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.