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.