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Regulation Matters 2020, Issue 3, December

Survey Provides Insight Into College Pandemic Communication

The College asked members for feedback from July 30-September 7, 2020 about our communications during the first wave of COVID-19. We wanted to assess what we did well, what we should stop doing, and what we could add to help dietitians provide safe, ethical and competent care to assist with the planning for the second wave of the pandemic.

378 dietitians (~9% of members) responded to the survey. 

 

CDO Response to Survey Feedback

In the past few months, we have all been faced with uncertainty and changes to our regular practice routines due to the COVID-19 pandemic. We might not have all the answers right now, but we want to let you know we are here – listening and acting within the scope of our mandate to achieve collaborative, evidence-based, and most of all, accountable work.

In response to your feedback:
 

  • We have established weekly meetings for staff to collaborate on communication updates during the pandemic.
     

  • Our Practice Advisors will host more webinars to discuss complex issues related to the pandemic as they arise.
     

  • Your input will be considered in our plans for future communications and resources for dietitians.

We would like to express our sincere appreciation to everyone who responded to the survey. A summary of survey responses is below. Thank you.

32% Never Accessed the College's COVID-19 Updates 

Approximately 32% of respondents (n=119) reported never having accessed the College’s COVID-19 Updates web page.  We would like to hear from those dietitians. 
 
  • Is there anything needed that perhaps we have not been providing?
     

  • Do you know where to find information on the site?
     

  • Are resources needed in specific areas?

Please do reach out to us with any of your comments by clicking on this link to access an anonymous comment box or contact us by email or phone.

OVerall, COMMUNICATION valued 

Overall, the feedback about College communication during the pandemic to date was positive. Survey respondents felt that communication from the College provided a valuable resource for dietitians in practice. Some members commented that they appreciated that the College sought feedback. The following themes emerged from your comments.

Note: Some quotes have been slightly modified for readability.

Communication Appreciated

Most survey respondents appreciated the frequency of communications by email on  the COVID-19 Updates page and from the Practice Advisory Service. In addition, communication about the deferrals of the Jurisprudence Knowledge and Assessment Tool (JKAT) and the Peer and Practice Assessments (PPA) were appreciated along with the Registrar’s messages about the pandemic.
 

  • “ Email & communications were adequate to guide my practice.“

  • Appreciated timely output of updated regulations, even after business hours.

  • “ I do not think the CDO could have done anything better. Very satisfied with the College’s response and communication to members. Gave very clear guidelines on how to change the practice safely, including using virtual care effectively.

  • I think communication was just what we needed.  I particularly liked the communication from the ED/Registrar.

  • Communicating about postponing assessments was extremely helpful during this difficult time. Your resources have been extremely valuable to me during this pandemic.  Please keep them coming. I hope more dietitians will take the time to read some of the info. ”

  • The COVID-19 webpage is very helpful. It summarizes nicely what the guidelines are for dietitians and the orders from the Ministry. It is easy to read and to find the info either in summary or the links to more details. Page was updated with newest information in a timely manner. New information well dated and noticeable.

  • The webinar communications/presentations gave very clear guidelines on how to change the practice safely, including using virtual care effectively. The updates on expectations and the webinar on virtual visits were all helpful to provide much needed assurance of being on the right track with patient care.

Improvements Suggested

  • “Provide clear concise guidelines for parameters of our work.”
  • “Make the main messages like the fact that we are to conduct mainly virtual visits (if possible) be in the body of the email vs. on the webpage & linked from email message.”
  • “Need for further clarification of redeployment requirements.”
  • Please send weekly email updates even if there are no changes if there is 2nd wave of COVID-19. That way we are most updated.”
  • “Provide more webinar educations on virtual care based on the questions that you receive from other dietitians. I really liked the one you offered recently.”
  • Need for further supports to public health dietitians redeployed to work outside of dietetics.”

Dissatisfied or Unsure About COVID-19 Communications

Three respondents expressed dissatisfaction.

  • “Emails were unclear, poorly written, not timely. Not encouraging given the fees we pay.”

  • “The College did not do anything overly well.”

  • "College should think about dietitians and not the public."

The respondents expressing dissatisfaction (n=3) also reported never accessing the COVID-19 Updates page.

A small number of respondents (n=8) expressed being unsure of the College’s pandemic response. These respondents reported never accessing the COVID-19 Updates page (n=5) or accessing at least once a month (n=3). 

IMPACT OF PANDEMIC ON DIETITIANS

Essential Virtual Practice

  • “I have switched to a totally virtual/phone platform which is working well. Sometimes more convenient for clients in terms of flexibility and timing.”

  • “Doing inpatient rounds virtually, more virtual patient interaction, same workload.”

  • “No impact - providing care via phone or video.”

Challenge with In-Person Care

  • “The Pandemic has minimized the number of homes where I and the Consulting RD's that are contracted with our company are permitted to work in.  It is challenging to only work remotely and not be able to physically assess swallowing ability, observe the residents eating, talk with them and speak and liaise with the whole care team in assessing nutritional needs.”

  • “There was huge impact. Wearing masks daily. Having to wear a lot more PPE for anyone at risk of being positive.”

  • “Resigned from my casual hospital position because I also work FT in LTC.”

Concerns About Redeployment

  • “In public health, registered dietitians were redeployed, but there was much confusion about what the skills and capabilities are of registered dietitians.”   
  • “Our entire Population Health team was re-deployed to COVID-19 communications.” 
  • "Redeployed to clinical (had to quickly upgrade my skills for EN and TPN); managing 2 programs at once along with personal issues is quite stressful.”
  • “I was redeployed. Twice. It was terrible. I would prefer not to talk about it.”
  • “Redeployment involved training in different sectors, outpatient to inpatient, understand medical orders, documentations, get familiar with virtual technologies etc.  get familiar with PPE how to use it to protect ourselves - more information should be given related to PPE for health providers in all the different sectors.”

Felt Supported by their Organizations

  • “Went all virtual immediately until able to resume some essential face to face visits. I felt well supported. Would have found it hard to be in private practice.”

  • “Not much has changed for me in LTC, except for wearing masks and having meetings and care conferences via phone or video chat.”

Felt Unsupported by their Organizations During the Pandemic

  • “I was suspended 'indefinitely' then terminated (LTC facility) with the perspective of a second wave.”

  • “I could not consistently perform physical nutritional assessments for intubated COVID patients to spare limited PPE for the nurses and RT’s.”

  • “My organization has not provided any support for the transition to home. The platform we use is inadequate for completing my work as I usually facilitate group programming, however, I have been making it work.”

  • “Furloughed early April and position in limbo.”

    Stress and Burnout  

  •  “I have been off on leave due to lack of childcare.  Returning next month.”
  • “Job is unfulfilling because all my client appts are by phone. My work has become tenfold busier, as I am leading food access program. Burnout is a huge deal.”

  • “I have been going into my home and working shoulder to shoulder with my colleagues in full PPE since the start of COVID in LTC.”

  • “I felt like I was a pawn, and no one cared about me. It also did not help much that the government did not see RDs as essential very noticeable burn-out from both patient and RD desiring in-person visit and feeling not enough was being done to satisfy these patients as well as reduce anxiety on part of the therapist.”

  • “I am very concerned about my CDO registration status.  I am greatly concerned about meeting my registration requirements - hours of work related to nutrition and professional development goals.  As I work in public health and have been redeployed to the COVID response.”

  • “Realistically, do not have time to focus on SDL due to stress, pressures of COVID-work

We appreciate receiving feedback on improving our communications. Data drives good decisions, and we will consider your input as we plan for future communications and resources for members. Thank you.