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Pivoting during the 2020 pandemic to maintain strategic growth

By Dr. Andrew West

The past months have been an exceptionally busy period for the members of the Canadian Society of Respiratory Therapists (CSRT) who have been providing essential care for Canadians affected by COVID-19. Canadian respiratory therapists (RTs) are an essential part of the frontlines of Canada’s healthcare response to the pandemic. They are experts in the management of ventilators and in airway management. They are essential members of our health care workforce, practicing alongside other health professionals to assure safe and effective respiratory care for those affected by the crisis in the community, in their homes and in our hospitals.

As the voice for Canada’s growing community of RTs, the CSRT has a mandate to advance the profession of respiratory therapy. The association achieves this by providing practice supports and continuing professional development for members, by advocating for RTs and their patients, and by fostering growth of the evidence basis of the profession.

To support its membership during the COVID-19 crisis, the CSRT responded with a comprehensive range of initiatives aimed at supporting members’ needs. These have all been accomplished while, like many associations, the CSRT confronted unforeseen challenges such as the changing landscape in which we now work and do business.

Over the two years leading up to the pandemic, the CSRT witnessed a period of significant renewal and growth. A central undertaking during that time was an infrastructure renewal initiative that saw the overhaul of many aspects of the organization’s operations. This initiative was undertaken to implement a range of technologies that would flexibly support the collaborative work of local and distributed staff and volunteers in order to achieve the association’s goals in a cost-effective manner. By investing in these opportunities, the CSRT has been able to strengthen the services available to members, all while achieving cost savings – positioning the association well to support members through the first wave of the pandemic.

At the outset, it appeared the COVID-19 crisis may pose barriers to the momentum of success relative to the ambitious goals outlined in the CSRT’s new strategic agenda. However, the recent operational and strategic reset had positioned the association well to support members through the first wave of the pandemic. The COVID-19 crisis prompted the CSRT to pivot operationally, while continuing to honor its strategic trajectory. Throughout this period, the CSRT has been able to deliver all services for members without interruption due to the recent infrastructure renewal.

PHASE 1: INITIAL ACTION UPON ANNOUNCEMENT OF THE PANDEMIC
Since the appearance of the virus late in 2019 and subsequent declaration of the pandemic, the CSRT diligently monitored and assessed the potential impacts of COVID-19. At all times, the health and safety of our members, volunteers, conference registrants, speakers, industry partners and staff were at the forefront of our discussions and planning. As the immediacy of the risks associated with this pandemic became clear, the CSRT acted expediently.

As part of its ongoing monitoring, the CSRT undertook a comprehensive public health risk assessment of the 2020 CSRT conference, pursuant to the guidelines established by the Public Health Agency of Canada (PHAC) and the World Health Organization (WHO). As soon as it was clear that there were substantial health risks associated with the 2020 CSRT annual conference scheduled for May, it was cancelled and some other activities planned for 2020 were delayed. In their place, innovative practice supports and continuing professional development (CPD) opportunities for RTs were implemented.

From the outset, the CSRT has prioritized supporting the practice of RTs by hosting a relevant and timely repository of information on COVID-19. We also established a national discussion forum for all members to share ideas about evolving professional practice issues related to COVID-19. In a time when we were all being inundated with information of varying degrees of reliability, the CSRT recognized that it was crucial that members have a trusted source for accessing reliable and relevant information. Immediately a repository of information on COVID-19 was implemented, providing a wide range of curated, practice-supporting resources for members.

PHASE II: INCREASING PUBLIC AWARENESS ABOUT RESPIRATORY THERAPISTS
There has been a longstanding desire amongst RTs for greater public awareness of the critical role they play in healthcare. By early March 2020, the CSRT begun working quite deliberately to engage all major media outlets across Canada in an effort to help provide the public with the information they need. We have been directly involved in interviews and in making connections between media and front-line RTs across Canada. As RTs were providing exceptional care in the face of this crisis, the country began to take notice.

RTs began receiving much more attention in local and national media than is typical. The terribly unfortunate circumstance being faced by people around the world suddenly created an incredible appetite here in Canada, and internationally, for information on the equipment and devices RTs use to treat patients. In particular, there was great concern amongst the public, a feeling shared by many RTs, that we would face shortages of vital treatment tools such as ventilators. This unprecedented level of media engagement on the part of the CSRT has positioned RTs well to influence the public narrative. The work and expertise of RTs across Canada and beyond is being written about, and discussed on television and in the streaming media. In addition, the CSRT set the foundation for heighted advocacy efforts by establishing connections in all levels in the public health agencies that were providing key leadership through the crisis.

