Critical care outreach

Effectiveness of critical care outreach services: a systematic review

What was this review about?

In 2000, as part of its “vision for future critical care services”, the Department of Health promoted the establishment of critical care outreach services. These teams, usually led by experienced critical care nurses, aim to: help staff on general wards to identify deteriorating patients; provide advice or treatment; ensure swift admission into a critical care unit; and share skills.

This review used a broad search strategy to locate both published and unpublished studies that evaluated the impact of introducing a critical care outreach service (or any outreach activity delivered by critical care staff) on any measure of patient health or professional performance. All study designs using concurrent or historical controls were included.

This systematic review was part of the Evaluation of outreach services in critical care.

What did the review find? 

The review identified 23 studies, of which 17 were full published papers and two were randomised controlled trials. The most frequent outcomes measured were mortality, cardiac arrest, unplanned critical care admissions from wards, length of stay, and critical care readmission rates.

Although improvements in patient outcomes were found, the evidence was insufficient to demonstrate this conclusively. The many differences in service delivery did not permit identification of service typology. 

The authors recommended that more comprehensive research of outreach services in the UK was needed.

Publication

  • Authors: Esmonde L, McDonnell A, Ball C, Waskett C, Morgan R, Rashidian A, Bray K, Adam S, Harvey S Title: Investigating the effectiveness of critical care outreach services: a systematic review Publication: Intensive Care Medicine Journal website PubMed citation