Evaluating Toronto Hospitals' COVID-19 Visitor Policy Using Accountability for Reasonableness

In March 2020, the Toronto Region COVID-19 Hospital Operations Table developed a policy to guide visitor restrictions at six hospitals (Toronto Region COVID-19 Hospital Operations Table 2021). We conducted nine interviews with the developers and implementers of the policy based on the accountability for reasonableness (A4R) framework. Participants agreed that the A4R principles were met suggesting fair development and implementation of the policy. However, recurrent themes suggested that the policy disadvantaged those unable to advocate for themselves and that there were unaccounted costs to patients, such as lost time and function. We suggest that visitor policies incorporate equity considerations upfront and predetermine metrics to measure harms to patients.