The provision of critical care outreach services in England: findings from a national survey |
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Authors: | McDonnell Ann Esmonde Lisa Morgan Richard Brown Roy Bray Kate Parry Gareth Adam Sheila Sinclair Ray Harvey Sheila Mays Nicholas Rowan Kathy |
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Institution: | Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Collegiate Crescent, S1 1WB Sheffield, UK. a.mcdonnell@shu.ac.uk |
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Abstract: | PURPOSE: The aim of this study was to describe the development, introduction, implementation, and current models of critical care outreach services. MATERIALS AND METHODS: We conducted a national postal survey of National Health Service acute care hospitals in England that routinely provide care for level 1 patients (n = 239). RESULTS: Completed questionnaires were received from 191 (79.9%) hospitals; 139 (72.8%) had a formal critical care outreach service. A third (32.8%, 45/137) of services covered more than one hospital; 33.8% (45/133) of hospitals provided telephone advice 24 hours a day for 7 days per week, but less than 15% of hospitals offered follow-up or direct bedside clinical support on the same basis. There was wide variation in the proportion of hospital wards covered, the size and composition of the team, the aims of the service, and the balance between provision of direct care and advice. CONCLUSIONS: There are still a significant number of National Health Service acute care hospitals in England with no formal critical care outreach service. In addition, critical care outreach is being delivered in many different ways across the country, and thus means different things in different hospitals. The variation may reflect the lack of evidence as to which approaches are likely to be most effective. |
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Keywords: | Critical care outreach service National Health Service Acute care hospital Inpatients |
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