The provision of critical care outreach services in England: findings from a national survey.
OBJECTIVE
The aim of this study was to describe the development, introduction, implementation, and current models of critical care outreach services.


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.
McDonnell
Ann
A
Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Collegiate Crescent, S1 1WB Sheffield, UK. a.mcdonnell@shu.ac.uk
Esmonde
Lisa
L
Morgan
Richard
R
Brown
Roy
R
Bray
Kate
K
Parry
Gareth
G
Adam
Sheila
S
Sinclair
Ray
R
Harvey
Sheila
S
Mays
Nicholas
N
Rowan
Kathy
K
D039602:After-Hours Care; D003159:Community-Institutional Relations; D003422:Critical Care / Q000458:organization & administration*; D004739:England; D019538:Health Care Surveys; D006284:Health Plan Implementation; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D016730:Program Development; D012944:Social Support; D013222:State Medicine; D011795:Surveys and Questionnaires