UHN Strategic Directions 2016: Global Impact – Local Accountability
Stemming from the UHN Strategic Plan are five domains and strategic themes that the organization uses as its framework, outlined in its purpose statement: “We are a caring, creative, and accountable academic hospital transforming healthcare for our patients, community, and the world.”
It is from these themes that Critical Care has based its own strategic themes, aligned to the UHN domains.
Create structure and governance that fully supports our people to become integrated collaborative leaders in Critical Care
- Develop and promote a culture shift towards an inter-professional model of care
- Collaboratively work toward standardization of roles and scope of practices between Critical Care environments
- Develop an environment that promotes and sustains staff engagement and wellness
- Become a fully integrated and collaborative entity with its own academic mission and vision
- Grow Academically
- Establish a single point of accountability for Critical Care areas
- Establish a committee to explore, identify and address issues important to staff related to education support, work satisfaction, and staff education.
- Promote a culture of innovation and continuous education to enhance the skills and processes related to patient care.
- Establish an ICU standards committee to establish guidelines around equitable patient assignments, consistent and flexible staffing models, and consistent role descriptions.
- Optimize the scope of practice of all staff
- Encourage open communication across all units and promote opportunities for staff to participate in discussions
- Promote “in the moment” debrief discussions and feedback related to incidents of loss of patients or difficult situations.
- Establish and promote a crisis team to address difficult situations and events in Critical Care for staff as well as serve as a mechanism to generate new ideas and process improvements.
- Continue to report independently to the UHN Board Quality Committee.
- Sustain Governance Structure through Critical Care Executive Committee.
- Recruit two to three physicians with academic interests aligned with Neuroscience, Lung Failure, Transplant and Oncology by 2016.
- Strengthen alignment of research and education to key programs, Neuroscience, Lung Failure, Transplant, Cardiovascular and Oncology.
- Re-profile the program with the establishment of three new endowed Chairs: Chair in Critical Care, Chair in Neuro-critical Care, and Chair in Advanced Lung Support.
- Establish permanent Medical Directorship who is acknowledged as a system leader across the network.
- Sustain Critical Care Executive and expectation of all Critical Care units across UHN.
Provide exemplary, safe patient care for our patient
- The Right Care, at the Right Time, at the Right Place
- Develop timely documented treatment plans
- Promote consistent & thorough communication
- Develop,nurture and support Advanced Care Planning outside of Critical Care areas
- Develop consistent patient safety and quality standards
- Develop standards around Patient Centered Appropriate Use of Critical Care Services.
- Implement a standard documentation policy for outlining critical care treatment plans.
- Establish standard practices in the development of patient treatment plans, e.g. Forms to be completed within 48 hours of ICU admission.
- Establish consistent documentation and practices across all ICU units, e.g. use of Patient Value Form and Family Meeting Form, and practices such as MD-led updates with patients and families.
- Establish effective communication strategies related to patient care by:-Documenting all treatment plans-Incorporating E-ClinDoc/EPR technology-Conducting discharge/transfer meetings from patients leaving the ICU with defined complex care needs-Revising the UHN Transfer of Accountability form to reflect inter-professional treatment plans, including the goals of care.
- Educate all physicians and support staff on Advanced Care Planning documentation to ensure patients are cared for according to their wishes.
- Provide consultation by the Critical Care Response Team (CCRT) to all units outside the ICU on how to create treatment plans that take critical care intervention and quality of life practices into account.
- Engage Palliative Care early in the patient’s journey and develop a treatment plan.
- Establish partnerships and integration to streamline care and enhance the patient experience between Critical Care and:-Krembil Neuroscience Program-Surgical Service/Critical Care Arthritis Program-Emergency Department-General Internal Medicine-Princess Margaret Cancer Program Multi-Organ Transplant Program Peter Munk Cardiac Center
- Establish a UHN-wide inter-professional support team for grief and illness counseling to support patients, families and staff.
- Establish a UHN-wide Critical Care Quality Committee to establish standard markers of quality in all Critical Care units, establish best practice standards, and promote discovery, innovation, and knowledge transfer.
Promote a culture of discovery, innovation & knowledge transfer
- Align research & programmatic priorities across the continuum of care
- Create an inventory of existing and future opportunities for collaboration
- Create a UHN ICU collaborative research group
- Establish a framework for research and program priorities that aligns to UHN priorities and promote collaboration across units.
- Clinical and Research programs should focus on:-Organ Injury and Repair-Continuum of Care for Patients & Families – Outcomes and Rehabilitations-Quality Delivery of State of the Art Care
- Establish a repository of current initiatives in Critical Care and ensure that this data is widely communicated and available to all members of the Critical Care program to promote inter-professional collaboration and enlisting patient participation.
- Establish a research group comprised of Critical Care unit research leads and program leads to identify opportunities for collaborative research programs across all Critical Care areas.
- Promote inter-professional research models across units, led by physician groups, as well as nurses and allied health professionals.
- Establish training and education modules to enable care giver groups to develop independent investigators and research leads.
Leverage Master Planning and system integration at the local and LHIN level to improve quality, patient outcome measures, and overall performance
- Increase Capacity & Accessibility
- Initiate Critical Care consultation rounds to improve communication and engage multi-disciplinary teams to review the condition of Level 2 patients.
- Explore sustainable strategies to improve patient flow and appropriate resourcing of critical care beds
- Leverage the Master Plan at all sites to initiate operational planning to increase both Level 2 and Level 3 Critical Care capacity across UHN.
Deliver exceptional education at all levels that enable the success of tomorrows healthcare leaders
- Promote a collaborative, inclusive approach to education opportunities
- Promote flexibility by increasing Critical Care nursing workforce capacity and experience
- Develop and standardize core competency programs for all medical trainees at UHN
- Develop a comprehensive education program for all trainees across the network.
- Develop educational opportunities that support & promote cross-unit electives.
- Establish and support a forum of nursing-led standardization of practice across all UHN integrated Critical Care programs.
- Establish a fixed number of Critical Care (prepared) nurses in the Nursing Resource Team (NRT) to promote flexibility to surge when required and provide relief when needed.
- Standardize Critical Care nursing education across UHN.
- Establish a Critical Care Competency Committee comprised of multi-disciplinary team members from all Level 3 Critical Care units to standardize and prioritize education of core competencies to all Residents.
- Establish partnership with the Wilson Centre to develop program evaluation strategies for education research in patient outcomes.