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.

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

Clinical Messaging

Curriculum Innovation

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

Feedback Tool

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

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

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

Innovate AFIB

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

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

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

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 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

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

Other Projects

Discharge Rates
Complex Care Clinic
Patient Satisfaction
CCAC Pathways
Team Orientation
HAPI Clinic
Procedure Carts
Goals of Care Discussion
GIM Amazing Symposium
Acute Care Clinic