Alternative Isolation Accommodation

June 15, 2020

Alternative Isolation AccommodationGoal: Reduce the spread of COVID-19 by providing a readily available and safe isolation location for individuals who have tested COVID-19 positive or are in close contact of a positive case and do not have an acceptable location in which to complete their required self-isolation period.

Alternative Isolation AccommodationProcess Overview - Workflow

Confidential – Draft for Discussion Only

Alternative Isolation AccommodationReferral and Intake

Confidential – Draft for Discussion Only

1. Create referral form (sample attached) 2. Confirm referral form submission process/office (phone, email,

other)3. Communicate/distribute referral form/process to referral sources4. Receive form, assess eligibility, prioritize (where appropriate)5. Contact client to:

i. Complete assessment and confirm eligibility/priority for AIAii. Review and accept/decline client accommodation terms

including what to bring during isolation stay6. Document and communicate outcome to referral source.7. Confirm booking/room location with hotel (based on risk).8. Schedule arrival with client including transportation to hotel if

required.

Alternative Isolation AccommodationDuring Isolation

Confidential – Draft for Discussion Only

1. Greet client at hotel and escort to room2. Provide/review welcome package3. Confirm/coordinate special requirements, personal, clinical,

other support needs4. Documented daily check-ins5. Escorted access outdoors (daily), if appropriate6. Clinical (PPE) and other supply7. Meals and security are provided by the hotel

Alternative Isolation AccommodationRelease from Isolation

Confidential – Draft for Discussion Only

1. Receive notification that client is ready for release from isolation 2. Complete client evaluation/feedback3. Coordinated release from isolation (with referral source) 4. Terminal cleaning of accommodations by hotel staff with

appropriate PPE5. Documentation and notification of release, evaluation and any

follow-up actions6. AIA data elements and coordinated/central reporting processes

are established7. AIA data is updated every Tuesday for the COVID-19

Dashboard

Alternative Isolation AccommodationSite Requirements

Confidential – Draft for Discussion Only

1. Site management meetings (daily)2. Facility walk-through & access3. Confirmed workflow, pathways and posted signage4. Locations for:

a. On-site command center spaceb. On-site storage location(s) ex. clean, dirty, PPE, inventory

5. Access restrictions/barriers where required6. Provide space at the hotel and facilitate hotel employee

attendance of education and training re: COVID-19, IP&C & Mental Health

7. Food, housekeeping, security (see client accommodation terms)

Alternative Isolation AccommodationStaffing Requirements & Support*

Confidential – Draft for Discussion Only

1. Sponsor/Leadership - AIA Lead(s)2. Intake Coordination3. Site Management4. Training & Quality Support5. Communications Support6. On-site Clinical Support Staff – Flexible staffing model 7. Infection Prevention and Control8. Mental Health9. Public Health10. Administrative Support11. Implementation Support – Business Analysis, Change Management,

Project Management, Information and Communications Technology* As much as possible completed virtually in consideration of social distancing

Alternative Isolation AccommodationPartnerships Capital Planning Communications Public Health OESH Health Links Mobile COVID-19 Testing ERS Mental Health Home Care Pharmacy

Manitoba Hotel Association Central Services Hotel IP&C Digital Health Red Cross PHAC FNIHB Indigenous Health

COVID-19 Business Process Alignment - Workflow Diagrams

Positive Case Identified

PH completes Investigation and Contact Tracing of Community Cases

Patient self isolates at home or at AIA

PH/Contact Centre Follows daily

Patient Condition Deteriorates – Calls

Health Links/911

Referral to AIA

Location updated in PHIMS

ERS attends patient location

ERS advises if patient needs

transfer and if so location of transfer

Patient Admitted to Hospital

Status Update

Patient referred to Primary Care

Assessment Clinic VIsit or Virtual Visit

Discharge Planning Coordination

Self Isolation Ends

Patient Discharged.

Status Update

COVID 19 Positive Case Workflow

YesAdmission?

NO

OH completes Investigation and Contact Tracing of

HCW

IPC completes Investigation and Contact Tracing of

Facility Patients and Residents

Investigation Documented in PHIMS

YesCondition Resolves?

PH/Contact Centre Refers

No

1

1

Patient Stable/Independent?

Yes

No

Patient Assessed in ER or Urgent Care

and discharged

Referral to AIA

Follow Facility Case workflow

Follow HCW CaseWorkflow

Investigation closed in PHIMS

Contact Identified

PH opens Investigation and refers to AIA as

appropriare

Patient self isolates at home or at AIA

PH/Contact Centre Follows daily –

Advises patient to identify as contact if seeking health care

Contact does not display symptoms

for 14 days

Referral to AIA Location updated in PHIMS

Self Isolation Ends

COVID 19 Community Contact of Positive Case Workflow

Patient referred to Testing Site

Positive? Yes

No

Follow Case Workflow

Investigation closed in PHIMS

If Decision not to Test symptomatic contacts

PH/Contact Centre questions patient at next follow up and

documents negative result

Symptoms? No

1

Yes

Patient Condition Deteriorates – Calls

Health Links/911

PH/Contact Centre Refers

1 Patient Stable/Independent?

Yes

No Outreach testing is arranged

PH/Contact Centre continues daily follow up until

symptom free for 24 hours

PH Notified / Contact becomes

case

HCP and Patient notified

Positive Case Identified as HCW

by PH

PH completes Investigation,

notifies OH and identifies and

follows community contacts – refers to AIA as appropriate

HCW self isolates at home or at AIA

PH/Contact Centre Follows daily

HCW Condition Deteriorates – Calls

Health Links/911

Location updated in PHIMS

ERS attends HCW location

ERS advises if patient needs

transfer and if so location of transfer

HCW Admitted to Hospital

Status update

HCW referred to Primary Care

Assessment Clinic VIsit or Virtual Visit

Discharge Planning Coordination

HCW Discharged.

