This document describes 6 proposed Performance Improvement Coaching Teams to support hospitals: 1) The End of Life Decision Making Team will assist hospitals in improving end-of-life consultation skills to empower patients and families and improve outcomes. 2) The Intensivist-Led Management Model Team will leverage expertise to support hospitals transitioning to specialist physician management of ICUs, improving outcomes. 3) The Surge Capacity Team will assist hospitals in developing and rehearsing detailed surge plans to test critical care surge response at hospital and LHIN levels. 4) The Patient Flow and Inter-Unit Coordination Team will help hospitals maximize use of critical care resources through improved patient flow coordination. 5) The Leadership and Team

1. Performance Improvement Coaching Team Descriptions
These are preliminary descriptions and may be subject to change.
End of Life Decision Making Team
Empowering and supporting patients and families to make informed decisions in end-of-life situations
requires specific training. When these discussions are handled well by both ward staff, ICU and Critical
Care Response Team (CCRT) members, the results include improved patient and family satisfaction,
avoiding futile ICU admissions (an access win for the system) and increased opportunity for organ
donation. This coaching team will assist hospitals in evaluating if they need to improve their end-of-life
consultation skills, will provide the training required to improve and will help hospitals monitor their
improving results.
Intensivist-Led Management Model Team
There is an extensive medical/scientific literature confirming that both hospital and patient outcomes are
substantially improved when specialist physicians (intensivists) manage access and patient care in
Intensive Care Units (ICUs). Over the past decade a number of Ontario hospitals have made this transition
and there is now in the Ontario system, physician and hospital administrator expertise regarding how best
to manage this transition. This Performance Coaching Team will leverage this expertise to support other
hospitals make this important transition.
Surge Capacity Team
A surge capacity coaching team will be made available to hospitals to assist in detailed, on-the-ground
surge plan development and rehearsal. This process will include an analysis of the critical care component
of existing hospital emergency planning, detailed improvements to these plans and will provide the hospital
with support in staging a rehearsal opportunity that tests the critical care surge response. This team will
also work with groups of hospitals for LHIN-level rehearsals.
Patient Flow and Inter-Unit Coordination Team
A key to maximizing access to critical care resources within a hospital is the flexibility and coordination of
patient flow between the wards, the Emergency Department, various step-down and high intensity beds
and the intensive care unit. This coaching team will help hospitals get the most out of their existing critical
care resources.
Leadership and Team Building Team
Intensive care units are staffed by interdisciplinary teams that need to be able to function with a high
degree of coordination. Leadership and team building that is specifically developed for the critical care
context enables staff teams to address crucial issues in training settings outside of the life and death work
of the unit. This coaching team will help hospitals assess their teamwork and leadership skills, will provide
training to assist in the development of these skills and track the results based on performance indicators
developed in consultation with the unique hospital context.
Critical Care Service Appraisal Team
Identifying and prioritizing target areas for performance and systems improvement within a critical care unit
may be challenging from an internal perspective. This coaching team will be able to assist hospitals in
appraising the key needs of their unit and defining their performance and systems improvement priorities
based on existing clinical and human resources, accessibility and organizational objectives. The Unit
Appraisal Team will help with detailed environmental surveys of existing critical care services, development
of key recommendations for performance and systems improvement, as well as ongoing support in the
selection of subsequent Performance Coaching Teams.