Winter Surge Planning: How one Ontario Health Team is Preparing for the Winter Influenza Season and a Potential Second Wave of COVID-19

RNAO is supporting the success of Ontario Health Teams (OHT) by offering a new Best Practice Spotlight Organization (BPSO) model called BPSO OHT. We are very proud of working with several OHT and today we want to profile the outstanding work of the East Toronto Health Partners OHT (ETHP). We thank our ETHP partners for writing the submission below that updates on their excellent community work to prepare for this year’s Winter Surge, which is likely to include new waves of COVID-19. We know other organizations, including other OHTs, can benefit from their planning. When I joined their meeting earlier this week, I was tremendously impressed with their comprehensive focus on vulnerable populations and community care.   

Each year in the winter months, hospitals and other health and social services feel the pressure of increased demand due to influenza and other seasonal ailments such as falls and seasonal affective disorder, a phenomenon called the Winter Seasonal Surge Season, fondly termed “Winter Surge”. This year, the seasonal strain on our health care system is expected to be compounded by a second wave of COVID-19 cases, so it is even more imperative to develop effective approaches to address Winter Surge.

Health and social services organizations in East Toronto have a long history of working together to address their community’s needs and improve health care for the 300,000 residents living in the community. It is no surprise, therefore, that when planning for Winter Seasonal Surge, the ETHP look towards its engaged partners to help with planning. The strong relationships built on years of collaboration primed these organizations to become one of the province’s first Ontario Health Teams (OHT) in December 2019. The East Toronto Health Partners (ETHP) draws its success from broad involvement with its community and over 50 engaged partners.

This is the third consecutive year the ETHP have collaboratively planned initiatives to address Winter Surge, and dedicated a large portion of Winter Seasonal Surge funding to community-led initiatives. This collaborative effort recognizes that influenza (and also COVID-19 this year) does not just impact hospital capacity, but impacts the capacity of all health, mental health, and social services organizations across our community. This past week, the ETHP held a Winter Surge planning workshop with over 50 engaged partners. The aim of this workshop was to determine how organizations across the East Toronto community could come together to address the pressures related to seasonal surges in volumes. The proposed community-based initiatives tackle this aim using five different strategies:

1.           Improve Wellness and Divert from Hospital

2.           Reduce Time in the Emergency Department

3.           Help Patients Transition Home More Efficiently

4.           Address Community Health Capacity

5.           Mitigate COVID-19 Impacts

Additionally, the ETHP are making sure that the proposed initiatives consider the Year 1 priority populations identified by the ETHP OHT:

1.           Seniors and Chronic Disease

2.           Substance Use and Health

3.           Youth Mental Health and Wellness

4.           Neighbourhood Improvement Areas

In total, the ETHP will be allocating $1.1M of funding towards 14 projects, and continuing on 4 projects that are now-self funded from last year. These projects will help address surge pressures in a number of different ways. For example, in one project, VHA Home Health Care and WoodGreen Community Services have banded together with Toronto Community Housing to deliver a mobile flu clinic. This clinic will proactively deliver flu shots in seniors buildings particularly for those who are homebound, have mobility issues that limit their ability to get the flu shot in the community, cognitive challenges or mental health and substance use issues. The East Toronto CHC Network also hopes to address access to the flu shot by providing outreach to shelters, retirement homes and other local community agencies. By working with the engaged partners, the ETHP are able to further identify priority target locations for these flu outreach initiatives.

Beyond flu initiatives, the ETHP are working to improve access to short-term transitional counselling for mental health patients through the SCOPE program. Enrolled family practices will have rapid access to urgent psychotherapy, counselling, and connection to longer-term supports. A final example of the ETHP surge initiatives is the work they are doing to provide enhanced psychogeriatric support to their patients to help facilitate discharges from ED or acute care and to reduce unnecessarily visits to hospital or returns to hospital.

The ETHP Community Surge planning is a prime example of the importance of collaboratively designing coordinated approaches to solving an issue that affects us all. Together, rather than siloed across sectors, the ETHP will improve care efficiency, outcomes and experience for the residents of East Toronto.

Check here for a Powerpoint presentation of this plan.