Arizona Hospitals and Health Systems’ Statewide Collaboration Producing a Triage Protocol During the COVID-19 Pandemic

We describe the process by which all hospitals and health systems in Arizona, normally competitors, rapidly cooperated to develop a statewide protocol (“Addendum”) delineating how to allocate scarce resources during the COVID-19 pandemic should triage be required anywhere in the state. Eight physician ethicists from seven different health systems created the Addendum, which was accepted by all hospitals and health systems, approved by the State Disaster Medical Advisory Committee (SDMAC), and then formally adopted by the Arizona Department of Health Services (ADHS). In addition, the entire state developed a plan to “stick together” such that no facility would be forced to triage unless all were overwhelmed. Because we are unaware of any other state’s hospitals and health systems producing and committing to a shared triage protocol and plan, we believe this experience can serve as a model for other locales during the absence of sufficient state or federal guidance.

Conversations with a neurosurgeon

In the third of three interviews in this issue, we speak to Dr Fawaz Siddiqi. Dr Siddiqi is an Assistant Professor of Neurosurgery and Orthopaedics at Western University. He is the president of the Professional Service Organization and sits on the Medical Advisory Committee as well as the London Health Sciences Centre Board of Directors. He is also the course chair for the Healthcare Systems course at the Schulich School of Medicine and Dentistry.

Bridging the Gap between Family Doctors and Regional Health Authorities

The communication between family doctors and regional health authorities has become more complex and fragmented over the last 2 decades. By using a novel approach, we developed a medical advisory committee structure for community physicians enshrined in the regional health authority bylaws. This has improved bilateral communication, policy making that affects patients in the community, linkages between programs and family doctors, and input into the institutional care of our patients. We believe this model could be implemented or adapted by regional health authorities elsewhere in Canada having as its ultimate goal better patient care.