SCHEDULE A
Background and Overview
Residents living in congregate housing are often medically complex and vulnerable to increased mortality and
morbidity, including from COVID-19 infection. Homes may have difficulty providing appropriate isolation of
residents. Non-SHA community based homes may have more limited supports in place to address increased
medical and clinical needs without targeted supports. The restrictions of family members who would normally
be present to aid in the care of their loved ones adds a substantial additional strain to the facility/home’s ability
to care for their residents, including those who may be COVID-19 positive.
Family physicians cannot always attend to patients in the homes, or cannot attend in a timely manner. Many
family physicians are themselves at increased risk of poor outcomes if COVID-19 were contracted, resulting in
additional caution when attending congregate living facilities with possible COVID-19. The DASH program will
help to ensure suspect or COVID positive residents living in congregate housing have access to an in-person
physician consult if one is needed.
Guiding Principles and Duties
• DASH physicians provide backup when the Most Responsible Physician (MRP) is unavailable for consults with
COVID suspect or positive residents.
• The MRP will always be the first point of contact by the homes. Homes cannot connect with DASH
physicians directly.
o If the MRP has provided a virtual/phone consult and has determined that an in-person consult is
required but cannot attend, the MRP may contact the network DASH physician. If required, the
MRP may engage the DASH physician to provide the initial virtual/phone consult.
o The MRP will connect with the DASH physician per the network process that is established.
o If a home has made two unsuccessful attempts to connect with an MRP and over an hour has
passed, homes can connect with a Virtual Triage Physician (VTP) via Healthline 811 for an initial
virtual/phone consult. If the VTP determines that an in-person consult is required, they can connect
with the DASH physician.
• DASH physician services required are:
o available for 24/7 call coverage, preferably in 1 week periods for clinical management consistency
o Response by telephone within 1 hour of consult and if required, to the bedside within 2 hours of
consult.
o Respond to requests from neighboring network area facilities (concept of mutual aid) as required
o Determine if transfer to an emergency department for assessment is required, and make
arrangements as required.
o Document to provincial standards of a consultation and make available to MRP
o Follow work standards/processes provided either provincially, or by the network (including PPE
requirements and donning and doffing best practices)
o Ensure escalation via MRP to network leads if concerns/risks are identified in the home that may
require attention that are outside of the DASH physician’s scope (i.e. unable to isolate, staffing
concerns, inadequate PPE usage, etc).
See DASH Physician On-Call Algorithm on next page.
