Our innovation and research projects bring together the expertise of our members to implement leading edge solutions and evaluate them in a real clinical environment. The process of developing a project always begins with the identification of a problem by our frontline staff or our patients. The CICC project team then does a thorough analysis of the problem and makes recommendations for how to address it. When the decision to start a new project is made, the appropriate resources and expertise for implementation and evaluation are brought together.
The CICC team is always looking for project ideas so if you have a problem that you would like analyzed, contact the team at: cicc@uhn.on.ca.
Accountable Care Organizations (ACO) in Ontario
This is a population-based system redesign project that is looking into novel approaches to organizing and incentivizing physician and hospital care in order to improve quality and reduce total cost. The project is supported by the Ministry of Health and Long-Term Care and the Canadian Health Services Research Foundation, and is a collaboration among the CICC, Li Ka Shing Knowledge Institute, Institute for Clinical Evaluative Sciences and Dalla Lana School of Public Health, the lead partner. Learn more
AFIB Innovation Program
Atrial fibrillation is the most frequently encountered arrhythmia for which patients are admitted to the hospital. Atrial fibrillation can be life threatening, as it is associated with extensive comorbid conditions and adverse consequences such as increased mortality and significant morbidity, due to risk of stroke and heart failure. The hospitalizations and treatment for atrial fibrillation can be challenging, costly and resource intensive. Learn more
BlackBerry Program
The use of BlackBerrys at the University Health Network (UHN) for administrative functions had been in place for several years. With the necessary infrastructure in place, the opportunity to pilot the use of these devices for clinical communication existed. Collaborating on work to deliver critical alerts by email and accessing evidence-based decisions support from the intranet, a pilot to demonstrate the impact of using BlackBerry devices to coordinate patient care ensued. We saw rapid adoption of this approach by our physicians and the use of BlackBerrys for communication are now a part of standard operations on the General Internal Medicine (GIM) service. Learn more
Call Re-Design
On March 2nd, 2009, the Toronto General Hospital (TGH) General Internal Medicine (GIM) Clinical Teaching Unit (CTU) implemented a major structural change to its admission process. Prior to the change, the four physician-led care teams rotated between designations of ‘on-call’, ‘post-call’ and ‘pre-call’ over the course of the week, and only the team designated ‘on-call’ accepted new admissions. This ‘bolus’ call structure created large variations in admissions and workload for each team. Previous work in this area tells us that daily variation in patient care processes, particularly relating to admissions and discharges, creates inefficiencies and decreases hospital inpatient capacity. Learn more
Checklist On Medicine-Patient Safety Study (COMPASS)
Our Canadian healthcare system is in dire need of innovation. Increasing healthcare costs, serious and recurring medical errors, along with rising incidence and prevalence of chronic diseases in our rapidly aging population have placed enormous and unprecedented pressures on our already overloaded healthcare systems. Learn more
Clinical Guidelines iPad Project
The Clinical Guidelines iPad project explores the broader question of how clinical decision support on a mobile platform can improve the process of providing high quality care and lead to better patient outcomes. Learn more
Clinical Messaging
Curriculum Innovation
The aim of the Curriculum Innovation project is to equip all undergraduate students in clinical fields with a mindset centred on quality improvement and patient safety, before they enter a healthcare setting. The CICC plans to incorporate the online open-school hosted by the Institute for Healthcare Improvement (IHI) into undergraduate curriculum across Ontario. Learn more
E-Referral
Referrals between acute and post-acute facilities are essential to patient flow within the health care system. Current referral processes involve lengthy paper forms and time consuming faxing of the forms between organizations. This results in unnecessary delays due to incomplete applications, illegible writing, or the matching of patients to inappropriate programs. Learn more
Futureward
Futureward is an architectural project that anticipates how the
diverse requirements of complex care patient rooms will change with
advances in communication technology over the course of the next 20
years. It seeks to use those changes as design opportunities to
create rooms that will help patients heal, family members feel at
home, and practitioners work safely and effectively. Learn more
Global Health Emergency Medicine (GHEM)
Global Health Emergency Medicine, or GHEM, are a group of emergency health care providers dedicated to improving the health of individuals in resource poor settings by the empowerment of local populations. Learn more
Go Viral
Social media tools such as networks, videos and blogs are powerful tools for engagement and communication. Although patients and clinicians are deeply engaged with these tools, we don't fully understand the impact they have on healthcare. Learn more
Heart Failure Simulation
Despite excellent guidelines distilling numerous systematic reviews and large randomized controlled trials, there is still a gap between the management of heart failure patients and scientific evidence. A recent needs assessment performed by the Canadian Cardiovascular Society recommended improving knowledge translation through tools such as interactive case-based learning. Learn more
Interferon Trial
Interprofessional Collaborative (IPC) Rounds on Internal Medicine
Exemplary health care is clinically effective, compassionate and safe. High-quality health care is not borne from individual caregiving but from a team effort, from interprofessional collaboration where health care professionals engage in effective communication, demonstrate mutual respect and trust, as well as knowledge and appreciation of colleagues’ skills. Learn more
Interprofessional Communication Tool
Overall clinical communication is complex and failures in communication are a significant cause of preventable adverse events. The issues include inefficient patient hand-over, inability to triage the urgency of messages leading to paging disruption, not being able to identify the most responsible physician, and lack of coordination across disciplines leading to delays in care. Poor communication impacts day to day operations and in light of the aging population, rising healthcare costs, and budgetary pressures, more effective communication processes are urgently needed. Learn more
"I took a Pledge"
