COVID-19 BC Renal Emergency Operations Committee: Their Role and Reflections on Successes
“I have been amazed and humbled by the response of the entire renal community to this crisis." - Dr. Mike Copland
The BC Renal network’s response to COVID-19 has been a collective effort across British Columbia’s five regional health authorities. Long-established specialized provincial committees and groups, such as the Hemodialysis Committee, all worked quickly to address particular clinical needs for kidney patients and staff. Their efforts have been complemented by those of the BC Renal Leadership team, Statistics and Methodology group, PROMIS team (Patient Records and Outcome Management Information System), and more.
However, the emergence of the pandemic brought about new challenges that went beyond the usual ones related to providing kidney services and care in BC. In the early weeks, these challenges spanned the safe transport of patients to appointments as well as the supply of drugs, personal protective equipment, lab tests, and more. In addressing these challenges, the rapidly changing health and safety needs of patients, families, health care providers and other essential workers needed to be considered. The critical nature of these needs led to the formation of a new Emergency Operations Committee.
The BC Renal Emergency Operations Committee was established and first met by video conference on March 16, the day before the provincial health officer declared a public health emergency. The team of six includes BC Renal executive director Dr. Adeera Levin and the five medical directors of BC’s regional health authority renal/kidney programs: Drs. John Antonsen, Melanie Brown, Michael Copland, Marie Michaud and Anurag Singh. (Please see below for quotes from each member.)
The team quickly settled into daily video conference meetings, Monday to Friday. After two weeks and considerable progress, they reduced their meetings to three times per week, with the frequency subject to change depending on need.
The committee has served as a hub for decision-making and action with a role officially described as, “critical for the integrated and safe functioning of kidney services provincially and regionally.” Working together as well as directly with the HandiDart bus service, BC Ferries, pharmacies and pharmaceutical companies, suppliers of personal protective equipment, BC labs, and more, they have been able to negotiate solutions and come up with creative alternatives when obstacles have persisted.
Because BC Renal was already a mature, interconnected provincial network with more than a 20-year history, the team has been able to quickly connect with key individuals throughout the province, make decisions and implement them across the five different health authorities.
Their work has been guided by the pre-existing Provincial Renal Emergency Management
and Business Continuity Plan and they have also taken into consideration the framework of provincial, regional and institutional Emergency Operations Committees.
In May, we asked each of the six team members the following question, and they came back to us with answers that not only show the strength of the committee and network structures, but also the dedication of the people who provide services and care for the 20,000 or so British Columbians who have diagnosed chronic kidney disease.
Q: What stands out for you as contributing to the successes of the BC Renal Emergency Operations Committee in being able to rapidly respond to the challenges of COVID-19? (In particular, challenges to patient experiences or kidney care in BC)
“We needed to prepare for COVID-19 without knowing what was coming. Angst and uncertainty brought many questions in March and April – questions I was ill-prepared to answer alone. It is said that two heads are better than one, so six must be even better, right? Leaning on each other for validation, confirmation and mutual support, the BC Renal Emergency Operations Committee accelerated our coordinated response to ensure better care and hopefully outcomes for patients in every part of our province. To put it bluntly, alone I would struggle to lead. Together, we helped our teams do amazing work.”
“The regular and frequent daily contact with the other health authority medical directors and BC Renal executive director allowed us to ensure we had a full understanding of what was happening around the province and to ensure we were addressing problems consistently. Decisions were made and ideas were shared collectively. This also acted as a support system and allowed us to express our concerns when we were worried about the safety and well-being of our patients and staff.”
“I have been amazed and humbled by the response of the entire renal community to this crisis. Never have I seen so much done by so many with such focus in such a short time to keep our patients and one another safe. It is amazing seeing traditional silos fall, and I hope that is a positive legacy from COVID-19 in the future.
I have also been impressed with how mature the BC Renal structures are at coping with a crisis like this. The machinery was built and ready to go; we just needed to flip the switch to get it turning. That was an exciting thing to both watch and be a part of.”
“The BC Renal Emergency Operations Committee has given me the opportunity to discuss the pandemic situation with the renal leadership, problem-solve related issues within a supportive group, review the evolving situation in the different programs across BC, and ensure that the adaptation to the situation and the standard of care in Interior Health continues to be equivalent with the rest of BC.”
“I feel what stands out for me was the established trust and relationships between BC Renal Emergency Operations Committee members that grew stronger as we worked together to problem-solve and support each other during this crisis. We didn’t need time to understand each other’s perspective, we already knew each other!”
“All members of the BC Renal Emergency Operations Committee are interested in ensuring the safety of patients and staff as our core motivator, and thus came together easily. There is clear delineation of our roles and responsibilities as medical directors for our health authority renal programs, and mobilizing individuals and committees to do the work that needs to get done is accomplished nimbly. BC Renal structure did not need 'rejigging' to be able to deliver patient- and staff-facing information, guidance and tracking.”
For additional insight into how particular provincial committees and teams have responded to COVID-19, please see the video recordings or PDFs of our Expanded Province Wide Rounds presentations, starting with the May 1 presentations, available on the BC Renal website here
- Planning for acute and chronic patients
- Determining capacity with changing environments and circumstances
- Communication within health authority locally and across multiple institutions
- Communication between health authorities and provincially
- Development and vetting of contingency plans
- Regular conference calls
- Review of emails/communication pertaining to situation in a timely manner
- Role modelling
- Attendance at local Emergency Operations Committee meetings
- Attendance at BC Renal provincial Emergency Operations Committee meetings