Out of our reach? Assessing the impact of introducing a critical care outreach service.
An outreach service was introduced in three surgical wards and the surgical high dependency unit in a large teaching hospital. A modified early warning score and callout algorithm were used to facilitate referrals to the team. Changes in unplanned admission rate to intensive care, length of stay, mortality rate and number of re-admissions following the introduction of outreach were sought. Following the introduction of the outreach service the emergency admission rate to intensive care fell from 58% to 43% (p = 0.05). These emergency patients had shorter lengths of stay (4.8 days vs. 7.4 days) and had a lower mortality (28.6% vs. 23.5%, p = 0.05). The re-admission rate also fell from 5.1% to 3.3% (p = 0.05). The outreach service had a significant impact on critical care utilisation.
Pittard
A J
AJ
Department of Anaesthesia, D Floor Jubilee Wing, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. alison.pittard@leedsth.nhs.uk
D000465:Algorithms; D003159:Community-Institutional Relations; D003266:Continuity of Patient Care / Q000458:organization & administration; D003422:Critical Care / Q000458:organization & administration*; D004739:England; D006302:Health Services Research; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data