COVID-19: Resources For PAs

Your supervising physicians and employers are the best sources of evidence and information related to COVID-19; however, we have compiled links to relevant resources that may be of interest. In many cases, these links have been shared by PAs from across Canada.

PUBLIC HEALTH AGENCY OF CANADA

COVID-19: For Health Care Professionals

  • Guidance on reporting, treatment, infection prevention, and more.

EMERGENCY MEDICINE

COVID-19 Resources For Emergency Medicine

  • Critical care – protected resuscitation / intubation
  • Critical care – other
  • Homeless and at-risk patient care and disposition information
  • Patient screening, testing, and clearance
  • PPE guidance
  • General patient care information
  • Information for patients
  • Other information for staff
  • Science/ epidemiology
  • PPE Innovations

COVID Research Roundup

  • Curated by Dr. Justin Morgenstern on his First10EM.com blog, a FOAMed project dedicated to emergency medicine, critical care, and evidence-based medicine. Dr. Morgenstern is the Director of Emergency Medicine Simulation Education at the Markham Stouffville Hospital.

An Evidence Summary of Paediatric COVID-19 Literature

  • Recent papers and an executive summary from a UK-based paediatric emergency medicine group.

COVID-19 In Older Adults: Key Points for ED Providers

  • Webinar recording for clinicians from March 30, 2020 (Geriatric Emergency Department Collaborative, U.S.).

CRITICAL CARE

COVID-19 Resources and Updates

  • Curated resources from the Canadian Critical Care Society.

COVID Critical Care

  • “Medical Management of Patients Under Investigation for COVID-19 or Confirmed COVID-19” (endorsed by the Medical Advisory Committee at William Osler Health System).

Free Online Course: Basics of Mechanical Ventilation

  • This University of Toronto course is offered April 14-17 at 6:00 p.m. ET and provides two lectures per day with questions and answers. RSVP is required – sign up here.

Society of Critical Care Medicine (U.S.)

  • Curated resources including Surviving Sepsis COVID-19 Guidelines and Critical Care for the Non-ICU Clinician.

EMCritProject

  • Independent medical bloggers and podcasters dedicated to FOAMed, with real-time posts related to COVID-19 (U.S.)

Hippo Education COVID-19

  • Practical FOAMed resources for clinicians on the front lines (to listen, read, or watch). (U.S.)

LONG-TERM CARE / END-OF-LIFE CARE

Advanced Care Planning and Goals of Care Conversations in LTC During the COVID19 Pandemic

  • A primer on goals of care conversations in LTC, prepared by Dr. Sandy Shamon for the Ontario Long-Term Care Clinicians Association.

Symptom management for adult patients with COVID-19 receiving end-of-life supportive care outside of the ICU

  • Adapted from BC Centre for Palliative Care Guidelines with input from palliative care MDs and pharmacists.

GENERALISTS

QuickICUTraining

  • A website created by clinicians and researchers at the University of Toronto and the Toronto Academic Health Science Network to support health professionals outside of critical care who may be called up to practice in this environment. It offers learning resources and reference materials to support your preparation.

Considerations for Family Physicians: In Person Visits When Phone / Video Isn’t Enough

  • Best-estimated safe practices that consider balancing patient needs with risks of exposure (Ontario College of Family Physicians).

Protecting Patients and Physicians during the Pandemic

  • Recorded webinar on office-based management when caring for patients face-to-face during the pandemic. Topics include aspects of viral transmission in the office, personal protective equipment recommendations (with consideration of limited resources), practice modifications, and cleaning guidance.
  • Led by Dr. Allison McGeer (microbiologist and infectious disease consultant in Ontario) and Dr. Jennifer Young (Ontario family physician and president of the Ontario College of Family Physicians), along with host Dr. Allan Grill of the College of Family Physicians of Canada.

WELLNESS / RESILIENCY

Three Steps To Coping With Anything (Including COVID-19)

  • A 7-minute chalkboard talk created by SARS veterans and Mount Sinai psychiatrists Drs Bob Maunder and Jon Hunter.

Ontario COVID-19 Mental Health Network

  • Facilitating pro bono mental health services for healthcare workers who have been impacted by COVID-19.

