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TBRHSC MEMO- Essential Care Partner Restrictions Update

TBRHSC MEMO- Essential Care Partner Restrictions Update

June 15, 2020

To:     All Hospital Staff and Professional Staff

From:     Dr. Stewart Kennedy, COVID-19 Incident Manager

Date:    June 15, 2020

RE:     Essential Care Partner (ECP) restrictions update

As you know, for the protection of patients, staff, professional staff and the community, Essential Care Partner (ECP) restrictions were implemented at our Hospital. ECPs play a key role in the care team. As our understanding of the COVID-19 pandemic evolves, it is important to evaluate the pandemic visitation restrictions and consider what is most appropriate for patient and community safety, while embedding our philosophy of Patient and Family Centred Care. Revisions have been informed by patient, staff and manager feedback and in consideration of visitation restrictions by other organizations including Health Sciences North, Kingston Health Sciences Centre, Trillium Health Partners and University Health Network.

The following outlines who qualifies for ECPs beginning Tuesday, June 16:
•    a patient who is dying or very ill (for whom imminent death is anticipated or possible in the next 72 hours): maximum of four different ECPs, no more than two present at a time;
•    a patient under 18 years old: maximum of two different ECPs, no more than one present at a time. Please refer to Essential Care Partner Guidelines Women & Children Program for more details;
•    patients undergoing surgery: maximum of one ECP, up to 16:00 the day following surgery;
•    women giving birth: maximum of one ECP, before and during labour and up to six hours post-delivery;
•    outpatients who require assistance to attend their appointment: maximum of one ECP if needed;
•    patients being discharged and care partner requires health teaching that cannot be provided post discharge or virtually (e.g. suctioning, injections);
•    patients with cognitive, mental health, or behavioural issues that impact the care team’s ability to provide safe care: maximum of one ECP;
•    patients with communication needs that cannot be easily addressed with existing resources and impact the care team’s ability to provide safe care: maximum of one ECP;
•    patients in the Intensive Care Unit: maximum of one ECP;
•    patients undergoing Medical Assistance in Dying (MAID) up to seven days before MAID is to occur): maximum of four different ECPs, no more than two present at a time.

In addition, the process for decision-making regarding ECP exceptions is modified effective immediately. Changes are as follows:
•    the manager may approve ECP visit exceptions for their unit, rather than the senior leader on call. Guidelines will be developed to ensure equity and standard approach to decision making;
•    the COVID-19 coverage leader approves urgent exceptions after hours and directs non-urgent requests to the unit manager to address on the next business day.

To support these visitation restrictions, screening processes and virtual visit services remain in place.

It is strongly encouraged that all patients and ECPs wear face coverings when at our Hospital. Due to socioeconomic realities for some people, face coverings are not mandatory for patients and ECPs at this time. Please share with patients and ECPs that face covering protect their loved ones, as well as staff and professional staff, from the spread of COVID-19. Evidence suggests that COVID-19 can be spread by people who aren’t showing symptoms and therefore, a face covering can help stop droplets from landing on nearby surfaces.

All Hospital COVID-19 updates are available on the iNtranet at

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