Dear Colleagues

This morning we had more than 200 staff join us for the first of our daily vidcasts.  These vidcasts are designed to keep you as up-to-date as possible and they will be hosted by the Chief Executive (Shaun Drummond), the Chief Operating Officer (Jackie Hanson) and the Incident Commander (Elizabeth Rushbrook/Alanna Geary).

As much as possible, three people will be hosting the vidcasts to ensure you get the most current messages and can ask any questions that you may have.  Thank you to everyone who joined, and everyone who posted their questions.  Between the three of us, we were able to answer 85 questions from staff, and it was clear there were a few common themes in what staff were asking.

In today’s message, I’ll try to provide some clarity around some of these and refer you to the overarching documents where you can find further detail.  The documents as they are the Metro North single source of truth.  They do change from time to time, and we’ll alert you to these changes as they come about.

PPE usage

A new Metro North Clinical Practice Guideline with about masks has been issued and is available on QHEPS.  This document is likely to be updated, and we will alert you to that as it happens.

Staff working in our Emergency Departments, Residential Aged Care Facilities and Disability Support Services, will now be wearing full Personal Protective Equipment (PPE) – this is full Droplet Precautions.  There are no exceptions from this directive at this time.  Please know however that if you are providing clinical care do not lose sight of the fact that standard precautions still apply to every other clinical scenario, so ensure that while you are looking after yourself from a COVID-19 perspective, we still need to ensure that we don’t let down other good infection control practices, like handwashing!!!

For those that don’t know I was an Infection Control nurse in a previous life and old habits die hard….wash those hands!!!!

As Shaun Drummond, our CE said this morning, our general approach for other clinical areas is to have a permissive environment, allowing staff to wear surgical masks provided by Metro North when they feel appropriate and necessary.  To be clear however, no staff should be wearing masks they have made themselves, or that have been brought in from home.  The only masks that may be worn are those Metro North has provided.  We have plenty of PPE in stock, and you are encouraged to use it wisely, but also when you feel there is risk to yourself or others.

When not to come to work

If you have a fever or any respiratory symptoms, you don’t come to work and you should get tested.

You then stay home until you have a negative result, and are well again.

A question has arisen around what happens when someone in your household has been tested and is awaiting a result, and whether or not this means you should also isolate and not come to work.   If a family member that you reside with has been tested and is able to be adequately isolated at home, the household contacts can go about their normal business even whilst waiting for results.  If the tested person is unable to be isolated at home away from the rest of the family – then all need to isolate together until test results are negative.

If you are in any doubt, contact your line manager before coming to work.   If you have concerns about your leave entitlements and what leave you should be taking, please talk to your line manager as there are provisions in these unprecedented times.

Visitor registers

As part of the changes enacted yesterday morning, we now will be keeping a record of everyone coming and going from our facilities.

The Hospital Visitor Direction has significantly limited the number of people coming to our facilities, but there will still be some circumstances where visitors are permitted – maternity, paediatrics, and palliative patients.  This afternoon we provided EOCs with material to support a new online system where visitors can register their details using their mobile phones.  We hope this assists not only you in managing the flow of visitors but also to streamline the process of registration.  The reason for registration is to ensure that we can track everyone who visits our facilities in the event that we have any suspected or confirmed case of COVID-19.

The same system will also be used to record patients attending our facilities for outpatient appointments.  There will be no changes to service delivery at this stage, so outpatient clinics will continue as planned.  Please ensure that if you are working in an outpatient setting that, as much as possible, patients are physically distanced.  If there is an inability to do this, please provide patients with a mask to wear while waiting for appointments.

Staff access and registers

Yesterday morning many of our facilities, including RBWH and TPCH, acted quickly to change the way their facilities were accessed.  We all recognise that for many staff it was an inconvenience, but it was a necessary change, and it was well executed.

In coming days facilities will try to refine this to make it work better for staff.  We are very mindful that it has meant that over the weekend people have had to walk significantly longer distances.  We apologise for this, but please know it was done with good reason and was a strategy which met the Chief Health Officer’s (CHO) direction and was designed to keep you and our patients safe.  Over the coming days we will review this and ascertain the best way forward.

We will now also be keeping a register of staff access to our facilities and hospitals.  In many places, this will be done using ID and swipe cards.  In other places, this may require clinical staff to physically sign-in and answer screening questions each day.  We are also looking at developing an app that will work in a similar way to the one we’re now using for visitor registrations.

Posters

We are developing posters to assist in the messaging to visitors and patients with regard to the requirement to wear masks.  We hope that this will assist you in explaining the situation to patients, and will help clear up any potential confusion.

Students

Students of all professions are still able to come to Metro North facilities as part of their education requirements.  We will not be placing students in the Emergency Departments or in community settings (home-based).  Where students had been allocated to those clinical areas, we will work to move them to an alternative clinical area.  Please work with your professional leads to ascertain alternative placement for these students, and please advise staff and students that we will ensure we provide them with an appropriate clinical setting to meet their educational requirements.  Professional leads will also work with university partners and advise accordingly.

With regard to students who may be working in RACF’s.  Unfortunately, the aged care restrictions mean that students who work in aged care will have to choose between working in their aged care role or undertaking their student placement.  If students need to clarify, they should contact their university, and we will work with the universities to assist where we can.

Vidcasts

We have another vidcast again tomorrow at 11 am.  You can access the session on Teams here.

Slido is now open for you to submit questions – just log in using event code #covidvidcast2.

This weekend

I want to say thank you so very much.  I have been in the Incident Commander role all weekend, and although it has been busy, we in the Metro North EOC could not have done what we have without the support of the facility and directorate Executive Directors and their EOC teams.  You have all been incredible.

I would also like to extend my personal thanks to Shaun Drummond and Jackie Hanson, who have, as always, provided exceptional leadership during what was a tricky weekend.  Also to Elizabeth Rushbrook, who supported and guided our HHS from afar.

Finally, I would also like to say a huge well done to my Metro North EOC team and those who came in for various functions, including Diane Bretherton, Carla Bailey, Helen Vickery, Julie Bunting, Travis Bell, Rebecca Ferriday-Smith, Christine Atkinson, Denise Hobson, Magid Fahim, Jon Fraser, Gihan Ranatunga, Adam Whitehead and our new police liaison officer Sgt Darren Carruthers.  This team worked incredibly long hours over the weekend and achieved much!!

See you tomorrow!!!!

Kind regards,
Alanna Geary
Metro North Incident Commander

Metro North HHS – Overview of Cases*

HHS	Patients being managed by HHS						FEVER Clinics
	Total In-patients			Virtual Ward / HITH / or similar	Deaths **	Total cases managed by HHS (including recovered) ***	# of clinics	Presentations
		ICU Pts
		ICU-NOT Ventilated	ICU-Ventilated					Last 24 hrs	TOTAL^
MN TOTAL	0	0	0	1	3	342	5	1,191	67,641 (2.7% A&TSI)

*With effect 23 August 2020, 1000

**Metro North has three recorded deaths (one person a return traveller into NSW, who passed away in NSW)

*** These numbers reflect the cases being managed by Metro North.