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Home Learn how EnTICE came about and the vision behind it. Meet the EnTICE Team! The EnTICE Toolkit is 7 simple steps that will help individuals or a team implement a best practice specific to their clinical setting. View the 7 steps and learn what it takes to make a difference. Watch these short videos as an introduction to the 7 simple steps highlighted in the Toolkit. Ready to implement your best practice? Complete this checklist to create a concrete blueprint, help you track your progress and keep the implementation organized. The devil is in the details! Download these worksheets that supplement the checklist and will help you answer all the important questions that need to be considered to successfully implement your best practice.

About us

The EnTICE toolkit emerged out of a problem faced by many front-line health care teams: “We know there is a better way to provide care to our patients, but how do we get our team on board?”

In our case, the “better way” or best practice was a delirium prevention practice.  Our champions, an Emergency Nurse Educator, a Geriatric Emergency management Nurse and an Emergency Physician, stepped back to look at the what was known about engaging an interprofessional team.  The literature was overwhelming, disjointed, contradictory, and often written in jargon specific to the divergent target audiences in social sciences, education, business, aviation and various health care professions.

In the fall of 2006, the Ontario Ministry of Health and Long-Term Care announced new funding for projects related to interprofessional education collaboration.  It was the perfect opportunity!  Starting with the lessons the team learned in trying to implement their specific delirium prevention program - Interprofessional Prevention of Delirium (IPPOD) – the team collated the existing evidence from divergent fields, consulted with experts, and developed a toolkit that was designed to help frontline clinicians with no previous experience to implement the best practice on their interprofessional clinical team.

Toolkit Vision:

  • Targeted at front-line health care givers who are short on time
  • Simple language, free of profession-specific jargon
  • Uses best evidence where available, and common sense and expert opinion when no evidence is available!
  • Gives health care givers concrete advice on how to implement change
  • Covert strategy to promote interprofessional collaboration
  • Focused on improving patient care

We hope you will find this toolkit helpful. Remember that your dedication is the most important factor in improving patient care.

Our Team

Jacques S. Lee, MD, MSc, FRCPC

Dr. Jacques Lee is a scientist with Sunnybrook Research Institute and Director of Research and Scholarly Activity, Department of Emergency Services.  Dr Lee is the Associate Director of Scholarship for the University of Toronto, Emergency Medicine Training Program.

Dr Lee’s main research focus is on improving the Emergency care of older persons through knowledge creation, translation, and advocacy. His current CIHR funded research project, “Paramedics Assessing Older Patients at Risk of Independence Loss” or PERIL study used information collected by 1600 paramedics in Edmonton, Ottawa and Toronto to identify older patients at risk for adverse outcomes. This grant was recently renewed for 2 further years, and was ranked first out of 23 applications.

Dr Lee is also funded by the Ontario Ministry of Health to develop the EnTICE toolkit, (Enabling Teamwork, Interprofessional Collaboration and Education) designed to be used by front line clinicians who want to successfully implement any best practices in their interprofessional healthcare team. This project was awarded the Ted Freedman award for innovations in education in 2009.

Click here to view Dr. Lee's articles.

Barbara Jonathan, R.N., B.N.Sc., B.A

Barbara Jonathan is a Geriatric Nurse Clinician at Sunnybrook Health Sciences Centre in Toronto.  She has held many different nursing positions with the Regional Geriatric Program of Metropolitan Toronto including Outreach Team, Day Hospital and Geriatric Emergency Management services.

Sharon Ramagnano, RN, MScN, MHA

Sharon has been at Sunnybrook Health Sciences Centre in the ED for the last 13 years where she has functioned at the staff level, Charge nurse, Clinical Care Leader, Clinical Educator and now as the Advanced Practice Nurse for the ED. Sharon teaches ACLS at Sunnybrook and is a Course Director for the Emergency Nurses Association teaching TNCC (Trauma nursing core course certification) and ENPC (Emergency Nursing Pediatric Course).  Sharon is also certified in Adult Teaching and Learning, Educator development and recently received a certificate in the Middle Management Leadership Development Course at University of Toronto Rotman School of Business.

