Host Hospital Checklist for Sending and Receiving Provincial Ventilators
2021 | Forms
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Our repository of critical care reports, guidance, toolkits, forms & educational materials.
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Host Hospital Checklist for Sending and Receiving Provincial Ventilators
2021 | Forms
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Requesting Hospital Checklist for Sending and Receiving Provincial Ventilators
2021 | Forms
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Requesting Hospital Checklist for Sending and Receiving Provincial Ventilators
2021 | Forms
CCIS Data Request Form (For Research)
2020 | Forms
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CCIS Data Request Form (Not for Research)
2020 | Forms
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Partner Hospital Reporting Form (PDF)
2020 | Forms
To be completed by Partner Hospitals prior to joining the Moderate Surge teleconference (organized by CritiCall Ontario). This form has been developed to confirm resources available at the partner hospital in the event of a moderate surge.
Partner Hospital Reporting Form (Word)
2020 | Forms
To be completed by Partner Hospitals prior to joining the Moderate Surge teleconference (organized by CritiCall Ontario). This form has been developed to confirm resources available at the partner hospital in the event of a moderate surge.
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Service Inventory Change Request Form (2020)
2020 | Forms
This form is to be completed by critical care units that are reporting substantive changes to their hospital’s critical care capacity information.
Ventilator Stockpile Allocation Sign-Back Agreement for Requesting Hospitals
2020 | Forms
The Requesting Hospital is required to complete this form and submit as instructed before the release of a ventilator from the Provincial stockpile.
Index Hospital SBAR Form (PDF)
2017 | Forms
To be completed by the Index Hospital’s critical care team (critical care manager, director or other delegate) and provided to the Hospital CEO/senior delegate prior to the Moderate Surge preamble call organized by CritiCall Ontario. The SBAR Tool provides a consistent method of reporting situations, which require escalation.
Index Hospital SBAR Form (Word)
2017 | Forms
To be completed by the Index Hospital’s critical care team (critical care manager, director or other delegate) and provided to the Hospital CEO/senior delegate prior to the Moderate Surge preamble call organized by CritiCall Ontario. The SBAR Tool provides a consistent method of reporting situations, which require escalation.
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