Critical Care Program

Outcomes Improvement & Patient Safety

The WRHA Adult Critical Care Program promotes continuous quality improvement in the ICU.  We investigate local, national and international strategies for improving patient care, and implement evidence based best practices aimed at meeting the critical care needs of our community.  Our Critical Care Program collaborates with Intensive Care Units across Canada to ensure the delivery of safe, quality care.  And through our combined efforts, we have developed meaningful partnerships with Safer Healthcare Now and the Critical Care Collaborative.

In 2012, our Critical Care Program established the Outcomes Improvement Team (OIT).   The OIT is led by Doctors David Easton and Kendiss Olafson, supported by the Quality Improvement (QI) Officer Basil Evan and comprised of multidisciplinary representatives, including a Patient/Family Advisor from within our region.  The organizational structure includes a regional steering committee that is responsible for the development of quality improvement initiatives and priorities with input from patients and their families, and a Quality Circle in each ICU that is responsible for developing customized strategies which ensure the successful implementation of these regional initiatives.  We measure the performance of our initiatives by systematically collecting high quality data and collating the results in our regional ICU database.  Our database provides detailed clinical information about every adult ICU admission in Winnipeg since 1988.

The WRHA Critical Care Program is committed to patient and family centered care.  Families are invited to attend Daily Rounds and encouraged to speak with their nurse about opportunities for participating in simple care activities such as moistening lips, brushing hair and applying lotion to the hands/feet of their loved ones.  Our interdisciplinary team members promote accountability, encourage transparency and are passionate about improving communication in the ICU.  We strive to provide our patients and their families with the best critical care services in the country.  Below is a list of our current improvement initiatives:

  • ABCDE
    • Daily Awakening Trials (DAT)
    • Spontaneous Breathing Trials (SBT)
    • Delirium Monitoring and Education (e.g. CAM assessment tool)
    • Early Mobility (includes activity events and use of the Bed Bike)
  • Communication upon transitions using SBAR (Situation, Background, Assessment, Recommendation)
  • Critical Care Bundles aimed at reducing Ventilator Associated Pneumonia (VAP), Central Line Blood Stream Infections (CL-BSI) and Sepsis
  • Daily Goals of Care
  • Falls Prevention (e.g. Schmid assessment tool)
  • Family Presence in ICU during Daily Rounds (includes activities aimed at improving Family Participation in Care)
  • Hand Hygiene
  • Medication Reconciliation upon Transitions
  • Organ Donation Awareness and Education
  • Palliative/End-of-Life Care (e.g. Cherry Blossom)
  • Patient and Family Satisfaction Survey
  • Pressure Ulcer Prevention (i.e. Braden Scale assessment tool)
  • Venous Thromboembolism (VTE) prophylaxis

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