NH SCS ICU
Context
Niagara Health St. Catharines Site (NH SCS) ICU is a 509-bed community
teaching hospital in Southern Ontario, Canada, which includes a 20-bed
ICU. The mortality rate of the ICU is 14.5%, in line with the mortality
rate at other community hospital ICUs.2,14 There are 8
physicians who rotated on a 5 day, 2 night rotation, along with 100
nurses who were rostered among nine full-time staff divisions. In
addition, palliative care and spiritual care staff were available by
consultation Monday to Friday from 9 am to 5 pm. A multi-disciplinary
team championed the project implementation and, included both clinical
and non-clinical staff. The 3WP physician lead had completed part of his
critical care fellowship training at St. Joseph’s Healthcare Hamilton
(SJHH), where the 3WP was first implemented, which inspired the
implementation of the project at NH SCS with the executive support of
the ICU manager. Frontline nurse champions included a senior ICU nurse,
as well as a junior ICU nurse. A part-time ICU research coordinator
collected quantitative data, while a research assistant collected
qualitative data alongside an ICU nurse with previous qualitative
research experience. Mid-way through implementation, the spiritual care
staff, palliative care team, and research coordinator involved in the
project implementation moved on from their positions.