By Christy Janssens


Lindsay Costaris is one of the medical professionals who participated in the upskill training.
Lindsay Costaris is one of the medical professionals who participated in the upskill training.

When the Ontario government released projections about the province’s limited capacity to care for COVID-19 patients in early April, Unity Health leaders saw an opportunity to ramp up critical care support. The need for additional staff in these specialized areas was no problem – they created a plan to provide education to staff who normally work in other areas, quickly bringing them up to speed on what they needed to know.

In under a week, a curriculum was created to ‘upskill’ these health-care professionals. Cecilia Santiago, Nursing Practice Manager at St. Michael’s Hospital, was one of the facilitators who designed the education with interprofessional ICU clinicians by creating booklets and presentations and gathering resources.

“The plan was put together so quickly,” Santiago said. “We needed to build capacity among clinicians to help support care in the ICUs. We also needed to look into other staffing models in case there was an influx of critically ill patients.”

The nurse-to-patient ratio is generally one nurse looking after one critical patient or two stable patients in the ICU. However, in the case of an influx of COVID-19 patients, the pod model would be initiated.

“The pod model is a team-based model rather than a primary care model,” Santiago said. In it, staff assemble into teams to care for three or more patients. An ICU nurse would become the team lead, supported by upskilled team members.

“The training was comforting,” said Lindsay Costaris, one of the nurses who was upskilled. “It validated skills we already had and how they would be translated into a critical care setting in order to support patients.”

The needs of COVID-19 positive patients were kept in mind during the training. Education included supporting patients on ventilators and managing arterial lines, as well as critical care-specific medications.

“We would work in a supportive role within a team approach,” Costaris said.

Rose Lee is a physiotherapist who also completed the upskilling curriculum. She appreciated the process and the foresight of the hospital to train employees before a potential surge happened.

“The communication was really transparent,” she said. “I knew what my responsibility was. I appreciate that we are staff who can be flexible and adaptive to the changes that are happening so quickly around us. Ultimately, this experience has been positive because everyone has been so supportive. This was a great opportunity to work with other disciplines – the whole hospital community stepped up and came together to work through this pandemic.”

Santiago agreed.

“It was a great inter-departmental collaboration including the Redeployment Centre, Professional Practice, the Education department, the clinical leader managers, the educators and the Critical Care nurses who are willing to be shadowed,” she said. “The willingness and commitment of everyone to come together to keep our patients safe is amazing.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.