PHASE III: LEADING THROUGH HEALTHCARE SYSTEM CAPACITY CHALLENGES
The impacts of COVID-19 were expected to (and did) stretch the capacity of many facets of Canada’s healthcare systems. As the realities of the pandemic set in, RTs began playing a leading role in this historic national response – not only on the frontlines of clinical care, but also through collaboration with all levels of government. In late March and through April 2020, much public attention turned to the availability of critical medical equipment, in particular ventilators. As the federal government announced the procurement of 30,000 new ventilators to be added to national stockpiles for use wherever need surpasses capacity in Canada, the CSRT had already been collaborating with the agencies involved to share the expertise of RTs in securing appropriate stockpiles.

The CSRT was actively working alongside the PHAC and Health Canada to procure ventilators from manufacturers domestically and internationally. Throughout this procurement process, the CSRT provided expert review of a range of ventilator models being considered for federal approval and purchase. This collaboration ensured that CSRT members’ expertise formed an important part of the decision-making process. Collaboration with PHAC positioned the CSRT to be well informed of the ventilator models available in national strategic stockpiles. To support RTs across the country who may use these in their practice, the CSRT was positioned to publish a collection of resources for each ventilator model available in the National Emergency Strategic Stockpile for members.

In collaboration with the federal Ministry of Innovation, Science and Economic Development, the CSRT provided expert advice on a range of Made-in-Canada innovative ventilator designs. The Ministry’s review process culminated in selection of new ventilators models that will be manufactured by Canadian companies who will modify or retool their production facilities. Again, CSRT members were positioned at the forefront of these creative and unprecedented solutions.

Equipment availability, is of course, only part of the equation of health system readiness for a pandemic. To help ensure the availability and readiness of RTs to care for Canadians, the CSRT made efforts to mobilize RTs and ensure the health human resource needs are safely met in each province. These efforts included launch of a Rapid Response Refresher Toolkit to support RTs returning to practice after retirement, and those who identified the need for continuing professional development in specific areas of practice. We have also released new position statements to provide practice guidance in increasingly challenging work environments.

PHASE IV: PROVIDING SUSTAINABLE SUPPORTS FOR MEMBERS
Over the past months, the CSRT has been working harder than ever for its members with the announcement of additional CSRT initiatives that would help support them through the pandemic and beyond. CSRT open access courses were made available through the CSRT website on practice-oriented topics related to the care of patients during COVID-19. These were developed specifically with the intention of supporting seasoned practitioners, as well as those who might be returning to practice after retirement. COVID-19 specific e-courses continue to be developed in real time and released as the science on the topic grows. Additionally, the first ever CSRT e-conference series was officially announced. Prior to COVID-19, members had been looking forward to another incredible CSRT annual conference in Montreal. Like other many other associations, after cancellation of the CSRT national conference there was a need and opportunity to fill the void this educational opportunity reliably filled. Perhaps uniquely, the CSRT implemented the e-conference as a series that will occur over a six-month period, facilitating the attendance of a very busy membership.

Recognizing that establishing momentum can be quite a bit more challenging that maintaining it, the CSRT continues to this day to actively pursue opportunities to advocate for our members. Leveraging the increased awareness of the profession and collaboration with government agencies and partners are seen as key in future advocacy endeavors. The CSRT is pleased with the successful track record of ongoing advocacy initiatives, such as one recently directed at the Government of Ontario aimed at ensuring RTs are recognized fairly for their contributions alongside their inter-professional colleagues. Positive outcomes like this decisively demonstrate the impact of the CSRT advocacy program.

MOVING FORWARD: OPPORTUNITIES
Through the COVID-19 crisis, the CSRT continues to experience a period of strong and sustained growth, leveraging its recent operational investments and redirection. Membership continues to grow, the organization’s fiscal position remains strong, as does its ability to deliver on an ambitious long-term mission.

Throughout the pandemic, the CSRT has been able to rapidly respond to the challenges being faced. At a time when healthcare was in the spotlight, a substantial media campaign that leveraged opportunities to advocate for RTs was mounted, governments at all levels were engaged and new partnerships with governmental departments were formed, and a wide range of continuing professional development supports for RTs were created. Together these enabled the CSRT to set itself apart by focusing resources on strategically important initiatives that drive growth.

The heightened level of activity by the CSRT has helped position RTs well to provide leadership in the Canadian healthcare system, and the CSRT as the association that supports their achievements. 

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