In her role as the ED APN, Sharon is a co-investigator and consultant on the CREW simulation study, IPPOD elder care study, CLOQs stroke study, EDVENT Study and MD RN Triage project.  She is the Principal Investigator for the Pre-Triage Flow Project recently initiated at Sunnybrook.  Sharon is also the Clinical Educator Consultant for the SPARC Network (Strategies for Post Arrest Resuscitation Care) for the Therapeutic Hypothermia Post Cardiac Study protocol for Ontario and is the lead contact for 43 Ontario hospitals as they roll out and develop their protocols. 

Sharon's interests are in the field of Knowledge Translation, Simulation Education and Staff Empowerment and Development opportunities. Sharon has completed a double Masters Program; Masters of Science in Nursing and Masters of Health Administration. 

David Patrick Ryan, PhD

Dr. David Patrick Ryan is a consulting psychologist in aging, organizational behavior, inter-professional education and practice, and knowledge translation. He is Director of Education and Knowledge Processes for the Regional Geriatric Program of Toronto and an Assistant Professor in the Faculty of Medicine at the University of Toronto.

His interests include inter-professional practice and inter-organizational collaboration, networked practice, and the knowledge to practice (KTP) process. His inventions include the “Build-a-Case” variant of case-based learning and the Dimensions of Teamwork Survey.

Presently, he is co-investigator on a Bell University Laboratories initiative developing a GPS enabled memory enhancing cell-phone and the Paramedics & Elders at Risk of Independence Loss (Peril) Initiative and primary investigator for a study of pain management following hip surgery. He provides leadership in geriatric service development in several LHINs. He provides consultation services to several projects including inter-professional coaching and mentorship, inter-professional practice in long-term care, and the inter-professional prevention of delirium in the emergency department.

Click here to view Dr. Ryan's articles.

Merrick Zwarenstein M.B.B.Ch., M.Sc., PhD

Merrick Zwarenstein is currently a Senior scientist, Director of Discipline of combined health services sciences and chair of the Centre for Health Services Sciences at Sunnybrook Research Institute.  His interests are in quality in health care, and strategies for improving it, doctor-nurse collaboration and patient-carer interactions.

His methodological interests are pragmatic, cluster randomized controlled trials of complex interventions, integrated with qualitative research. He also conducts systematic reviews for evaluation of health care interventions.

His teaching and educational interests have been focused on intensive interactive short courses for in-service training of health care professionals.  His information technology interest is in the use of palm top computers for data collection for surveys, where he has a provisional patent.

Click here to view Merrick Zwarenstein's articles.

Katie N. Dainty, PhD

Katie Dainty is a Post-Doctoral Research Fellow in Knowledge Translation and Quality Improvement at Rescu and St. Michael's Hospital Toronto. She completed her PhD in the Institute of Medical Science at the University of Toronto in November 2010 and her Masters and undergraduate degrees at the University of Western Ontario. 

She brings an extensive background in both clinical and health services research and has designed and implemented several large and innovative projects, with an emphasis on clinical performance improvement, knowledge translation and pragmatic randomized designs.  Her most recent research interests and doctoral work are in the use of qualitative methods to understand the sociologic constructs of collaborative quality improvement and knowledge translation at the frontlines of healthcare.

She also spent 2 years in a secondment position with the Ministry of Health and Long Term Care leading the Performance Improvement Collaborative in Critical Care which has given her a unique perspective on the larger health system and the researcher-decision maker-clinician triad.  In 2008 she was awarded the CIHR Rising Star Award for Knowledge Translation and has been involved in more than $3.5 million dollars in research funding in her short career.

Click here to view Katie Dainty's articles.

Eliane Kim, BHS, MPH (c.)

Eliane is the Research Coordinator for the EnTICE project at Sunnybrook Health Sciences Centre.  She has been involved with emergency medicine research for the past 5 years assisting in the coordination and implementation of several projects.  Her educational background is in Health Studies with a specialization in Health Policy and is currently enrolled in the Master of Public Health with a specialization in Epidemiology.