Hand hygiene is considered the most important strategy in preventing healthcare acquired infections (HCAIs). In recent years, the Ministry of Health and Long Term Care (MOHLTC) and University Health Network (UHN) have committed to improving hand hygiene by increasing access to hand rubs and publicly reporting hand hygiene compliance. However, frontline health care workers on General Internal Medicine (GIM) at Toronto General Hospital (TGH) unanimously state that there is room for improvement. Our discussions highlighted certain barriers to hand washing, which include: physical obstacles blocking pumps, visibility of pumps, lack of reminders and championing from peers. Learn more
Nephrology Modeling
Nephrology modeling is an operational modeling project that looks at the difference in operational costs between nephrology patients who receive dialysis at their hospital versus through home dialysis and how it might drive inpatient care and use. Learn more
Neurovascular Modeling
Neurovascular modeling is an operational modeling project that investigates what the impacts on hospital operations will be from implementing a 'stroke unit' model of care. Learn more
Operational Modelling
The Operational Modelling project involves the use of system dynamics (a methodology that helps understand complex feedback systems over time) to study the common and chronic operational problem of patients boarding in the emergency department (ED) who have been admitted to hospital. Learn more
The Opportunity Project
This project looks at personalized medicine in the care of lung cancer patients in Ontario. Targeted therapies provide customized treatments for individual patients through the use of genetic mutation testing. New breakthroughs in epidermal growth factor receptor (EGFR) mutation testing can enable healthcare providers to offer their patients the most appropriate treatment and the opportunity to have the best possible outcomes. Learn more
Patient Empowerment Program (PEP)
The objectives of the Patient Empowerment Program (PEP) are to create and distribute unique tools for people going through serious illnesses within the healthcare system. Often patients feel a loss of control during serious illneses and it is our intention to help facilitate the ease of their recovery by offering them materials that will not only educate them regarding their own condition but also assist them in attaining a sense of autonomy and influence in their healing process. PEP is the first patient lead project at the CICC and was mentioned by the Honourable Debra Matthews, Minister of Health, in the Ontario Legislature on May 3rd 2010. Learn more
Patient Experience App
There is no doubt that there have been significant and exciting advancements in medical research that have led to improvements in pharmacological therapies, innovative processes using technology, and novel breakthroughs in understanding illness and methods of treatment. We have yet, however, to make significant gains in understanding and seeking to improve the experiences of patients going through illness who are navigating the vast complexity of our current health care system. Learn more
Patient Satisfaction
The goal of this project is to create and evaluate an anonymous, rapid-fire, concise and quantitative and qualitative patient satisfaction survey, as well as a process whereby this feedback can be communicated back to healthcare professionals. This model is intended to not only improve the patients' survey response rate, but also to increase the value of the feedback by improving its accuracy and potential for integration by healthcare professionals into their practice. Learn more
Pulsecheck
The CICC partnered with the University of Toronto’s Collaborative for Health Sector Strategy (CHSS) to assemble an interdisciplinary group of six University students. The team, comprised of students from engineering, industrial design, social work, business, and medicine, embarked on a nine week journey to create an online simulation to teach strategies in change management. The students paired up with industry partner, ExperiencePoint - a leader in the development of online simulations for business. Learn more
Put a Face to a Name
Communication is critical within healthcare, and is the root cause of most errors. With increased adoption and use of new information technologies and mediated communication systems, such as Electronic Health Records (EHR), we can begin to look at the potential of photographic aids to improve patient satisfaction, clinician communication, and ultimately quality of care. Learn more
REACH
In April 2008, the government of Ontario announced a $109 million investment to reduce Emergency Department wait times1. In response to this initiative, the REACH (reducing emergency and acute care hospitalization) pilot was launched at PMH in June 2009. Learn more
Social Media
People are turning to various web-based platforms to seek and share health information and for health-related activities. Research shows that individuals are changing their health behaviours based on the information they find and the social interactions they have online. Social media platforms such as Facebook, Twitter and virtual worlds like Second Life allow users to generate their own content. Individuals are using these sites to seek and share health content; to engage in social interactions with other patients, care givers and healthcare professionals; to use tools to self-manage and quantify their illnesses; to seek health advice from both healthcare professionals and other patients; and to pursue their own health research such as patient-led clinical trials. Learn more
Team Feedback
Feedback is a powerful tool that can be used to motivate and improve organizations, groups and individuals. Although feedback can facilitate learning and promote effective performance, there are cultural barriers within healthcare can prevent or inhibit this type of behaviour. The goal of the Feedback Tool is to explore how feedback can be used to drive quality and process improvement in the healthcare environment. Learn more
Team Scorecard
While hospital Balanced Scorecards have been proven to effectively measure overall system performance by utilizing metrics defined by their organizational strategy, there is a critical missing step in measuring frontline clinical performance. Learn more
Virtual Ward
The CICC is continuously developing innovative solutions to improve the process of care for patients living with complex medical issues. We are a Centre dedicated to using an interprofessional model to collaborate, develop, and implement new best practices that will positively impact both patients and care providers in inpatient as well as community settings. The system currently lacks sufficient community-based initiatives that provide the necessary follow-up care and support required by our complex medical patients after hospital discharge. Learn more
Other Projects
Discharge Rates
Complex Care Clinic
Patient Satisfaction
CCAC Pathways
Team Orientation
HAPI Clinic
Procedure Carts
Goals of Care Discussion
GIM Symposium
Acute Care Clinic