What is Critical Care?
Ontario's Critical Care Services
Critical care services meet the needs of patients facing an immediate life-threatening health condition—specifically, that in which vital system organs are at risk of failing. Using advanced therapeutic, monitoring and diagnostic technology, the objective of critical care is to maintain organ system functioning and improve the patient’s condition such that his or her underlying injury or illness can then be treated.
These services are provided by specialized teams of health care professionals in adult intensive care units, paediatric intensive care units and in a variety of post-operative and step-down units. Thus, critical care units play a pivotal role in acute care hospitals. If these units get overwhelmed with a sudden spike or surge in patient volumes, some surgeries are cancelled and emergency department wait times can get backed up. These services are both expensive and limited.
At the core of the critical care system is the hospital Intensive Care Unit (ICU). Common roles within the ICU are the Medical Director, who may provide oversight with respect to patients’ conditions as well as administrative activities in the unit; the Unit Manager, who oversees operational activities in the unit, such as staffing and budgeting; and the Most Responsible Physician (MRP), who is the person primarily responsible for a specific patient’s care. These health care professionals work around the clock to save the lives of critically ill patients.
Patients are admitted to the ICU from the emergency room, hospital wards and following surgery. As of March 2012, the largest ICU in Ontario had 30 beds and the average length of stay in high acuity ICUs is about 7-10 days. In Ontario, there are two types of critical care units. Level 2 units are capable of providing service to meet the needs of patients who require detailed observation or intervention, including support for a single failed organ system, short-term non-invasive ventilation or post-operative care. Level 3 units are capable of providing the highest level of service to meet the needs of patients who require advanced or prolonged respiratory support—including invasive ventilator support—or basic respiratory support together with the support of more than one organ system. Within Ontario, there are nearly 2,000 critical care beds spread across 98 hospitals in 14 LHINs (as of March 2012).