title: The provision of critical care outreach services in England: findings from a national survey.
abstract: 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.
authors.affiliation: Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Collegiate Crescent, S1 1WB Sheffield, UK. a.mcdonnell@shu.ac.uk
authors.forename: Ann
authors.initials: A
authors.lastname: McDonnell
authors.forename: Lisa
authors.initials: L
authors.lastname: Esmonde
authors.forename: Richard
authors.initials: R
authors.lastname: Morgan
authors.forename: Roy
authors.initials: R
authors.lastname: Brown
authors.forename: Kate
authors.initials: K
authors.lastname: Bray
authors.forename: Gareth
authors.initials: G
authors.lastname: Parry
authors.forename: Sheila
authors.initials: S
authors.lastname: Adam
authors.forename: Ray
authors.initials: R
authors.lastname: Sinclair
authors.forename: Sheila
authors.initials: S
authors.lastname: Harvey
authors.forename: Nicholas
authors.initials: N
authors.lastname: Mays
authors.forename: Kathy
authors.initials: K
authors.lastname: Rowan
mesh_terms: 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