Managing Stress and Anxiety Related to COVID-19

  • From the EM Ottawa Blog, which is a resource for EM practitioners and an archive of articles reviewed by the Department of Emergency Medicine at the University of Ottawa.

What It’s Like to Work in an ER During a Pandemic

The COVID-19 pandemic has swiftly and dramatically changed our daily lives. We’re speaking to Canadian women about how coronavirus has affected how they work, parent, run their businesses and more. Below, Danielle Lucky, a physician assistant at Scarborough Health Network, discusses her experience on the frontlines as the COVID-19 pandemic unfolds….read more at ELLE Canada.

 

 

CAPA Letter to Federal Health Care Leaders

Ms. Tina Namiesniowski, President, Public Health Agency of Canada
Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada
The Honourable Patty Hajdu, Minister of Health

Dear Ms. Namiesniowski, Dr. Tam, and Minister Hajdu,

We are writing on behalf of the Canadian Association of Physician Assistants (CAPA) regarding physician assistants (PAs) and potential contributions to the federal health care workforce during the COVID-19 pandemic.

In addition to your current call to create an inventory of nurses to have on-call, we are asking you to consider the benefits of integrating the PA model in the federal workforce. We would be pleased to provide additional information about Canada’s PA workforce and are requesting the opportunity to speak by phone with your officials in the coming weeks.

COVID-19 Policy Implications

The impact of the novel coronavirus on Canada’s health care workforce and our current response to the pandemic have important short and long-term policy implications.

Before COVID-19, the shortage of health care professionals in many parts of the country was dire and it is now clear that Canada needs a comprehensive strategy to expand the workforce. Some physician regulatory colleges have already asked retired physicians to reregister for their licences. The Canadian Medical Association formally recommends the establishment of emergency pan-Canadian licensure for health care professionals to easily practice in regions experiencing higher infection rates:

“In this time of public health crisis, the federal government must ensure that regulatory barriers do not prevent health care providers from delivering care to patients when and where they need it. Many jurisdictions and regions in Canada are experiencing significant shortages in health care workers.”

It is vital that, during this time of national crisis, our federal health leaders not miss the opportunity to call Canadian PAs into service, along with our physician and nursing colleagues.

Regulatory Relief for PAs

A critical regulatory relief measure that can help boost the government’s health workforce capacity is the immediate authorization of physician oversight of PAs in federal health care settings where they are not yet integrated.

PAs are “physician extenders” and work as advanced practice clinicians under the supervision of a licensed doctor to provide primary, acute, and specialty care in all types of settings (more here in our Information Brief). Provinces like Manitoba and New Brunswick, where PAs are regulated under provincial physician colleges, provide a roadmap for how physician oversight can efficiently and effectively function. In the Canadian Armed Forces PAs often operate as senior medical leaders, both domestically and internationally, and the CAF can offer an example of oversight that can be quickly replicated.

The shifting of medical tasks, through substitution or delegation, to free up physicians for more complex care, is a key benefit of integrating the PA model. The PA model allows for the efficient reorganization of the workforce and provides one viable solution for improving coverage, efficiently using human resources, and increasing capacity.

Ready To Serve

Right now, PAs are with doctors, nurses, pharmacists, and many others at the frontline of this pandemic. They are helping to manage COVID-19 screening and testing sites, managing isolation areas where respiratory illnesses are screened and treated, and manning telephone help lines to divert patients from the emergency department.

During this time when the federal government is exploring policy measures to respond to COVID-19, CAPA strongly believes that integrating the PA model is worthy of serious consideration.

Thank you in advance for your consideration. And, more importantly, on behalf of our members we thank you all for your leadership, commitment, and compassion during this very difficult period.

Sincerely,

Leslie St. Jacques, CCPA
President

Patrick Nelson
Executive Director

President’s Message — COVID-19

I’m writing to recognize the incredible effort you are all putting forward to help Canada respond to COVID-19. Whether you’re in emergency departments, primary care, surgical specialties, or in our Canadian military, so many of you are at the frontline of this pandemic.

In the last few days, I’ve heard about PAs that are running COVID-19 testing clinics and others who are actively managing an isolation area, where all respiratory illnesses are sent to be screened or treated, until testing sites are activated. And you’ve likely seen our own Maureen Taylor, an Ontario PA in Infectious Diseases and former medical journalist, interviewed several times by national media outlets.
These are just a few examples of your impact—I know there are many more.

