Medical Surgical and Neuro ICU at Toronto Western Hospital
Toronto Western Hospital Medical-Surgical and Neuroscience Intensive Care Unit is a 38-bed critical care unit. The TWH MSNICU admits approximately 950 medical-surgical and neuroscience patients per year, with a case mix of 55-60% general critical care patients and 40-45% neuroscience patients (including acute ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, status epilepticus, traumatic brain injury, spinal cord injury, and neuromuscular disease). The ICU has a busy Critical Care Response Team, handling more than 900 inpatient consults per year .
The Toronto Western Hospital is located in the vibrant heart of the downtown communities of South Annex, Chinatown, Little Italy, Little Portugal and Queen Street West. It is a 272-bed academic health science centre which houses a world-leading specialty program in neuroscience – the Krembil Brain Institute. The hospital also has a strong community focus, providing emergency care and innovative outpatient programs for its large multicultural surrounding population. With expertise in musculoskeletal health and arthritis, the hospital’s programs also include orthopaedics, rheumatology, ophthalmology and the hand program. The bariatric comprehensive program offers medical and surgical care for candidates for bariatric surgery. Finally, its busy Emergency Department sees more than 60,000 patients annually.
Clinical coverage is provided with a two-team model. Each team is comprised of an intensivist, a designated fellow and half of the resident house staff. The Critical Care Response Team is staffed by an intensivist, a fellow and a critical care nurse.
PARTNERS IN CARE IN THE MSNICU
Being a partner in the care of our patient means that you can be as involved as you would like to be.
It also means that
- You are given information in a way that you can understand
- You can take part in decisions about the care of your loved one
- Your family situation, what you think, and what you have to say are considered in the plan of care for your family member
Joining in the MSICU Patient and Family Centered Medical Rounds is one way for you, our patients, and family members to be partners in care.
WHAT ARE PATIENT AND FAMILY CENTRED MEDICAL ROUNDS?
Every morning between 9:00 a.m. and 12:00 p.m. doctors, nurses, respiratory therapists, pharmacists and other members of the MSICU team meet to talk about each patient.
They will talk about
- Overnight issues and any changes in the last 12-24 hours
- The patient’s progress and current health condition
- New lab, study, or test results
- Possible options for treatment
- Daily plan of care
Each team member will share his or her opinion and ideas for care. The attending doctor will make the final decision on the plan of care.
Rounds are a teaching time for doctors in training and staff. Rounds are a learning time for everyone, including you.
WHO CAN ATTEND THESE ROUNDS?
UHN is responsible for safeguarding a patient’s medical information, so it is important that only certain people close to the patient take part in rounds. These people include
- The patient
- The person he or she has chosen to receive information
- The Substitute Decision Maker (SDM) or designate if he or she is not capable to speak for himself or herself
If a patient is capable of telling us who they want at rounds, we will ask who they want to receive medical information and who they want to attend rounds.
WHAT IS MY ROLE IN PATIENT AND FAMILY CENTRED MEDICAL ROUNDS?
As a member of the health care team, you are invited to actively take part in rounds. You are welcome to write down your questions and take notes before and during rounds. At the end of the medical discussion, there will a few minutes set aside for you to ask questions to clearly understand the information and decisions being made and to tell the team what you think will help your family member. If you have more questions than there is time for, a doctor will return later in the day to address them.
DO I HAVE TO TAKE PART IN ROUNDS?
Taking part in medical rounds is up to you; you do not have to attend if you do not want to. You decide how comfortable you feel talking during rounds. Just listening is okay too!
WHEN AND WHERE TO ROUNDS HAPPEN?
Rounds happen each day outside the patient’s room between 9:00 a.m. and 12:00 p.m. If the patient is able and wants to take part, rounds will be held in the patient’s room. It usually takes 15-20 minutes for each patient.
If you wish to attend rounds, speak to your nurse. We can’t predict exactly what time the team will round for each patient.
PRIVACY AND CONFIDENTIALITY IN THE HOSPITAL
University Health Network is committed to protecting the privacy of each patient and their family. Keeping patient information confidential is very important to us. While you are in the hospital, you may overhear information about another patient. We ask you to help us maintain privacy for every family by keeping the information private. Don’t share information you have overheard about another patient with anyone, including the other patients.
WHO CAN I TALK TO FOR MORE INFORMATION ABOUT PATIENT AND FAMILY CENTRED MEDICAL ROUNDS?
Despite our best efforts and the therapies implemented, your beloved one may succumb during their ICU stay. Please accept our most sincere condolences should that be the case.
This resource includes some information on subsequent steps and how to get support through this difficult moment.
Our team is composed of nine intensivists who collaborate in close relationship with registered nurses, respiratory therapists, physiotherapists, social worker and spiritual care, as well as with other medical and surgical specialties.
Allied Health Professionals
TORONTO WESTERN HOSPITAL
The ICU is locate in the Fell Building, on the 2nd floor. The closest entrance is off Bathurst Street.
TWH Floor Map
You can contact us 24/7 by phone: (416) 603 5818
399 Bathurst Street
Nassau entrance (between Dundas and Leonard)
Leonard entrance (between Nassau and Wales)
Dundas entrance (just east of Bathurst)
Bathurst entrance (just north of Dundas)
Krembil entrance (corner of Leonard and Nassau)
AFTER HOURS ACCESS
Bathurst and Leonard Street entrances — locked at night from 10:00 p.m. to 6:00 a.m.
Emergency Department entrance (Dundas Street) — always open
511 Bathurst – Stop outside the hospital, on Bathurst
505 Dundas – Stop at corner of Bathurst and Dundas
506 College – Stop at Bathurst and walk south
A free shuttle service runs Monday-Friday, between TWH and TGH.
There is no shuttle service on weekends and statutory holidays.
TWH (Leonard St. entrance) 6:00 am – 8:00 pm, runs every 15 min.
TGH (University Ave. entrance) 6:15 am – 8:15 pm: runs every 15 min.