all entry points (clinics and EDs) to HHS now need to ask patients about travel outside Canada in the last 14 days when screening them for potential exposure to COVID-19.
  • Staff must also ask patients if they have been in contact with someone with a suspected or confirmed COVID-19 case or who has returned from travel outside of Canada in the last 14 days before getting sick.

Testing guidelines and reporting to Public Health

Physicians and hospitals are required to report a suspected or confirmed case of 2019-nCoV to their local medical officer of health. Necessary measures to investigate, complete lab tests and conduct case and contact management will then be conducted by the local public health unit.

Personal Protective Equipment (PPE)

​​​​​​​​​What’s happening now

Earlier this week, HHS moved to an extended PPE protocol in emergency departments and in our ICUs as the first step in our phased approach. The rationale is based on:

  • High acuity and high risk situations where patient status is unknown;
  • Existing high use of PPE due to large number of patients in additional precautions.
  • Opportunities to reduce PPE usage by extending the use particularly of masks and respirators in this specific area of the hospital to preserve supplies.

What this mean for ED staff

  • Staff should be keeping their first surgical mask on until grossly soiled or wet, or until a N95 respirator is needed for an aerosol generating procedure (e.g. intubation).
  • After the procedure, the N95 will be kept on until grossly soiled.
  • At this time, re-use of masks or N95 respirators, e.g. donning and doffing after a break, is not recommended in this setting

PPE Donning and Doffing Instructions (March 21)

PPE directive (March 15, 2020)

  • Droplet and Contact Precautions are recommended for the routine care of patients (includes non-intubated patients in critical care) with suspected or confirmed COVID-19.
    • Generally, a N95 respirator is not required, including for NPS swabbing.
  • Airborne Precautions should be used when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19.
    • Primary examples of AGMPs would be intubation, bronchoscopes BIPAP, CPAP, high flow oxygen, bronchoscopy.
  • For suspected or confirmed COVID-19 intubated patients in adult critical care:
    • N95 respirator should be worn by the bedside nurse
    • A surgical procedure mask is to be used by all other healthcare providers with short exposure
    • N95 may be worn by healthcare workers manipulating the tubes resulting in an increased risk of disconnections

Staff safety – Masks

  • We continue to prioritize fit testing of N95 masks for staff and physicians in clinical areas most likely to be involved in potentially caring for 2019-nCoV patients.
  • Given the low risk level in Ontario, wearing masks during screening is not required. One of the best defenses currently is hand hygiene and keeping hands away from the mouth, nose and eyes.
  • Patients who are showing infectious respiratory symptoms, no matter the presumed cause, should be instructed to don a surgical mask.

Staff safety – N95 mask fitting

UPDATE: List of priority areas and contact information

  • If you are working in an identified high risk area, which is one of the areas most likely to be involved in providing care, please ensure your mask fit test is current within the past two years.
  • Staff and physicians who are not involved in caring for PUIs or do not require an N95 for their normal duties do not require that level of protection.​

Supplies, Equipment & Logistics, Finance

Preserving phone lines for patients and clinical work (March 18)​​​​​​​

The main number HHS 905-521-2100 is very busy and especially at 9am each day. Our Health Information Technology Service (HITS) team is offering the following tips to help preserve this number for patient care and clinical purposes:

Please try to schedule conference calls after 10am.

• Use Skype or Zoom Conferencing where applicable and reserve the ext 73111 and ext 49992 conference bridges for clinical use.
• For KW, Foundation, HITS, and Community & Population Health users, please use Avaya Equinox on your laptop as first choice to make calls if you have the application installed to avoid calling the main number on your cell phone.
• Please try to reduce the number of calls made to the main number from your cell phone. This takes up incoming lines.

Personal Protective Equipment (PPE) Supplies Management (Update on March 5, 2020)

  • HHS is working with suppliers and our Mohawk Medbuy warehouse partners to manage supplies.
  • Suppliers are carefully managing their inventory to ensure supplies go to their customers based on their needs.
  • HHS is receiving stock of N95’s. Programs will see deliveries as the product is forwarded and this may not follow our regular supply patterns.
  • Any questions or concerns regarding supplies should be directed to the Logistics Site Supervisor. See contact information on the right sidebar.

Appropriate use of supplies

  • Please use supplies appropriately to ensure they remain available for patient care. Don’t take supplies outside HHS. Find out more here.
  • Order supplies only when necessary and don’t hoard or stockpile PPE and other equipment in your area. Don’t take supplies from your unit’s carts to store them elsewhere.
  • Supply management and allocation processes may change the timing of stock replenishment. Contact your logistics staff and leaders if you have supply concerns.
  • The supply chain and logistics team is now monitoring orders to ensure every unit has access to what they need.

Staff Safety, Travel & Absences

Staff safety precautions

Your contribution as a frontline healthcare worker is essential to providing safe care to our patients. Here is a short list of precautions to consider adding to your routine to keep yourself and your family safe given your exposures in the workplace. You were likely already doing many of these things before COVID-19. They are more important now than ever.

International travel, self-isolation and self-monitoring (updated March 14)

Travel outside Canada is STRONGLY DISCOURAGED and may result in staff and physician’s inability to return to work.

