Coordinating the flow of patients in a hospital is like piecing together a puzzle. With the emergence of COVID-19, the puzzle pieces became more complex. Lindsay Hogeboom, Osler’s Manager for Corporate Access and Flow, supports the team responsible for managing patient flow from the time a patient is admitted to hospital, to their transfer to inpatient bed.

“The priority for us during COVID-19 is ensuring the patient is admitted into the right bed at the right time with the right support,” says Lindsay. “This need became heightened from a patient safety perspective, as well as for staff safety.” Despite reduced patient volumes in the Emergency Department in the early days of the pandemic, additional space was required to ensure patients being investigated for COVID-19 were properly isolated.

Patient Flow Centres were created at Brampton Civic and Etobicoke General, so that all stakeholders could work alongside one another.  “Collaboration among the multiple different teams, such as Admitting, Infection Prevention and Control, as well as our Access and Flow Leaders has helped ensure our patients are being placed in the right bed and cared for by the right team,” says Lindsay.

Along with the inevitable challenges came the rewards of providing aid to people in need. “I think the proudest moment through COVID-19 for us was helping to support the transfer of nursing home patients into the building alongside medical and allied health colleagues,” she says. Moves that would normally take days to plan were executed in hours. “Being able to support those transfers of acutely ill patients to ensure that they had access to the health care they required was rewarding.”

Lindsay also serves as interim Clinical Services Manager of the Clinical Resource Team, a group of nurses that fills temporary vacancies in medicine and surgical units.  When the nurses were tasked to staff an expanding surge unit at Etobicoke General, she saw staff come together in an unprecedented way. Most touching, she says, was their role in connecting patients with their families.

“The ability to have family members present was one of those things that we recognized as such a loss through COVID-19,” says Lindsay. “So we were setting up virtual visitations and doing things to reconnect families, so we could make sure they were still very much involved in the care.”

The Clinical team had to come up with creative solutions to help keep patients engaged.  One patient with a cognitive impairment would sometimes become agitated and try to wander from his room, which put him at high risk for falls. To improve patient safety and reduce the associated risks, one of the team members had the idea to give the patient a baby doll. “It’s been amazing to see him with his baby doll, sitting in his chair rocking it. The staff are very proud to have come up with inventive ways to try and keep patients safe and engaged.”

On days when exhaustion sets in, Lindsay says the drive to keep going comes from the ability to impact change. “There’s the gratitude of having a job to go to where you're able to make an impact, so whether you feel exhausted or not, you’re actually grateful.”

Having moved from a role in the Women’s and Children’s Unit just a year ago, Lindsay has had to adjust to a very different population of patients with acute medical needs. “I think your priorities become more focused. You see life and death, you see the impact of COVID-19, but then you're also more aware of how precious life is. You just want to make the most of it."