Jean Morrow

Critical Care Program

The Critical Care Program admits 3,600 patients each year from across Ontario who require life support and specialized monitoring following multiple trauma, surgical procedures or who have complex medical disorders.

A multidisciplinary team of 445 professional health care providers, including nurses, respiratory therapists and dietitians, is directed by physicians who have specialty training in critical care. The program’s philosophy of collaboration to deliver patient-centered care is enhanced since LHSC’s critical care physicians are also surgeons, anesthetists, emergency physicians and general internists.

The Critical Care Trauma Centre (CCTC) at Victoria Hospital is a 26-bed medical-surgical-trauma unit. At University Hospital, the 25-bed medical-surgical Intensive Care Unit (ICU) specializes in the care of various patient populations while the 14-bed Cardiac Surgery Recovery Unit specializes in the post-operative care of patients who have had cardiovascular surgery. These areas all have state-of-the-art equipment and specially trained staff to meet the complex needs of critically ill patients.

The Critical Care Program is also home to Critical Care Outreach Teams, or CCOTs. These teams are made up of critical care physicians and specially trained nurses and respiratory therapists who provide a complementary, effective safety and critical care resource to patients beyond the walls of the ICU and CCTC.

The Critical Care Program provides teaching and training to all medical and health care specialties. Many members from the team are actively engaged in medical research and provide leadership at the local, provincial and national level to promote the delivery of safe and high quality care to critically ill patients.

ABOVE: Jean Morrow is a registered nurse with the Critical Care Outreach Team.

BELOW: Dr. Claudio Martin (left) meets with George Sherrill a few months after helping to save his life.

Dr. Claudio Martin (left) meets with George Sherrill

NEW PARTNERSHIPS provide faster, safer
critical care

On an otherwise unremarkable February evening, George Sherrill and his wife were sitting down to dinner when he began feeling unwell. Within a few minutes, he had sunk back into his chair and was unresponsive. After a frantic 911 call from his wife, paramedics arrived to find George in full cardiac arrest.

Taken immediately to LHSC’s Victoria Hospital Emergency Department, a specialized team of health care providers initiated a number of critical care procedures that helped to save Sherrill’s life.

One of those procedures — the ‘hypothermia protocol’ — involves cooling a heart attack patient’s body temperature by a few degrees for 24 hours. This protocol shows significantly improved patient outcomes, and since 2004 has been performed by staff in LHSC’s Critical Care Program in either the Intensive Care Unit (ICU) at University Hospital or Critical Care Trauma Centre (CCTC) at Victoria Hospital. Acknowledging that earlier implementation of the hypothermia protocol would improve patient care, with assistance from members of LHSC’s Critical Care Outreach Team (known as CCOT or “C-cot”) this protocol is now provided directly in the emergency department instead of in the intensive care or critical care units.

CCOT allows patients like George with life-threatening illnesses and injuries to receive critical care services no matter where they are located in the hospital, rather than requiring the patient to be transferred to the ICU or CCTC where traditional critical care takes place.

“In our model of care, critical care provides an essential service regardless of location. We take the critical care staff and support to the patient, instead of the patient to the critical care unit,” says Judy Koljak, director of the Critical Care Program. “The focus is on partnerships with everyone involved in the care of that patient. This approach improves communication and provides a more timely response.”

Other new best practice initiatives at LHSC that have been led or supported by critical care include the surviving sepsis campaign and central line infection prevention, both aimed at providing safer, quality patient care. And with CCOT bringing critical care to patients throughout the hospital, the team’s expertise is now beginning to be tapped beyond the hospital walls, with a 24/7 on-call member available for critical care consults with other hospitals in the region.

“CCOT is a tool to bridge the gap and ensure that critical care best practices are provided in a timely fashion, no matter where the patient is located in the hospital, community or region,” says Dr. Claudio Martin, medical director of critical care.

“In the end, everything we do links back to the patient,” adds Judy. “We continue to ask ourselves: how can we provide the best care and what can we do to deliver on quality and safety?”

For George and Ann Sherrill, they will forever be grateful for the expertise of the CCOT who allowed for quick, safe and effective treatment.

“George received excellent care, and the doctors and nurses were very informative,” says Ann from their home where George continues to recover.

“We like going for walks together and George enjoys talking with our neighbours. His personality is back, and that is the most important thing.”