We are strengthening our approach to self-isolation beyond what Ontario currently requires and aligning with federal directive. Our primary goal is to contain the spread of COVID-19 and to ensure that we maintain an active workforce to treat patients who need urgent and emergency care. Please read these instructions on returning to work after travel and/or illness.

View this travel absence map for a quick resource.

As with everything right now, this is evolving rapidly and direction may change soon. We will communicate those changes clearly when they take effect.

This reporting form must be filled and sent to Employee Health Services (EHS) before any international travel.

Questions can be submitted to EHS by email at covidforms@hhsc.ca

Virtual Care Information

Making virtual care work

As an alternative to in-person visits, physicians and other health professionals are encouraged, where appropriate to consider delivering care through virtual care modalities. Two key options to providing care virtually in this context are phone calls and eVisits (home video visits).

Some general guidelines in transitioning in person appointments to virtual care appointments include:

  • Verbal consent should be obtained from patients and documented in their chart (see attached for specific suggestions from the OMA on consenting for eVisits in the attached).
  • Virtual appointments should be booked and registered in the applicable HHS scheduling system (Meditech, PatientLink, Mosaic) where possible.
  • Documentation of virtual visits should be done in the same way as in-person visits (dictation, note, etc.).
  • Consideration should be given to patient education (if required) and support in the event of technical difficulties.
  • A plan should be created to ensure tasks after the visit are completed (eg. investigation requisitions and prescriptions are sent, follow-up appointments are booked, etc.)
  • Ensure you have the required technology.

Technology

HHS recommends the use of the OTN Hub. It is PHIPA compliant and can be accessed at no cost.

The steps for physicians to get access to the OTN Hub are in the resources section below.

For HHS staff or McMaster administrative staff needing access, please contact Nate VandenDool (vandendn@hhsc.ca, ext. 72267).

Additional resources to using the OTN Hub can be found here.

If the OTN Hub is not an acceptable option for physicians, other options exist for your consideration as outlined on the Ontario MD website.

Information on physician billing for eVisits can be found in the attached OMA documents. For users of the OTN Hub, a guideline for billing can be found here.

Resources

The documents on the right hand side offer information on:

Resources & News

Latest from HHS

Latest from the Ontario government, Public Health and the OHA

Provincial news release asking for hospitals to scale down activities (March 15, 2020)
M​inistry of Health page
Public Health Ontario
Ontario Hospital Association

Latest from the World Health Organization and from around the world

World Health Organization visualization tool (map) – Please access this outside of Citrix, in a browser other than Internet Explorer

John Hopkins University & Medicine Coronavirus Resource Centre, includes:

HHS Presentations

​​Coronavirus and Ethics: The moral dimensions of an outbreak (March 11, 2020)
Video of grand rounds: Mapping the moral dimensions of an outbreak (sign in required, username: EDR, PW: EDR2)

Keeping Our Hospitals Clean

Our Customer Support Services (CSS) and Crothall Core Housekeeping Staff continue to work diligently to keep our facilities clean with the critical goal to decrease spread of organisms and ensure the safety of patients, staff and visitors.

As non-essential service areas close, we will monitor needs in order to redeploy staff as necessary to meet any changing requirements.

Cleaning frequency FAQ:

  • Public areas
  • Elevator buttons and handrails are cleaned a minimum of three times daily with a thorough clean of surfaces in the evening
  • Lobbies and entrances are cleaned twice daily. Services include waste removal, checking and replenishing hand sanitizer stations and dispensers, sanitizing of horizontal surfaces and chair arm rests, with additional regular monitoring throughout the day
  • Our Volunteer Association spaces are all thoroughly cleaned once daily with frequent sanitizing of high touch points in servery areas of cafeterias and coffee shops
  • Gift shops are cleaned once daily with frequent sanitizing of high touch surfaces points while open

Public washrooms

  • High volume public washrooms such as those in Emergency Departments or at the Urgent Care are cleaned every four hours in compliance with PIDAC standards
  • Our main public washrooms are cleaned 4 times per day, and medium-volume washrooms twice daily.

In addition to these services there is supplementary patrolling by housekeeping to remove waste, wipe down high touch surfaces, and replenish supplies.

  • Washrooms in our inpatient rooms are cleaned daily, or upon patient discharge or transfer.
  • Staff-only washrooms are cleaned once daily.
  • Office ensuite washrooms are cleaned weekly and use should be limited to the office occupant.

Nursing stations

  • Nursing stations, charting offices and clinic reception areas are cleaned daily. If your work station is shared between multiple people, all staff and affiliates must be responsible to clean high touch point surfaces prior to using the space.
  • Conference rooms, HRLMP lab spaces and our Ambulatory clinics are cleaned daily Monday through Friday

Clinical Areas

  • Waiting rooms in our Emergencies and the Urgent Care are cleaned 3 times per day, while waiting rooms in Diagnostic Imaging, ICU, Operating Rooms and L&D are cleaned twice daily
  • JCC Clinic Area waiting rooms and high volume washrooms will be cleaned 2 times per day

What are some tips that I can use to help maintain a healthy work environment?

