Nursing stations plugged in to virtual critical care

Katie Keesickquayash, the telemedicine co-ordinator in Mishkeegogamang First Nation, one of the four pilot sites for the expansion of the Regional Critical Care Response program to nursing stations in northwestern Ontario.

Thunder Bay’s Regional Critical Care Response Program will ultimately serve 24 Indigenous communities.

Critically ill patients in four remote Indigenous communities in northwestern Ontario can now be triaged and cared for by critical care docs and other highly-skilled staff at Thunder Bay Regional Health Science Centre’s Intensive Care Unit via videoconferencing equipment prior to air transfer via Ornge.
The four communities – Pikangikum, Deer Lake, Sandy Lake and Mishkeegogamang – have been part of the Regional Critical Care Response (RCCR) Program since Spring 2017, and will soon be joined by another group of Indigenous communities.
The ultimate goal, according to Dr. Michael Scott, North West LHIN critical care lead, is to connect 24 remote nursing stations to Thunder Bay Regional’s RCCR Program.
When the RCCR Program was launched in the spring of 2015, it served the Emergency Departments and Intensive Care Units at the region’s 11 hospitals, including Sioux Lookout Meno Ya Win Health Centre, “but we found we were often getting calls from Sioux Lookout about patients in nursing stations,” recalled Scott.
“They’d tell us they thought the patients they were calling about needed to bypass Sioux Lookout and come directly to Thunder Bay, and we thought it would be much better to get a visual on the patient.”
That’s how the idea of extending the program to the nursing stations came about.
“We started thinking about it two years ago, had meetings with the LHIN and Health Canada, and started moving forward,” said Scott.
The original idea was to first have Sioux Lookout do a visual assessment of the patients in the nursing stations and determine where they should be sent, but that hasn’t happened, so Thunder Bay Regional takes the calls directly.
The program has a dedicated nurse available 24/7, who can call in the hospital’s on duty intensivist and additional medical staff, including a respiratory therapist, critical care pharmacist and trauma nurse, as required. Ornge’s on duty critical care docs at the air ambulance service’s base stations can also get in on a call and view live video of the patient.
“That helps them immensely because otherwise they wouldn’t know what they’re getting when they arrive at the nursing station,” said Scott.
The highly skilled staff at Thunder Bay Regional help nurses in the Indigenous communities stabilize patients and decide where they should be sent.
“It’s much easier to make a decision when you can see the patient,” said Scott. “I couldn’t imagine being a nurse by myself in a nursing station with no one around to help except for the Sioux Lookout doc on the phone. I’m sure they feel so much more supported, especially when patients are sick enough to require our services.”
Calls to date have involved cardiac arrests, as well as drug overdoses.
A partnership bringing together Thunder Bay Regional, the North West LHIN, the Ontario Telemedicine Network, Keewaytinook Okimakanak and Health Canada contributed to the success of the program.
“The LHIN connected us with Health Canada and facilitated discussions with the northern communities to move things forward and get the appropriate people to the table,” said Scott.
Several more nursing stations are scheduled to go live mid-year provided necessary improvements are made to the communication infrastructure in the communities selected.

Filed in: Featured, News

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