‘Medical 9-1-1’ proves to be valuable tool for physicians

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Physicians in Ontario community hospitals have a vital link to the resources of larger, more specialized hospitals in their region and the province, thanks to a program based in Hamilton.

The Ontario CritiCall Program is an emergency-referral service for hospital-based physicians in the province. It is the one-number-to-call, 24-hour-a-day referral service for physicians caring for seriously ill patients in Ontario. The program is a ‘medical 9-1-1’ for physicians and assists in contacting on-call specialists and arranging for appropriate hospital beds. CritiCall has been Ontario’s sole emergency patient referral program since 1996.

By calling CritiCall’s toll free number that is answered 24 hours-a-day, seven days a week, physicians in community hospitals who require assistance for critically ill patients can be put in touch with a specialist- fast.

When a physician contacts CritiCall, a specially trained Call Taker answers the call and asks specific questions for each situation. All of the questions are relevant to the placement of a patient and are specific to the specialty the patient requires. From that point, the Call Taker contacts a medical specialist at the most appropriate hospital for the patient. Once the ‘receiving’ physician is called, the two physicians are connected to discuss the patient’s health status. From there, the physicians determine if the patient can receive the care required where they are, or if a transfer to a tertiary care centre is necessary. Sometimes, a consultation is all that is needed and the call ends after the doctors’ talk. However, if the patient requires a transfer to another hospital, CritiCall can help facilitate the transfer. CritiCall stays with the call until the patient arrives at the final destination.

“The Ontario CritiCall Program facilitates emergency communication between physicians across the province,” said Shelley Moneta, CritiCall program director. “Our goal has been to lessen the complexity of navigating the health-care system for physicians in emergency situations. By providing strategies that identify who does what where, and how to contact them, we help ensure physicians can spend more time with their emergency patients instead of on the phone.” In 2004, the program received close to 10,000 physician calls.

In order to operate efficiently and effectively, the Ontario CritiCall Program relies on its internet-based Ontario Central Bed and Resource Registry. The on-line, secure Registry is regularly updated by more than 140 Ontario hospitals and provides immediate access to bed and resource availability for each hospital and contact information for on-call physicians in more than 55 medical specialities.

“With the information provided by the Bed Registry, communication is enhanced for hospitals, ambulance dispatch centres and other health care providers,” said Shelley. “The Registry provides a real-time snapshot of the resources available throughout Ontario.”

In addition, CritiCall can assist with placing critical patients during an emergency situation, whether it’s a power loss, a disaster or an outbreak like SARS.

During an emergency or disaster, CritiCall can assist with alerting area hospitals, alerting Trauma / Burn / ICU specialists, can confirm bed availability in and out of the region all in preparation to handle the disaster and non-disaster decanting of critically ill or wounded patients. By having CritiCall assist with the patient transfers, hospital and nursing staff can focus on patient care.

“The Bed Registry was an invaluable tool during the SARS crisis,” says Shelley. “We were able to provide integral, timely information during an always-changing emergency.”

The Program is involved with a number of projects at the local and provincial levels to help meet the ever-changing needs in health care. One key initiative CritiCall is working on is interfacing with hospital Admit/Discharge/Transfer systems. Through this project, automatic bed updates are made to the provincial Bed and Resource Registry screen as soon as a bed’s status changes within the hospital. “Real-time data will help enhance CritiCall’s ability to communicate resource challenges when they occur,” said Shelley.

CritiCall is supported by a program director, an operations manager, 16 call takers, and support staff located in the Hamilton office, as well as nine medical directors and six regional project managers located throughout Ontario.

CritiCall is funded by the Hospital’s Branch of the Ontario Ministry of Health and Long-Term Care. The program is managed by Hamilton Health Sciences and is based at the Henderson General Hospital.

For more information about the Ontario CritiCall Program go to www.criticall.com