Danielle Paes (left) and Carly Diamond (right) are pharmacists at Holland Bloorview Kids Rehabilitation Hospital in Toronto
Holland Bloorview Kids Rehabilitation Hospital is the largest pediatric rehabilitation centre in Canada. The hospital team supports children and youth with disabilities and complex health-care needs. Danielle Paes (Rx2014) and Carly Diamond (Rx2016) are clinical pharmacists at the hospital and have played an active role helping their worksite prepare for and respond to COVID-19.
“Before COVID, each pharmacist was assigned to their own unit and services, and was focused on caring for specific patient populations,” says Carly. “This could be children recovering from surgery, with complex cardiorespiratory needs or those with autism spectrum disorder accessing care through our outpatient clinics. As a member of the brain injury rehab team, I would often support our clients while up on the unit and follow their care from admission through to discharge.”
Carly Diamond and the blue team at the hospital, standing apart and wearing masks
After COVID-19 struck, the hospital pharmacy staff split into two skeleton teams, staggering working hours between morning and afternoon shifts to reduce physical contact between staff. The two teams huddle every morning and discuss clients using videoconferencing software. There is now cross-coverage among all patient care units with handover of care happening midday. Additionally, each pharmacist is supported to work from home one day a week whenever possible.
“The hospital is exceptionally digitalized, so we’re able to do a lot while offsite — it’s amazing,” Danielle reflects. “Through a virtual private network we can access electronic health records, review patient charts and lab work, as well as verify medication orders remotely.”
The change has affected both the hospital staff and their inpatients — clients who used to be able to go home on weekends to spend time with their families can no longer do so in the same way. However, the hospital has expanded its rehab offerings over the weekend, and, as a result, some clients have been able to be discharged home earlier than anticipated.
Although we’re spending less time physically on the units and have fewer opportunities to talk with our patients face-to-face, we’ve been able to hone in on our inter-professional communication skills so that we can communicate with everyone involved in the circle of care efficiently.
Pharmacists at the hospital are now practicing more broadly, providing medication management support for patients across all departments, instead of just their unit. The change has kept Danielle and Carly on their toes, ensuring that they are up to date in all aspects of pediatric medicine.
“When put into challenging circumstances, you may surprise yourself with what you are able to accomplish,” says Danielle. “There have been times when one of us is the only clinical pharmacist on site for the entire hospital. I think we’ve risen to those challenges well.”
Danielle Paes and the green team at the hospital, standing apart and wearing masks
The team has also found success in how they handle concerns about drug procurement. Through diligent planning and preparation by pharmacy technicians, the team has been able to conserve their medication supply and avoid critical medication shortages.
“We’re experiencing a lot of first times as a team,” says Danielle, who previously worked primarily on the Specialized Orthopaedic and Developmental Rehab and Complex Continuing Care units. “We’re providing care in new areas and adapting to using technology in ways we haven’t before.”
We’re also balancing our own personal wellness and mental health by promoting self-care and being a source of support for each other. Many staff are living distantly from their families to reduce the risk of exposure, which makes the challenges of this time both personal and professional.
The experience has brought the team closer together even as they are working apart. They’ve found ways to stay socially connected as colleagues; Danielle’s team did a surprise dance for Carly’s team at a virtual meeting to build moral. The hospital also has weekly theme days, like pajama day. These little moments of positivity give patients —who are all children — and staff something fun to do together.
“It sounds cliché, but we’re growing as a result of being forced outside our comfort zone, and we are learning every single day,” says Danielle. “We are becoming stronger practitioners because of these circumstances - having to think on our feet, jump into new clinical scenarios and problem solve using creativity. We are developing new skills and evolving into dynamic and well-rounded pharmacists.”
The alumni have also recognized the incredible value of strong leadership in challenging times.
“So many changes happened very quickly, which required a lot of decisions to be made and then communicated effectively — the hospital has been exceptional,” says Carly. “We feel safe coming to work. With the screening being done at the door and precautions taken to protect us, our patients and families — we are grateful to be able to come in and provide care.”
