Caring for patients on COVID-19 units: an approach for hospitals

Toronto and Spanish physicians describe in CMAJ (Canadian Medical Association Journal) an approach to create dedicated COVID-19 patient units, infection control protocols and care teams to help other hospitals safely care for patients.

"The care of patients admitted to hospital with COVID-19 cannot be construed as falling within usual hospital operating procedures," writes Dr. David Frost, a general internist at University Health Network and the University of Toronto, Toronto, Ontario, with coauthors. "Meticulous planning is required. There are unique challenges regarding necessarily strict infection control procedures, provision of care to potentially large numbers of patients and clinical considerations specific to COVID-19."

The approach is based on real-world experience in Madrid, Spain, and from Toronto's University Health Network, one of Canada's largest hospitals, as well as relevant medical literature.

Some highlights include

• Creating a dedicated COVID-19 unit with delineated risk zones and protocols
• Establishing a buddy system for health care professionals to safely doff and don personal protective equipment (PPE)
• Considering how rapidly care teams can be scaled up, how to integrate other physicians and how to maintain continuity of care
• Standardizing procedures with checklists to maximize efficiency and safety for ward rounds
• Adopting patient-centred practices to help lessen isolation and ensure links with families and caregivers
• Fostering a culture of safety and clear communications to all stakeholders

To provide rapid access to the approach, the authors have created an open-access website http://www.torontocovidcollective.com.

"The ability to rapidly disseminate information, iterate protocols and collaborate with physicians around the world will continue to be important through subsequent waves of the pandemic," the authors write.