1. University Health Network

2. Objectives Jan. 2002: 1.To learn about Critical Care practice in various countries represented at the meeting. 2. To create a needs assessment for future educational forums. 3. To create an agenda for an educational forum directed at intercontinental critical care providers to be held in Toronto May 2002. 4. To form a collaborative group interested in creating educational tools, utilizing them, and evaluating their impact. 5. To discuss long term goals and strategies. www.ice-ccm.org

3. Leadership Training Course for Critical Care Clinicians Leadership? CourageVisionIntegrity

4. Bold Seizing Initiatives Welcoming Responsibility Courage:

5. Vision: Enthuse and Inspire Create Followers

6. Integrity: Honor and a Good Name

7. 55% of Americans Feel New Direction / Focus in Life CNN / ABC NEWS POLL, NOVEMBER 11, 2001

14. Compliance with Lung Protective Ventilation in ALI/ARDS Day 3 Before After 6% 3% Rubenfeld GD et al. ATS 2001

15. Why Shouldn’t you Change?

16. 1. You don’t believe the results.

17. Why Shouldn’t you Change? 1. You don’t believe the results. 2. Risks outweigh benefits.

18. Why Shouldn’t you Change? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it.

19. Why Shouldn’t you Change? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it. 4. You have other data you are not sharing.

20. Why Shouldn’t you Change? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it. 4. You have other data you are not sharing. 5. You haven’t heard about the results.

21. Dr. B. Kashin Dr. H. Clasky Dr. T. Rogovein Dr. D. McRitchie Ontario Critical Care Information Network (OCCIN) Dr. S. Lapinsky, Dr. T. Stewart, Dr. R. Wax, Dr. S. Fischer Technology Application Unit & Intensive Care Unit

22. Why Shouldn’t you Change ? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it. 4. You have other data you are not sharing. 5. You haven’t heard about the drug. 6. You don’t like new things.

23. Why Shouldn’t you Change ? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it. 4. You have other data you are not sharing. 5. You haven’t heard about the drug. 6. You don’t like new things. 7. You are lazy.

26. Why Shouldn’t you Change ? 1. You don’t believe the results. 2. Risks outweigh benefits. 3. You can’t afford it. 4. You have other data you are not sharing. 5. You haven’t heard about the drug. 6. You don’t like new things. 7. You are lazy. 8. You are having trouble rallying support.

27. Reference Diseases Incidence in US (cases per 100,000)Incidence in US (cases per 100,000) –Colon cancer 50 –Breast cancer 110 –AIDS 17 –Congestive heart failure ~130 –Sepsis ~300 Number of deaths in US each yearNumber of deaths in US each year –Acute myocardial infarction 211,000 –Severe sepsis 215,000 Incidence in US (cases per 100,000)Incidence in US (cases per 100,000) –Colon cancer 50 –Breast cancer 110 –AIDS 17 –Congestive heart failure ~130 –Sepsis ~300 Number of deaths in US each yearNumber of deaths in US each year –Acute myocardial infarction 211,000 –Severe sepsis 215,000 Angus D. SCCM 2001

28. All unstable / possibly unstable patients - All unstable / possibly unstable patients - Expensive (almost 1% US GNP). - Growing demands (Technology, Therapeutics, Aging population ). Critical Care

29. USA Today Feb. 2001 - ICU need increase 66% by 2030 - Only 36% of ICUs staffed by trained intensivists - 30,000 lives could be saved annually - $1.5 Billion could be saved.

31. Computerized Physician Order Entry Evidence-based Hospital Referral ICU Physician Staffing