Screening Site Locations and Business Units
For Pilot Phase of the CDL RSC project, most organizations do not include all of their employees and will need to determine which location(s) and business units to include. The following should be taken into consideration when determining the location and business units:
Existing medical office location(s)- it is easiest to have the pilot in the same location of any existing medical office since the medical team will be highly involved in the pilot and it might also make sense to do the screening within the existing medical office. This is only applicable to larger companies that have this currently.
- Note: This may not apply if you proceed with a self-administration option with non-medical supervision.
- Number of people working onsite - many organizations have a lot of people working from home and may want to only include people in the pilot that are essential workers required to be in the workplace. Organizations may want to bring employees back to the workplace and will use this pilot as an extra layer of safety in bringing them back. The intent of the pilot is to have as many people screened as possible but since it is a pilot it is easier to start small and increase the number of participants in future pilots or at full implementation of the project.
- Job functions - it may be easier for employees of a certain job function to participate in the pilot than other employees. In order to have as many people participate as possible the pilot needs to be convenient and not be a burden to the employee and therefore screening should take place at a location that is convenient and where the employees will be at for their job function.
- Implementation model - consider who will be administering the screens and who will oversee the screening process (medical vs non-medical professionals). See Screen Administration section below for more information.
Once the location and business units have been determined, the next step is to create a preliminary schedule to ensure the project key milestones are met and the pilots are started as soon as possible to enable more people to be continually screened. It is important for organizations to launch their screening sites as quickly as possible as the sooner the screening starts and the more people that are screened, the sooner the chain of transmission can be stopped. It is better to launch without all the details worked out and make edits to the program as required, then to wait too long and there is an outbreak at the workplace.
Once the high level schedule has been reviewed and approved by key stakeholders, a more in-depth schedule including responsibilities, adjacencies and dependencies should be developed.
Recommendation is to use Microsoft Project to develop and iterate on the Project Schedule, but if your project team doesn’t have access to this program, Microsoft Excel can be used.
Pre-Launch Schedule Template
Example from a Founding Consortium Member provided below:
- Initial communications (invitation to participate, registration form, info session details)
- Information sessions
- Data entry and privacy training (for trained personnel)
- Welcome communication
- Screening Centre walk through (necessary changes made before dry run)
- Participant Kickoff (hybrid model to combine with info session is better)
- Dry run with project team including process for walk ups and a presumptive positive
- On-site personnel training
- Go/No Go Meeting
Leadership Communication and Buy-in
One of the first steps in the Project Kickoff is to communicate the project mission, approach and preliminary schedule with the leadership team (recommended leadership team to include leaders of the business units participating, HR and Communications team leaders) -- this supports buy-in and alignment. Transparency and open communication are important for participant buy-in and this initial step to ensure the leadership team understands and supports the initiative will help with participation later.
Pilot Communications Approach Objective
- Ensure the leadership team understands the public good around this pilot - that we are working to accelerate rapid screening to support re-opening of the economy
- Employees’ and their family members health and safety is very important and this is one additional step to support employees
- Pro-active screening of employees helps to find cases early and reduces chances of an outbreak and also mitigates potential reputational risk related to the outbreak
- Communicate details of the false positive and false negative rates associated with rapid antigen testing. You may be asked this question from your leadership team while they are considering potential workforce implications as a result of a positive screen.
- The leadership team should also understand the use of de-identified data by CDL as part of the Central Data Infrastructure.
- Ensure frontline team members involved in the pilot feel safe and informed
- Keep broader team informed of the return to workplace plans and timelines
Once the above steps have been completed and approved by the key stakeholders it is important to engage the union leaders if any participants in the pilot are part of unions. As with leadership, transparency and open communication is key and early engagement will help to create trust and reduce delays.
Roles and Responsibilities
You can now begin to assign roles and responsibilities amongst the project team members. Resource Requirements highlights the necessary information on the roles required at a CDL RSC Screening Site. Additional team members should be brought in as quickly as possible so that they can be familiarized with the project prior to communicating to employees.
If you have not done so already, engage Human Resources and Communications team members, if applicable to your workplace.