  • Do not bring cleaning products from home to work. By bringing something from home into a public setting, you could be putting others in danger of having a reaction to the introduced product. As such ensure the following products are available to staff at all times for cleaning of high touch point surfaces:
    • Wipe your phone / desk / door handles/patient charts with:
      • Oxivir wipes – Stores Order # 049156 or
      • CaviWipes – Stores Order #028217
    • Wipe your keyboard with approved keyboard cleaning cloth
      • Stores Order # 074904
    • Comply with our hand hygiene policy (found in the policy library) and all times and have a Purell hand-pump dispenser available where large dispensers are not installed
      • Stores Order # 072525
    • Use Alcohol pads to wipe down cell phones and other electronic equipment
      • Stores Order # 073765
  • Dispose of food or general waste at nearest central waste depot only. If you do not know your location, please contact housekeeping at your site.

Office Cleaning:

Office cleaning frequency is 1:20 and all areas should have a hard copy calendar indicating the cleaning date. Be aware of when your office is scheduled to be cleaned. Put a reminder in your calendar so you can keep horizontal surfaces clear of clutter and paperwork so housekeeping can provide a thorough clean.

We are committed to enhancing cleaning in public waiting rooms and high traffic areas and continue to redeploy resources as they become available for this purpose.

If you have questions or concerns, please don’t hesitate to connect with your CSS or Crothall site leadership teams as appropriate.

Screening at Hospital Entrances

Starting Wednesday, March 18, we will begin limiting access to entrances at our sites. OnThursday, March 19, we will begin screening all patients and visitors for COVID-19. Staff and physicians will be asked to self-assess using ministry guidelines.

The only points of entry and exit for staff and physicians will be:

Hamilton General Hospital

• McMaster Wing Entrance

• Rehab Sliders South Entrance

• Staff and Physicians on call who are responding to emergencies can use Level F Parking Ramp entrance or Front Entrance

Juravinski Hospital

• G wing main entrance main level

MUMC

• Red Parking Level

• Stairwell 42 from the underground

West Lincoln

• East Basement Door

St Peters

• Courtyard entrance

The Ron Joyce Children’s Health Centre is closed.

Screening at visitor/patient entrances will begin at 8 a.m., Wednesday, March 18 at JCC, and at locations noted above at 6 a.m., Thursday, March 19.

Please have your ID badge with you at all times otherwise you will not be given entry. If you do not have an ID badge, visit your site security office before Thursday at 6 a.m.

Temporary Removal of Kronos Biometric Scanning

Effective Friday March 20, 2020, we will be temporarily removing the biometric finger scan requirement on all Kronos terminals. All users will still be required to swipe in and out.

This removal of the biometric finger scan requires re-configuration of the Kronos terminals.

All employees are reminded that frequent and appropriate hand hygiene is a critical factor in preventing the spread of infection.

During re-configuration, you may experience any of the following:

After a badge scan, you are prompted for a biometric finger scan.

•Action: Complete the biometric finger scan as this terminal has not yet been re-configured

The terminal you normally use is “Updating” and not allowing you to scan your badge.

•Action: Complete the scan of your badge at another Kronos terminal, or indicate the missed punch on your unit’s exception sheet, or notify your Manager/Delegate via e-mail of your missed punch.

After a badge scan the terminal displays an “Accepted Punch” and no longer prompts you for biometric scan.

•Action: No action required, your punch has been successful.

Further communication will be shared when the biometric finger scan will be re-enabled.

If you experience any issues with a Kronos terminal, please contact the Corporate Scheduling Office at 905-521-2100 ext. 46865 or by email to cso@hhsc.ca.

Staying Cyber Safe

HHS is continuing to strengthen our information technology systems and networks capacity during the COVID-19 pandemic.

What’s happening

Sadly, external agents might attempt to take advantage of the situation and the fact that more HHS people are working from home, and attempt to breach our cyber defences. Such attempt have already been made against our networks.

Cybersecurity tips

The Health Information Technology Service (HITS) team is reminding everyone of basic cybersecurity practices to preserve the integrity of our systems at HHS. Everyone at HHS needs to exercise caution about emails.

Reminders

•Don’t open phishing emails or click on unfamiliar links.
•Don’t open attachments from unknown sources.
•Open attachments or links ONLY if the sender is a known contact AND if you are expecting it.
•Ensure that your home computer is protected by up-to-date antivirus software.

Resources

Effective cybersecurity starts with a common sense approach by HHS users. When faced with something suspicious or unknown, caution is key.

•When facing such a situation, or when in doubt, users can contact the Helpdesk via email (hepdesk@hhsc.ca) to receive assistance and guidance.
•You can also visit the Hub for more information.
•More information is available from the federal government on staying “cybersafe” during COVID-19.

Changes to Learner Placements

Updated March 15

As part of our response to the COVID-19 pandemic, we have put measures in place to help minimize transmission of the disease. These measures are in accordance with our commitment to keep learners safe and also ensure they are getting the best learning experiences possible. Questions regarding placements can be directed to studentaffairs@hhsc.ca.