Critical Care Updates for Staff

The following weekly update provides an overview of the current critical care situation within Health PEI hospitals.

Update for June 9, 2023

Weekly Patient Flow Snapshot


  • SIMS training: sessions will be held on stabilization and transfer simulations for Western Hospital ED- June 19 and Kings County Memorial ED July 4 and 5th

  • Tabletop exercise (PCH and WH)  follow-up is planned to ensure issues are reviewed and communication back to teams

Clinical Resources

  • Critical Care Order sets were approved by PD&T June 6th for use by all acute care facilities when transferring critically ill individuals.

  • Virtual care options continue to be explored such as Critical

  • iEMS and HPEI reviewing dispatch data to determine HPEI priorities going forward

Monitoring and Evaluation

  • Data: collected on a weekly basis and reviewed for trends 

  • Review of transfers ongoing to determine if any learnings can occur and improvement to processes made 

  • PSMS monitoring to identify and transfer issues


  • Trends indicate ongoing need for 8 ICU beds at QEH with ability to surge to 9-10 on short term and 8 PCU beds at PCH

  • Expressions of interest for QEH ICU for vacant shifts

  • RT casual posting for QEH over the summer months and PCH considering same

  • Permanent positions, Leadership are exploring options with finance to be able to fund permanent positions within facilities.

  • Recruitment of internal medicine and ICU trained nurses (including Travel nurses)  to fill vacancies continues.

  • To date, seven travel nurses have been hired for the spring and summer to support QEH ICU.


Update for May 30, 2023

Weekly Patient Flow Snapshot


  • On May 14, 2023 the PCH ICU transitioned into a Progressive Care Unit (PCU) and began transferring those who require ICU level care to the QEH.

  • Staffing continues to be a priority to ensure that there is critical care capacity in the province.

  • Health PEI continues to review staffing models and patient demographics to design a safe and viable option for a provincial response to critical care needs on PEI.

  • Emergency patients continue to be seen and assessed at PCH before transfers.

  • We are working with staff at both sites so that PCH has capacity for up to 8 PCU level care patients and QEH have capacity for up to 10 ICU level care patients.

  • The Hospital Operations team continue to review the overall impact of decreased internal medicine physicians across HPEI systems so that risks are identified, and mitigation plans are put into place to provide safe critical care services for Islanders.

  • Ongoing evaluation and monitoring of critical care delivery across the Province is a priority for HPEI with a goal of recruiting a full complement of IM Physicians at PCH.

Work to Date

  • Recruitment efforts for permanent and locum IMs continue through the Recruitment and Retention Secretariat and the hiring of a private recruitment firm. Weekly HPEI updates with these groups has been initiated to help escalate any barriers to recruitment.

  • Hospitalist D line began supporting the PCH PCU level care patients within their scope of practice in collaboration with IM.

  • Enhancement of the scope and education of Family Physicians and Hospitalist physicians to enable them to support PCU level care patients at PCH with back up support from IM continues. (Advanced Cardiac Life Support Certification May 16 and 17th, Stabilization and Transport high fidelity simulation training May 24, 25 and 26th) This SIM education was Interprofessional Education to support the team including the physicians and had participation from ED/ICU RNs and PCH RTs. 

  • There is an Internal Medicine physician either in house at PCH Mon-Friday 8-4 or on call, as well as 24/7 on call coverage for the off hours (covered by PCH IM, PCH Locum or QEH IM group). Access to the on-call IM is through local switchboard operators at PCH and QEH. 

  • Continue to explore and discuss with key stakeholders the feasibility of virtual critical care supports. 

  • Expression of interest to fill vacant shifts at the QEH for the first 6 weeks has been sent out with the intent to post expression of interest for the remainder of the shifts during the summer ASAP.

  • Ongoing recruitment of travel nurses.

  • With the support of an experienced ICU nursing consultant, tools have been developed and continue to be evaluated to support this transition for physicians and staff:
    • Transfer guidelines
    • Transfer checklists
    •  Stabilization and transfer education
      • High Fidelity Simulation education occurred at the PCH on May 24, 25 and 26th with PCH staff involved in the stabilization and transfer of critically ill patients to ensure the highest level of safety. 
      •  These sessions will be repeated for staff in KCMH and WH mid-June and July.
  • PCU patient population screening tool- reviewed May 23, 2023.

  • SMART pump PCU medication libraries.

  • Critically ill transfer via iEMS order set (PCH specific however looking to adopt Provincially)-sent to leaders May 24th with goal to send to PD&T for June meeting.

  • PCH Decompensating inpatient process.

  • Bi-weekly meetings continue with Senior Leadership to escalate concerns and support decision making. 

  • Tabletop exercises occurred and gaps identified continue to be worked on. 

  • Collaborating with IEMS staff and Health PEI leadership regarding ICU level transfers to the QEH or off Island as appropriate.

  • Critical Care Transport Team has been developed and began supporting on Island transfers from PCH to QEH May 22, 2023 with a goal to spread to the rest of acute care in the coming weeks. This team will work with iEMS to support care decisions during ground transports as clinically indicted during the entire transfer until care is handed over to a receiving physician.

  • RT coverage at PCH is being expanded to include an RT 24/7 on call whenever possible to assist with stabilization and transport of critically ill patients.

  • Working with HR and Finance to identify ways to fund new positions to support critical care needs at PCH and QEH sites. 

  • Developing an evaluation matrix to provide data for future decision making.

  • Regular review of transfer process for critically ill patients.

This has been a difficult transition. Thank you to everyone involved for their support. Change can be difficult, but every one of our healthcare workers is vital to our overall system. 

We appreciate everyone working together as that is the only way we can be successful – as a team.
Thank you, 
Dylana Arsenault, Executive Director
Hospital Services and Patient Flow


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