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About the Critical Care Strategy
Transforming critical care service delivery is integral to keeping Ontarians healthy, ensuring better access and reduced wait times, and providing an environment within which all healthcare practitioners can deliver their best.
The Critical Care Strategy is the effective prioritization of the recommendations outlined in the Ontario Critical Care Steering Committee Final Report into a highly integrated 7-part program. Together, these programs enable the system to help the system; enhancing accountability, empowerment and coordination at the hospital, LHIN and Provincial levels to support new and ongoing improvements to critical care Access, Quality and System Integration.
This initiative will :
Establish a province-wide system for critical care performance measurement and quality improvement
- Improve on the degree of standardization of best practices and critical care training across Ontario
- Increase efficient and effective delivery critical care service delivery via operational management processes, and surge capacity response planning developed and coordinated at the LHIN level
- Flatten the demand curve, mitigating, as far as possible, the need for increased capacity investments and provide clarity where investment is required
Implementation of the seven initiatives is proceeding under the direction of Dr. Bernard Lawless, Provincial Lead, Critical Care and Trauma Strategy.
| Critical Care Information System |
Mandate : Enable evidence-based decision-making to support system-wide capacity planning and targeted performance improvement initiatives through data collection, analysis and reporting.
Key Deliverables :
- Design and build the provincial Critical Care Information System (CCIS)
- Pilot CCIS in 7 hospitals (January 2007)
- Rollout CCIS to additional hospitals over 2007/08
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| Critical Care Response Teams |
Mandate : Bring critical care expertise out of the ICU to patients throughout the hospital 24/7 to improve patient outcomes and efficiency of resource utilization.
Key Deliverables :
- Launch Intensivist-led CCRTs in larger hospitals that meet criteria
- Demonstration Project to test the CCRT model in 4 paediatric sites
- Demonstration Project to test alternate CCRT models in smaller hospitals
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| System-Level Training Initiatives |
Mandate : Expand the skill and capacity of existing Critical Care Health Professionals, enhancing pre-and post-ICU care, and supporting surge capacity response plans.
Key Deliverables :
- Provide training to over 350 RNs and RTs in support of CCRT Expansion
- Provide ACES training to over 100 physicians in community hospitals
- Conduct provincial training needs assessment with CC LHIN leaders
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| Performance Improvement Collaborative |
Mandate : Employ innovative approaches to achieve quality benchmarks defined at the hospital, LHIN and provincial level, and cultivate a culture of ongoing accountability and performance improvement in critical care services delivery.
Key Deliverables :
- Establish Performance Improvement Coaching Teams to address priorities
- Conduct an annual online hospital application process for Coaching Teams
- Deploy Performance Improvement Coaching Teams into 40+ hospital sites
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| Ethical Issues of Access |
Mandate : Establish specific/actionable and medically relevant admission, discharge and triage (ADT) policies supporting Ontario's critical care healthcare providers and patients.
Key Deliverables :
- Research initiatives to contribute towards the development of a Green Paper
- Establish committee of clinician advisors to prepare a draft of ADT policies
- Submit Green Paper and ADT policies draft to the Blue Ribbon Panel for the development of formal recommendations to the Government of Ontario
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| Health Human Resource Investments |
Mandate : Address shortages in key health human resources. Establish, and support the achievement of provincially recognized standards in critical care nurse training and education programs.
Key Deliverables :
- Funding to support critical care nurse training, and to raise the number number of intensivists trained from 8 to 18 annually
- Establish provincial standards in critical care nurse training and core competencies
- Develop college and hospital incentives to upgrade programs to meet standards
- Promote achievement of Standards by nurses through flexible, accessible programs
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| Critical Care Capacity Investment |
Mandate : Increase the number of critical care to address key pressure points, and develop alternatives for medically stable, chronically ventilated patients.
Key Deliverables :
- $19.50M to fund 27 ICU beds and 6 Chronic-Vent beds in 9 hospitals in 2004/05
- $10.25M to fund 14 ICU beds and 4 step-down beds in 8 hospitals in 2005/06
- Implement the recommendations of the Final Report of the Chronic Ventilation Task Group for managing chronic care patients
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