It is important to engage your Human Resources team in order to ensure:
- Alignment on pilot
- Protocol for positive screen
- Assistance in sourcing site specific roles
- Provide business units specific recommendations for pilot roll out
- Determine target group and assist in getting necessary employee lists for communications
It is important to engage your Communications team in order to ensure:
- Develop target group communications inviting them to participate
- Engage leaders to send information out to their teams
Screen administration should be considered early in the planning process as this will affect resources and site setup. Each province has its own regulations and refer to the Regulatory Requirements section for more information regarding individual provinces.
Screen Administration Options
- Registered Health Care Practitioner (HCP) - Specimen collection (swabbing) for screen administration is performed by a registered HCP and program participants only need to lower their mask and the HCP completes all other steps of the process. For many organizations this means they would have to hire HCPs to perform the screens.
- Trained Professional (TP) - Specimen collection (swabbing), processing and results are all completed by a TP. Often training is provided by a HCP but not required unless stipulated by the province.
- Self-administration - One or more steps in the screening process are performed by the participant. Consideration should be given to whether the self-administration steps are supervised by a HCP or TP or not supervised at all.
- Self-administration - steps in the process:
- Self-swabbing - The individual being screened swabs themselves.
- Self-processing - This is the process of mixing the swab with the buffer solution in the tube, adding drops to the cartridge and starting the timer.
- Self-reporting - Once the 15 minutes is complete, read and record the results and share as required.
- For self-administration it's possible for a participant to do one or all of these steps while a HCP or TP performs the other steps.
- Many organizations may choose to start with HCP before switching to TP and self-administration, and eventually home-screening. The goal is to start screening as soon as possible with as many participants as possible, and using a HCP or TP to start may be beneficial.
- The advantage of self-administration is that the throughput can be increased and less HCP or TP would be required. Even with self-administration, it's possible to have a higher ratio of number of participants to number of people supervising. For example, four participants could be swabbing with one TP supervising.
- Batching can be done with participants self-swabbing and leaving their labeled swab for a HCP or TP to process a batch of swabs at once. It is important to read the screen manufacturer's instructions to make sure that the swabs are processed within the time limit required. If not done properly there is a higher risk of error with this method.
- Organizations that allow for self-administration should always have a HCP or TP available to administer a screen for someone that may have limited physical abilities to be able to perform it themselves.
- Self-administration - steps in the process:
- Home-screening - The participant performs all three steps of self-administration at their home, either virtually supervised or unsupervised. At this time, home-screening has only been approved by a limited number of provinces.
- Reasons to implement home screening:
- Prevent asymptomatic transmission within the workplace through upstream detection
- Provide employees with a simplified experience from the comfort of their own home
- Increase ability to scale the rapid screening program to more participants across the country
- When initially starting home-screening, recommendation is to have the process virtually supervised to ensure the participant is comfortable with the procedure and that it is administered properly. If the participant previously participated in supervised self-administration at the workplace this may not be required.
- Recommendation is to use an app so that participants can easily add their results and upload a photo of the result. If an organization is very small it is possible for participants to email the rapid screening project team/supervisor or add results to a shared excel document.
- There is a risk of participants sharing the screens with family and friends but it is recommended to trust employees to do the right thing. If necessary audits can be done to ensure that all screens are accounted for. There may be more spoilage in home screening and this should be accounted for when ordering screens.
- Where permitted, home screening is especially beneficial for smaller locations where it would be difficult and costly to set up screening onsite.
- Reasons to implement home screening:
Notify Public Health
Organizations are responsible for letting their local Public Health department know that they are engaging in a private testing program and screening asymptomatic employees using rapid antigen tests. This should be done prior to initiating testing and early in the process in case the local Public Health department requires more information. Organizations must have processes in place to report all positive results from antigen screening to the local public health unit if required by the applicable public health authority.
If the organization has a medical team and someone from the team is working on the CDL RSC Pilot Site, this individual should notify Public Health.
The following information should be shared prior to starting the screening process:
- Location of the screening
- Approximate number of people being screened
- Test manufacturer and test name
- Frequency of screening
- Process for positive screen results:
- Notify Public Health
- Confirmatory PCR test within 24 hours
- Internal contact tracing
- Continuing Public Health processes:
- Daily Health questionnaire for anyone entering the workplace
- Physical distancing
- Mandatory mask wearing
- Hand hygiene
The links below are for the Public Health departments in each province: