“We have to think about our health services as a system, and we need to ensure that our health system is there for each Ontarian and our welcomed guests,” Hall says. “The influx of people alone will increase the amount of care that could be needed. And we need to make sure that we can effectively respond to that demand.” They will look at a wide range of potential issues, from a chemical attack to heat-related incidents to transportation.
“How do we make sure an ambulance can get to a routine event, like a crash on the highway? How can we ensure that the same consistent standard of care would be available to that person? How do you get the ambulance onto the Don Valley Parkway when there are two million extra people in the region?”
Dr. Mazurik was part of the SARS Operation Centre in 2003 and was the Toronto Central LHIN G20 planning lead. She has conducted multiple multiagency exercises in Toronto since 2003 and will draw on her experience during those events to help prepare for the Pan Am Games. As the games approach, she’ll work with external partners, like EMS and police, to plan simulated crises.
“The easiest time to discuss what you should do is not at the time of a crisis,” Dr. Mazurik says. “Having stakeholders review their disaster plans simultaneously in preparation for a planned event or exercise creates readiness. The unexpected byproduct of this process is revealing innovative ways to deliver health care more efficiently now.”
She worked with a team in the lead-up to the G20 to create an electronic dashboard that could provide an at-a-glance look at the capacity of the critical services of 20 hospitals in Toronto. Hospitals uploaded their capacity data. A green icon meant all was well. Red triggered a teleconference. The system proved extremely useful, she says.
“The riots downtown meant that dialysis patients couldn’t get to appointments. There were burning cars; the TTC wasn’t running,” Dr. Mazurik says, adding they worked closely with police and military. “It triggered a response via the dashboard. All the other hospitals that had dialysis that weren’t in that zone of terror were ready and willing to take those patients. It was unprecedented. In the past, we would not have been aware there was a problem, let alone be able solve it.”
Dr. Mazurik is in talks to update the dashboard to be used during the Pan Am Games. And, better yet, all the time.
“There are certain kinds of situations that we hope aren’t going to come again,” Dr. Mazurik says. “But, as they say, there is no such thing as luck; there’s just working hard to be prepared.”
WHEN THE LIGHTS WENT OUT
When ice and wind took out power lines and left much of Toronto in the dark on December 21, 2013, Sunnybrook’s emergency response principles were put to the test.
Emergency generators immediately kicked in, providing critical areas with power and keeping patients safe.
And the emergency operations centre – bringing together staff leads from power plant, risk and patient safety, administration and units across the hospital – was up and running soon after the lights went out.
“I think it’s human behaviour to hear the word ‘emergency’ and think the worst,” says Trevor Hall, Sunnybrook’s patient safety specialist and emergency preparedness leader. “Sunnybrook’s response proved that an emergency can be controlled. People came to work. We had great communications, which is something that often fails. Most patient service wasn’t interrupted. I think all of Sunnybrook and our external partners did a great job working as a team and maintaining the patient experience.”
Because it was unclear how long Sunnybrook would be off the grid, a decision was made to transfer six babies out of the Neonatal Intensive Care Unit (NICU) to neighbouring hospitals. The NICU had undergone mock Code Green (evacuation) exercises to practise these scenarios.
Sunnybrook’s power was restored within two days. But as power outages around the city continued into the third day, a concern arose among Toronto hospitals, the local health integration network and community partners, as well as the Ministry of Health and Long-Term Care, that the emergency departments across the city could see a surge in patients due to the extreme cold.
The province’s Emergency Medical Assistance Team was deployed and set up a field hospital in Sunnybrook’s McLaughlin Auditorium within nine hours. The field hospital saw patients not sick enough for a medical bed, but who had other issues preventing them from being released to a warming centre or home.
“This demonstrated great leadership and enhanced patient safety,” Hall says. “It also proved that Sunnybrook can provide surge capacity for the city and the GTA when it matters most.”
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