REGIONAL CRITICAL CARE RESPONSE (RCCR) PROGRAM: AN INNOVATIVE VIRTUAL PATIENT STABILIZATION INITIATIVE
CCCF ePoster library. Scott D. Oct 26, 2015; 114752; P48 Disclosure(s): One time project funding was received from the NW LHIN through the Small Rural Hospital Transformation Fund to establish the program. The project to institute the program is complete March 31, 2016.
Dr. Michael Scott
Dr. Michael Scott
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Abstract
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P48


Topic: Quality Assurance/Quality Improvement Project


REGIONAL CRITICAL CARE RESPONSE (RCCR) PROGRAM: AN INNOVATIVE VIRTUAL PATIENT STABILIZATION INITIATIVE



Dr. Michael Scott, E. Hart, C. Johnson, B. Tassone, L. Beck, D. Murray, D. Crocker-Ellacott, D. Chow, D. Raukar, W. Winslow, J. Hawley

Chief of Critical Care Thunder Bay Regional Health Science Centre, Critical Care Lead for NW LHIN, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | Regional Critical Care Response Clinical Lead, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | Clinical Nurse Specialist Trauma, Critical Care and Nerosurgery, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | Respiratory Therapy Professional Practice Lead, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | Director of Trauma and Critical Care, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | CEO of Meno Ya Win Health Centre, Meno Ya Win Health Centre, Sioux Lookout, Ontario, Canada | Executive Vice President of Patient Care Services and CNE Patient Care Services, Thunder Bay Regional Health Science Centre, Thunder Bay, Canada | Northwest Regional Medical Director for ORNGE, Chair of ORNGE medical advisory committee on education., ORNGE, Thunder Bay, Canada | Family Health and Preventative Medicine Resident, Northern Ontario School of Medicine, Thunder Bay, Canada | Manager of Critical Care Services, Thunder Bay Regional Health Science Centre,

Introduction:

The Northwest Local Health Integration Network (NW LHIN) Regional Critical Care Response (RCCR) program is a pilot project that delivers 24/7 video-conferenced; intensivist led critical care consultation from Thunder Bay Regional Health Science Centre (TBRHSC) to eleven Northwestern Ontario community emergency departments and one Level 2 critical care unit.

The RCCR outreach critical care service utilizes the North West integrated electronic medical record (EMR) and the picture archiving and communication system (PACS) to facilitate real time viewing of patient data. This coupled with the Ontario Telemedicine Network’s (OTN) five point personal computer video conferencing (PCVC) system; the RCCR team can provide real time patient assessment. (1) It has been said “One look is worth a thousand words” (2).

TBRHSC has the only Level 3 critical care unit for the northwest and as such, has an obligation to ensure timely access and quality service to the residents of the region outside of Thunder Bay(1). Through RCCR the regional hospitals utilize mobile videoconferencing equipment for consultation when required. The RCCR team consists of an intensivist, a critical care nurse, a respiratory therapist, and when required a critical care pharmacist and dietitian.



Objectives:

The objective is twofold. The first is to enhance the accessibility of advanced-level critical care services by providing real time access to current evidenced-based critical care medicine using an inter-professional critical care team. The second is to improve patient outcomes by providing resuscitative support to regional hospitals. This program focuses on early stabilization of critically-ill patients, facilitation of timely transfer for those requiring advanced level critical care, and prevention of unnecessary transfers for those patients who are able to receive definitive care within their home communities.



Methods:

Through the review of Ontario provincial data (3) it was apparent that patient care outcomes could be enhanced through the development and use of a Regional Critical Care Response program utilizing videoconferencing technology supported by OTN. The program began in 4 pilot sites and is expanding to another 7 hospitals by September 2015. Data from the pilot sites is being collected to evaluate transfer processes and times, impact to patients and how many transfers can be avoided with appropriate supports in place. A patient and family satisfaction survey is being developed and staff perceptions and satisfaction of the program are being evaluated by the Critical Care Secretariat of Ontario.



Results:

Since March 31, 2015 the RCCR program as consulted 38 regionally located patients by video conference with an additional 21 interactions including follow up video conferences and phone support (3). Eight transfers have been avoided by patient stabilization and support allowing the patients to be cared for in their home community (3) saving approximately $136,000 to the Ontario healthcare system.



Conclusion:

The Regional Critical Care Response program provides: (a) real time, essential critical care support to remote and under serviced communities within the Northwest LHIN, (b) optimized patient care related to early critical care specialist engagement and intervention, (c) patients are provided with appropriate level of care within their communities resulting in fewer transfers, and (d) the Regional Critical Care Response program is demonstrating promising results of significant financial savings to the Ontario healthcare system.



References:

1. Hawley, Jennifer. Project Charter Virtual ICU, Aug 2014;4

2. 'One Look Is Worth A Thousand Words'. Piqua Leader-Dispatch (page 2). August 15, 1913

3. CritiCall Ontario. Regional Critical care Response Summary Report. 4/1/2105-4/30/2015; 1-6

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