In order to maintain the health and safety of patients, residents, staff, and physicians during the COVID-19 pandemic, visitor restrictions and policies were introduced at Baycrest in March 2020. Policy changes impacted visitor access in the hospital, the long-term care home, and the retirement home. With restrictions fluctuating depending on the COVID-19 situation in the organization and the local community, it was important to establish a principle- and value-based process to consider visitation appeals.
Prior to the introduction of a formal appeals process, requests for visitor exceptions were managed within business lines (e.g., the hospital or the long-term care home) which had the potential to: i) compromise the therapeutic relationship between the care team and client and family; and, ii) result in inconsistent processes and outcomes for patients and families.
The keys to establishing a successful appeals process were threefold:
- Structured decision-making consistently guided by established ethics principles and values.
- An Appeals Committee comprised of individuals with varied perspectives, including two client and family partners, the Director of Clinical Ethics, and the Client Relations & Experience Officer.
- Ad hoc consultation with operational leaders and subject matter experts (e.g., Infection Prevention and Control) as appropriate stakeholders to the case under deliberation.
The appeals committee meets on an ad hoc basis in response to visitor or client appeals with the expectation that decisions are communicated within three business days of appeal submission.