Virtual Critical Care Response Models

24/7 intensivist-led interdisciplinary ICU services through multipoint videoconferencing to care for critically ill adult patients.

Virtual Critical Care Response Models, including the North East Virtual Critical Care Program (VCC) and the North West Regional Critical Care Response Program (RCCR), provides patients with more rapid access to critical care in geographic areas of Northern Ontario where access to specialized treatment may be limited, or otherwise require a patient transfer. Local health care providers are able to access advice from specialists virtually on an emergency basis, providing quicker critical care that saves time, and when time matters most, that can make the difference in saving lives.

Virtual Critical Care Response Models support initial patient visits, follow up consultations, and daily rounds.

Patient transfers can be optimized, ultimately reducing travel for both patients and their families.

Alternatively, the teams assist with the decision to transport to a facility that can accommodate a higher level of care.

The programs facilitate partnerships in improved patient care and the sharing of resources, best practices and educational opportunities.

North East Virtual Critical Care Program (VCC)

The North East Virtual Critical Care Program supports both initial and follow up consultations of critically ill patients, enabling patients to be cared for locally when possible. Patient care facilitated through VCC includes the addressing of treatment level and palliation plan, vasopressor and antiarrhythmic support, the initiation of non-invasive ventilation, Respiratory Therapist consultations for assessment (review of ABGs), the initiation of antiviral therapy, dietitian requests, pharmacist consulting, and the ordering of medications, lab tests, echo, ex-rays, and review of ECGs.

The program also facilitates the sharing of resources, best practices, educational opportunities, and partnerships for improvements in patient care.

Every hospital with an ICU / ED in the northeast is a referring site to the VCC program.

North West Regional Critical Care Response Program (RCCR)

North West (NW) LHIN Regional Critical Care Response Program (RCCR), led by Thunder Bay Regional Health Sciences Centre (TBRHSC) links critical care physicians, nurses, and respiratory therapists to the region providing early identification, collaborative management between TBRHSC, regional partners and ORNGE for patients who are critically ill.

Videoconferencing allows for a real time evaluation of the patient from the inter-professional perspective. Sending, transporting, and receiving team members simultaneously communicate, providing an expedited, timely and safe transfer of the patient.

In addition, the RCCR program, regional partners, and ORNGE standardized critical care drug formularies, ventilation equipment, and medication and ventilation policies within the NW region to enhance continuity of care.

Virtual Critical Care Response Models | Emergency Medicine: Content

VCC Program Leaders

The North East Virtual Critical Care Program is led by Health Sciences North, and managed by:

Dr. Darek Manchuk, Lead Physician, Health Sciences North Virtual Critical Care Unit

Renée Fillier, Nurse Clinician, Virtual Critical Care

RCCR Program Leaders

The North West (NW) LHIN Regional Critical Care Response Program (RCCR) is led by Thunder Bay Regional Health Sciences Centre (TBRHSC) and managed by:

Dr. Michael Scott, Cheif of Critical Care, Thunder Bay Regional Health Sciences Centre

Lisa Beck, Director Trauma Program, Emergency and Critical Care Services, Thunder Bay Regional Health Sciences Centre

Chad Johnson, Manager, Critical Care Services

Edie Hart, RCCR Clinical Lead, Thunder Bay Regional Health Sciences Centre

“Seeing the patient is worth its weight in gold.  It’s a huge advance.  We can zoom in with the camera or look around the room to talk to the team or family.  It’s a much better way of assessing and gathering information…..If we want to give people equal access…. we have to link them to these specialists……This essentially eliminates distance as a challenge to patients in these areas needing specialized intensive care, as they can now receive more of that care in their home communities.”

– Derek Manchuk, Lead Physician of Health Sciences North Virtual Critical Care Unit and Medical Director of Critical Care

RCCR promotes a culture of patient safety and responsiveness, acute care education, and sharing of best practices. Most importantly, it results in better outcomes for our patients and families through earlier access to specialized treatments, shorter transfer times, and potentially eliminating the need to transfer a patient at all, resulting in exceptional care closer to home. We are grateful to the Northwest LHIN and our Ministry champions for their support throughout the development and now expansion of this critical program.”

Dr. Michael Scott, Chief of Critical Care, Thunder Bay Regional Health Sciences Centre

Patient Eligibility Criteria

  • Adult patients that are critically ill or medically unstable.
  • Adult patients with compromised airway or breathing, hemodynamically unstable or with a decreased level of consciousness.
  • Adult patients for which there is a serious concern.

Patient Eligibility Criteria

  • Adult patients that are critically ill
  • Adult patients who are medically unstable
  • Adult patients for which there is a serious concern

Participation in the Virtual Critical Care Service requires that referring sites meet certain criteria including a virtual care enabled clinical area (e.g. ICU, emergency department), knowledge of the referral protocol and patient eligibility criteria, and the ability to clinically present the patient via virtual care.

Sites will also need an OTN certified clinical cart videoconferencing system (with 12x zoom camera and far end camera control functionality) to be used at the patient’s bedside and available OTN network drops in the emergency department and/or intensive care unit (if applicable).

How to Access the NE VCC program

Participating organizations can access the NE VCC by contacting CritiCall (1-800-668-HELP) and asking for the NE-Virtual Critical Care consult.

How to access the NWRCCR program

Participating organizations can access the NW program by contacting CritiCall (1-800-668-HELP) and asking for the NW RCCR Virtual Critical Care consult.

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