I’m incredibly proud to hear these stories, but I also know that many of you are feeling the stress associated with this unprecedented situation and the risk you experience in your work.

It’s important that you acknowledge that this stress is normal and can impact anyone working in health care today. Try to find time to rest and recover, take a break from media coverage, and most importantly, ask for help if you feel overwhelmed.

RESOURCES

Managing stress

The EM Ottawa Blog post on Managing Stress and Anxiety Related to COVID-19 has been widely shared in recent days. It offers strategies we can all use and I encourage everyone to read it.

There are other resources, including links below to sign-up sheets or contact people who are offering health care workers help with the everyday tasks of life outside the hospital or clinic. (This is just snapshot, so please enquire in your community about what might be available):

Helpful podcasts

The American Society of Microbiology’s This Week in Virology has a podcast page with high-quality discussions among physicians, scientists, students and others.

World Health Organization

This one-hour course on “Infection Prevention and Control for Novel Coronavirus” offers a helpful review of infection control procedures.

And more here on “Rights, Roles, and Responsibilities of Health Workers, Including Key Considerations for Occupational Safety and Health”.

ADVOCACY

You may have read recent stories about provinces asking retired doctors to re-register and the federal government creating a nursing inventory. In the coming days CAPA will be writing to various federal and provincial stakeholders to remind them of opportunities to leverage the PA profession during this global crisis.

CAPA 2020 AND THE CERTIFICATION EXAM

Lastly, we have all seen health care conferences in Canada and around the globe postponed to help flatten the curve. With both our annual conference and the PA certification exam scheduled for October 2020, we are proceeding with “business as usual”, but are closely monitoring the situation. We will, of course, communicate with members should timelines change.

THANK YOU

Thank you again for your professionalism and dedication. In the days, weeks, and months ahead please be sure to take care of yourselves and each other.

Sincerely,
Leslie St. Jacques, CCPA
President

Proven health initiative stalled for last decade—New Brunswick lags behind other provinces

The Canadian Association of Physician Assistants is asking the Higgs government to fulfil its campaign pledge and hire more physician assistants as part of provincial health reform

FREDERICTON, February 25, 2020—The Canadian Association of Physician Assistants (CAPA) is calling on the New Brunswick government to hire 30 new physician assistants (PAs) to help address the province-wide shortage of health care professionals. The recommendation is part of CAPA’s submission during the public pre-budget consultation process.

“Health workforce staffing is the underlying issue in this health care crisis,” said Kevin Dickson, CAPA’s Provincial Director for New Brunswick. “Our message to Premier Higgs is that the next budget must include measures to establish a pipeline of PAs who have the training and skills to meet patient needs, tackle wait times, and advance team-based care.”

PAs are highly skilled advanced practice clinicians who work under the supervision of a licensed doctor to provide primary, acute, and specialty care in all types of settings. Other provinces, and countries around the world, use the PA model to address unmet needs, decrease costs, and boost the efficiency of the physician workforce.

Unlike other new roles in health care, PAs represent a new workforce that can fill existing vacancies, instead of simply shifting gaps from one profession to another. And with a generalist training, the government can quickly deploy PAs to fill needs across the health system.

CAPA’s 2020 pre-budget submission makes three key recommendations on how New Brunswick should be leveraging the PA profession to benefit patients:

  1. Provide health authorities with funding earmarked to hire an additional 30 PAs over the next three years, at a cost of approximately $3.6 million.
  2. Expand the College of Physicians and Surgeons of New Brunswick’s regulation of PAs to allow PAs to work in all clinical settings and beyond the direct employment of a regional health authority.
  3. Work with physicians, health system leaders, and municipalities to identify the clinical settings and communities where PAs should be deployed to have the greatest impact on patient access to care.

“New Brunswick is stretched to capacity,” said Dickson. “If the government is serious about innovation in health care, it’s crucial to add more PAs to bridge the gaps in care and improve the services we all depend on.”

Additional Information

Reports from the Conference Board of Canada on the role, effectiveness, and value of physician assistants:

About the Canadian Association of Physician Assistants

The Canadian Association of Physician Assistants is the national voice of physician assistants in Canada. We support quality standards and competencies and help establish the profession within the national health care framework. Learn more: capa-acam.ca.

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