Case Study: The Impact of Nursing Professional Practice during the COVID-19 Pandemic at a Large Community Hospital in Canada.

The COVID-19 pandemic posed numerous challenges experienced by healthcare organizations. Nursing professional practice plays a crucial leadership role in supporting nursing staff and leaders in developing policies, parameters and philosophical approaches for delivering safe patient care. The professional practice leadership at Humber River Hospital, a large Canadian community hospital, implemented three key interventions in this hospital-based case study: (1) proactive workforce planning, (2) increased nursing student placements and (3) novel "stretch model of care" in the intensive care unit (ICU). The overall results following the implementation of these interventions resulted in substantial improvements. For example, proactive nursing workforce planning supported both a 98% reduction in agency utilization and an accelerated ICU certification program with an 84% certificate completion rate. Through innovative strategies, there was a significant increase (33-67%) in the number of nursing student placements during the first two years of the pandemic compared with previous years. Within the ICU setting, we maintained optimum ICU capacity that resulted in stronger partnership-driven relationships between nurses and physicians through an interprofessional "stretch model of care." Finally, we avoided emergency department closures and Code Orange calls during peaks of the pandemic.

Partnering with Patients: The Toronto Central LHIN Telehomecare Experience.

Chronic obstructive pulmonary disease (COPD) and heart failure are responsible for significant healthcare costs in Ontario. One program developed to improve the management of these conditions is Telehomecare, which provides six months of health status monitoring and patient self-management education at no cost to participating COPD and heart failure patients. The Toronto Central Local Health Integration Network (LHIN; formerly the Toronto Central Community Care Access Centre), an early participant, enrolled over 3,000 Telehomecare patients between 2012 and 2016. Research shows that the program reduces emergency department visits and hospital admissions, improves patient confidence and self-management skills and is associated with high patient satisfaction. Program improvements and expansion are ongoing.