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UPDATED GUIDELINES FROM THE MINISTRY OF HEALTH

The College of Medical Radiation and Imaging Technologists of Ontario (CMRITO) is sending this email to all CMRITO members to inform you of the latest guidelines from the Ministry of Health, which is working towards a gradual restart of services and taking steps to ensure that frontline health care workers are protected while caring for Ontario patients.

On May 26, 2020, the Chief Medical Officer of Health for Ontario issued two documents designed to provide guidelines for health care providers restarting their practice. 

CMOH Directive #2 for Health Care Providers – Revised May 26, 2020 replaces Directive #2 from March 19, 2020. Directive #2 for Health Care Providers now outlines the following steps required by Health Care Providers who are considering a restart of services: 
  • All deferred and non-essential and elective services carried out by Health Care Providers may be gradually restarted, subject to the requirements of this Directive. 
  • In the gradual restart of services, Health Care Providers must comply with the requirements as set out in COVID-19 Operational Requirements: Health Sector Restart, including, but not limited to, the hierarchy of hazard controls. 
  • Health Care Providers must consider which services should continue to be provided remotely and which services can safely resume in-person with appropriate hazard controls and sufficient PPE. 
  • Health Care Providers should be sourcing PPE through their regular supply chain. PPE allocations from the provincial pandemic stockpile will continue. PPE can also be accessed, within available supply, on an emergency basis through the established escalation process through the Ontario Health Regions. 
  • Subject to the requirements of this Directive, Health Care Providers are in the best position to determine which services should continue to be provided remotely (online, by telephone or other virtual means) and which should be provided in-person. This should be guided by best clinical evidence. Health Care Providers must also adhere to the guidance provided by their applicable health regulatory college, and the following principles: 
    • Proportionality. Decision to restart services should be proportionate to the real or anticipated capacities to provide those services. 
    • Minimizing Harm to Patients. Decisions should strive to limit harm to patients wherever possible. Activities that have higher implications for morbidity/mortality if delayed too long should be prioritized over those with fewer implications for morbidity/mortality if delayed too long. This requires considering the differential benefits and burdens to patients and patient populations as well as available alternatives to relieve pain and suffering. 
    • Equity. Equity requires that all persons with the same clinical needs should be treated in the same way unless relevant differences exist (e.g., different levels of clinical urgency), and that special attention is paid to actions that might further disadvantage the already disadvantaged or vulnerable. 
    • Reciprocity. Certain patients and patient populations will be particularly burdened as a result of our health system’s limited capacity to restart services. Consequently, our health system has a reciprocal obligation to ensure that those who continue to be burdened have their health monitored, receive appropriate care, and be re-evaluated for emergent activities should they require them. 
Decisions regarding the gradual restart of services should be made using processes that are fair to all patients. Hospitals have been directed to consider the principles outlined in Ontario Health's May 7, 2020 document A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic when developing restart of services plans for their facilities to assess their readiness and plan for the gradual resumption of scheduled surgeries and procedures, while maintaining capacity to respond to COVID-19.

During this gradual restart of services, MRITs must adhere to the processes and protocols of their place of practice. CMRITO’s role is to support MRITs’ ability to provide safe, effective, and ethical services to patients, and to help them understand their professional obligations and accountabilities. CMRITO cannot provide advice to MRITs on how to restart their practice – those decisions are made by the individual facility, hospital, cancer centre, or clinic. For more information and advice on operational guidelines, please visit the COVID-19 Operational Requirements: Health Sector Restart document.

Hospitals and health care workers may contact the Ministry’s Health Care Provider Hotline at 1-866-212-2272 or by email at emergencymanagement.moh@ontario.ca with questions or concerns about this Directive.

As circumstances change and new guidance is received from government, CMRITO will continue to keep you informed with relevant email updates and posts with the latest information on the COVID-19 page on our website.