Critical Illness Recovery Program (CIRP)

The Critical Illness Recovery Program (CIRP) focuses on caring for patients whose critical illness has stabilized and require more consistent integration of rehabilitation into ventilator weaning, and creation of care plans/routines to meet their goals of care. Patients accepted into the Critical Illness Recovery Program will remain in the ICU, but their care team will transition from the Medical-Surgical ICU team or Cardiac Surgery Recovery ICU team to the CIRP team.

Our expert inter-disciplinary healthcare team has significant experience in providing high-quality care to patients requiring invasive life support for longer periods of time and those who remain dependent on technology after hospital. Specific areas of focus include:

  1. Rehabilitation
  2. Consistent approach to weaning from the ventilator during therapies.
  3. Supporting patients and families with long-term ventilator dependence during the transition to home or community with new technology.
  4. Harmonization of care plans with patient wishes, values and goals of care.
  5. Guiding patients and families through the dying process if recovery cannot be achieved.

Patients are considered for this program when they no longer require the intensive monitoring of the main Medical-Surgical ICU or Cardiac Surgery Recovery Unit yet remain dependent on life support technology and must remain in ICU. Patients will stay in the CIRP until they no longer require this intensive monitoring, a process that can take several weeks to months.  

The consistent approach by a smaller team benefits the patient and family. For example, integration of patient baseline into regular routines can help manage the sleep/wake cycle, allowing for a better quality of sleep and rest.

CIRP Medical Team

The ICU consultants, registered nurses and respiratory therapists, pharmacists, physiotherapists, registered dieticians and speech and language pathologists rotate between the main Medical-Surgical ICU, CSRU and CIRP.

A new face you will meet once transferred to the CIRP is our clinical nurse specialist (CNS). The CNS is the case manager for this program and provides continuity for patients and families during the patient’s stay.

Patient/Family Updates in CIRP

Multidisciplinary team rounds occur weekly in CIRP. Each member of the team sees the patient daily and care plans are revised as needed.  

Like the MSICU, the bedside nurse is the best resource for day-to-day updates. If you would like to talk with the consultant looking after your loved one, please let the bedside nurse know.

Shortly after transfer to the CIRP, the CNS will call the substitute decision maker and organize an initial family meeting to review care plans, address questions, etc. There are regular updates organized after this initial meeting, initiated by the team or family members.

If you have family members/loved ones unable to attend a meeting in London, we can organize meetings to include a telephone conference call.

Resources and Growth:

CIRP communicates and contributes to provincial initiatives geared towards providing high-quality, evidence-informed care for patients recovering from critical illness and those requiring ongoing respiratory technology after discharge. In partnership with health systems in Ontario Health West and Micheal Garron Hospital, care pathways and best practices are in constant development, implementation, quality assessment and distribution.

The LHSC CIRP offers multidisciplinary consultation for patients throughout the region experiencing difficulty liberating from invasive life support. Providers are encouraged to contact a CIRP liaison listed below to discuss a case. Depending on the nature of the challenge, CIRP will facilitate a virtual conversation with relevant bedside providers from referring sites to propose guidance

Contact Information:

Clinical Nurse Specialist: Victoria Johnson

Manager: Jason Gibson 

Medical Director: Dr. Karen Bosma 

Medical Assistant Director: Dr. Paul Cameron

Program Director: Joseph Gajasan