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Provincial Paediatric Critical Care Response Team (PCCRT) Initiative

The Extramural Program

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Ontario’s Critical Care Strategy seeks to improve access and quality by addressing issues that contribute to wait times for critical care

7 priority areas have been identified and funded

CCRT’s & PCCRT’s are a core priority for the Strategy

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What are PCCRT’s?

The PCCRT intramural service helps ward staff provide critical care to children on hospital wards who are at risk of deterioration

The MOHLTC and the Ontario PCCRT Working Group have been looking at ways of extending the benefits of PCCRTs outside the walls of the tertiary care centres and into to the community hospitals

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Outside the WallsThe Rationale for Extramural PCCRT

Community hospitals are often the first point of contact into the health care system for children with critical illnesses

Community hospitals have fewer paediatric acute care resources available

Initial stabilization and hands-on management occurs in settings with limited acute care paediatric resources

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Extramural PCCRT: Physician to Physician

The extramural service involves a paediatric intensivist who is on-call to support physicians in other hospitals who may be caring for critically ill children

Any hospital physician that is caring for a critically ill child in Ontario can access the extramural PCCRT service through CritiCall

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Extramural PCCRT Goals

Access to a paediatric intensivist will:

Support the physician caring for the critically ill child

Potentially reduce need for critical care transport or prolong period of stabilization prior to transport team arrival

Improve early access to paediatric intensivist involvement in care

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What You Get When You Call the PCCRT A coordinated service requiring only a single

phone call to access the following services:Paediatric Critical Care Expert AdvicePaediatric Critical Care Transport Resources Provincial Paediatric Critical Care Bed Availability

Use of conferencing technology to improve communication between physicians from different centers to avoid repetition of information and delays in accessing care

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What If Transport Out of Region Is Required? Via CritiCall, the Paediatric Critical Care Response

Team physician (PCCRT MD) from the regional tertiary referral centre, will remain the consistent point of contact even if transport is required to another institution until an accepting physician is identified

Following transfer of information from the PCCRT MD to the accepting MD, all further communication to the community physician will occur from the accepting physician

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Quality Assurance

Digital recording technology at each tertiary referral centre will allow more detailed review of difficult cases and improved system delivery

Province-wide uniform data collection on advice calls and critical care transport outcomes

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For further information: www.criticall.comwww.health.gov.on.ca/english/providers/program/critical_care/cct_strategy.html