VHA and SickKids Pilot Integrates PSWs into Bedside Clinical Care and as Core Members of the Health Team
The COVID-19 pandemic has uncovered many realities about the health care system in Ontario and that includes the vital role personal support workers (PSWs) play across all care settings. After COVID restrictions significantly affected the Hospital for Sick Children’s (SickKids) volunteer system, a new partnership with VHA Home HealthCare (VHA) was formed to fill this gap and provide additional benefits during a challenging time.
Pre-pandemic, personal support workers at SickKids mostly supported and observed patients that required 24/7 watch. Since the pilot launched in November 2020, VHA PSWs have been assigned to two inpatient units and trained to deliver a range of bedside support as an extension of the nursing team.
By providing a consistent presence for their patients and families, along with personal support duties, PSWs have helped to reduce pressure on nurses, other clinical staff like social workers, and family caregivers. There are currently 20 VHA PSWs working across SickKids, with plans to expand the pilot to two more units shortly.
“While the pandemic was certainly an important catalyst to start incorporating more PSW support to our clinical workforce, it was not the only one. It was also encouraged by the increasingly complex needs of our patients and families and by PSWs’ unique skillset that fills the space between the care provided by specialized nursing teams and family caregivers,” said Judy Jung, Senior Clinical Manager, Inpatient Multi-Organ Transplant & Medical Specialties at SickKids.
“Our families rely on PSWs not only for activities of daily living like bathing, feeding, transferring and mobility, but also—and often most importantly—for small moments of reprieve from an emotionally exhausting journey,” she said.
This partnership was also particularly helpful during the third wave of the pandemic when SickKids opened their paediatric intensive care unit (PICU) to adult COVID patients to help alleviate some of the pressures facing the adult ICU system across other hospitals.
“In the PICU with our adult population, bathing and oral hygiene care are important aspects of reducing central line and ventilator-related infection risk. In addition, regular repositioning is critical to prevent pressure ulcers. With PSWs providing hygiene care and positioning changes, nurses were able to focus on their specialized functions which was instrumental to the success of this emergency initiative,” said Mary Chen, Senior Clinical Manager of the PICU at SickKids.
During a time when resources and patient volumes have been so unpredictable, PSWs’ contributions at the bedside and unit level have been felt by the entire clinical team.
“Nurses describe their partnership with PSWs as collaborative, allowing the nurses to have more bandwidth to concentrate on the acute and sensitive tasks that are relevant to their specialized training. Medical staff agree that PSWs have offered families a level of comfort and respite that they just couldn’t receive in previous care models,” Judy said. “VHA PSWs have also brought an awareness of hospital to community transitions that has been so helpful for families navigating acute care at the hospital or the return to supported care at home,” she added.
Not surprisingly, this partnership has been overwhelmingly positive for the PSWs themselves who are working in units across SickKids.
For Edelyn Catatuya, the workload over the last year has definitely not been easy, but it’s the patient connection that makes it all worthwhile. “This is important work and that’s why it’s so challenging—every day is different. We’re the first point of contact for families and provide eyes on our patients for the rest of the medical team. The children and families that I care for feel like my own and I love doing a job that takes so much heart,” she said.
Similarly, VHA PSW Rorie Sison feels like the hospital setting with paediatric patients is just where she’s meant to be. “Working side-by-side with the nursing team is such a great learning opportunity. It’s complex, but I’m always asking questions and digging deeper. I truly feel like I’m making a difference in the lives of parents, babies and children every time I go to work,” Rorie said.
“What has really been a highlight of this project for me is how eager, engaged and adaptable the personal support team has been. This was abundantly clear in the temporary Adult ICU unit when our PSWs jumped at the opportunity to help, even though many of them did not have experience in that clinical area,” said Desmond Kiu, Manager of Private and Integrated Services at VHA.
After the success of this pilot, the model is being evaluated and expanded to other units in the hospital. “I know that for the team at VHA, we’re really excited to have another chance to highlight personal support work as essential, valued and critical to keeping our most vulnerable populations safe, healthy and cared for,” Desmond said.