CAPA Letter to PEI Health Minister

Dear Minister Aylward and Deputy Minister Spidel,

I’m writing on behalf of the Canadian Association of Physician Assistants as a follow up to our meetings last fall regarding the integration of physician assistants (PAs) in Prince Edward Island’s health system. At the time, your Government was working towards introducing the PA model at the Queen Elizabeth Hospital Emergency Department and reviewing legislative options to formally integrate the profession.

COVID-19 Policy Implications

We appreciate that the provincial response to COVID-19 is now your top priority, and as you consider measures to address health workforce capacity, the loss of health care providers to quarantine, and the well-documented demand for health care professionals, we encourage you to include PAs in your pandemic planning to realize short and long-term benefits.

In their recent federal recommendations, the Canadian Medical Association called for the elimination of barriers that stop health care workers from delivering care where it is most needed:

“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.”

CAPA strongly supports this opinion. We believe that provinces should take similar steps to allow “all hands on deck” during this crisis and facilitate the recruitment of PAs over the next year, and potentially sooner.

Regulatory Relief for PAs

A critical measure that can help boost local workforce capacity is your immediate collaboration with the College of Physicians and Surgeons of PEI to authorize physician oversight of PAs in the province.

PAs are “physician extenders” and work as advanced practice clinicians under the supervision of a licensed doctor to provide primary, acute, and specialty care. Manitoba and New Brunswick, where PAs are regulated under provincial physician colleges, provide a roadmap for how physician oversight can 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.

By shifting medical tasks to PAs, through substitution or delegation, physicians are freed up for more complex care. The PA model allows for the efficient reorganization of the workforce and, thanks to the versatility of the PA scope of practice, provides one viable solution for improving coverage, efficiently using human resources, and increasing capacity.

Ready To Serve

Right now PAs across Canada 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 helping manage emergency departments, critical care units, and surgical wards.

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

We would be pleased to discuss these issues with your officials and are requesting the opportunity to speak by phone at the earliest opportunity.

Thank you for your consideration and for the important work you are doing to protect the health and wellness of Islanders. I look forward to hearing from your office soon.

Sincerely,

Patrick Nelson
Executive Director

Marriott Special Rates for Medical Caregivers

A “Community Caregivers Rate” is available to expedite bookings for health care and relief professionals, and support staff. This rate is available through June 30, 2020 at participating Marriott hotels.

Please see the information sheet for guidelines on how to book group and transient rooms. The program is in the preliminary stages and additional sites may participate in the coming days.

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

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