Status update

COVID 19 Positive HCW Case Workflow

YesAdmission?

NO

OH contacts HCW to obtain symptoms, workplace(s) and dates at work – Notifies IPC and Management as

appropriate

Investigation Documented by OH

Investigation Documented in PHIMS

YesCondition Resolves?

PH/Contact Centre Refers

No

1

1

HCW Stable/Independent?

Yes

No

HCW Assessed in ER or Urgent Care and

discharged

Referral to AIA

Referral to AIA

OH/IPC complete contact tracing for

coworkers and patients/residents.

Follow HCW contact workflow

HCW returns to Work

OH Notifies Manager and closes

incident

Investigation Closed by OH

YesCleared for RTW?

OH contacts HCW and does RTW

assessment

2

2

No

PH/Contact Centre notifies OH HCW is ready to come back

to work

Investigation Closed in PHIMS

Occupational Health (OH)Is notified of

exposed HCW from IPC or PH

OH completes investigation (dates of work, area, PPE, length of contact)

OH Directs HCW to Self Isolate – Refers to AIA if appropriate – Notifies Manager

PH/Contact Centre

Follows up daily –

Advises HCW to self

identify as a contact

Location updated in PHIMS

COVID 19 Health Care Worker (HCW) Contact Workflow

Investigation Documented by OH

PH receives information from

OH on HCW requiring daily follow up and documents in

PHIMS

Yes

HCW returns to Work

Investigation closed

in PHIMS

OH, HCP and HCW receive negative

result

OH Notifies PH to close investigation ,

notifies manager and closes incident

Considered Exposure? NoQualifies for

testing?

Yes

Referral to AIA

NoSymptoms?

Contact does not display symptoms

for 14 days – PH refers

back to OH

Investigation closed by OH

1

Yes

Positive? Yes

No

Follow HCW Case WorkflowHCW calls 911

HCW self refers for testing and notifies

OH1

HCW Stable/Independent?

Outreach testing is arranged

OH and PH notified - HCW Contact becomes case

HCW referred to Testing Site or

outreach testing arranged

YesCleared for RTW?

No

No

Yes

OH contacts HCW and does RTW

assessment

Yes

No

HCW not allowed inworkplace

or becomes symptomatic

HCW self isolates awaiting test results

and contact OH

Symptomatic Health Care Worker or screened out of workplace

OH starts investigation, refers to AIA if appropriate

HCW notifies manager, self refers to testing site and is

tested as priority group

Test Results Received Positive? PH and OH receive

positive result

Follow HCW Positive Case Workflow

HCW returns to Work

OH completes RTW Assesment

OH documents in RL6 and notifies

Manager

Referral to AIA

Yes

No

OH notifies Manager and closes

incident

Investigation closed by OH

YesCleared for RTW?

No

Investigation opened by OH

HCW continues to self isolate

HCW contacts OH when asymptomatic

for 24 hours

HCW/ Manager notifies OH

Positive Case Identified as Facility

Based by PH

Public Health notifies Infection Prevention and Control (IPC) of

positive inpatient or PCH resident

IPC completes contact tracing for patients/reidents

COVID 19 Positive Facility Case Workflow

IPC notifies management and

OH and starts investigation

Investigation Documented by OH

Investigation Documented in PHIMS

OH complete contact tracing for

HCW

Follow HCW contact workflow

PH does follow up with Community

Contacts

Follow communitycontact workflow

Patient/resident is isolated as applicable

Referral to AIA

IPC manages patient until discharge or condition resolves

PH is notified when patient

discharged or condition

resolves

Locations and Functions

Public Health

Public Health Contact Centre

Occupational

Health

Infection Prevention and Control

ERS / Clinical Coordination Centre (CCC)

PHCC –Health

Links

Primary Care/

Assessment

Clinic

Hospital / ER/ U

rgent Care

Alternative Isolation Accom

modation

(AIA)

Screening √ √ √ √ √ √ √

Referral for Testing √ √ √ √ √ √ √

Testing √ √ √

Case Investigation √ √ √

Contact Tracing √ √ √

Case daily follow-up √ √

Contact daily follow up √ √ √

HCW Return to work assessment √

Referral for Assessment √ √ √ √ √

Referral for Treatment √ √ √ √ √

Case transportation √

Provider support and consultation √

Patient Assessment √ √ √

Patient Treatment √ √ √

Referral to AIA √ √ √ √ √ √

Isolation √ √

Isolation Navigation

Isolation Navigation