Pioneers in patient care: consultants leading change
South East
Innovation: Development of a critical care outreach team
Dr Tim Leary
Norfolk and Norwich University Hospital
Job Title: Consultant anaesthetist
Speciality: Anaesthesia and intensive care
Hospital staff who work on general wards are often anxious about diagnosing and treating critically ill patients and there is overwhelming evidence that patients may receive sub-optimal care prior to intensive care admission.
In a bid to help all staff care for such vulnerable patients, consultant anaesthetist Tim Leary has set up a critical care outreach team (CCOT), made up of consultants and senior nurses, at the Norfolk and Norwich University Hospital to help all staff care for such vulnerable patients.
The service is funded by the NHS and was introduced in January earlier this year. Dr Leary says: “The plan is to disseminate critical care skills beyond the intensive care unit to all areas of the hospital so that highly dependent patients or those at risk of a critical illness get the best possible care as they move from intensive care to general wards and vice versa.”
The team is very much tailored to local needs and has proved a real success with patients, says Dr Leary. “Patients are usually glad to see the CCOT, especially those who have been in the intensive care unit for long periods of time. We are able to help smooth the transition from an area of very high medical and nursing input into the general wards.
“Tracheotomy care has been standardised throughout the hospital and the education of junior medical and nursing staff as well as physiotherapists and radiographers will help reduce the number of intensive care admissions and detect ‘at risk’ patients.”
Dr Leary says: “Improved liaison between critical care staff and staff on the general wards means that patients can now be discharged from the critical care unit with fewer concerns about their ongoing care. Early intervention on the wards may reduce the number of cardiac arrests and mortality.”
Dr Leary believes that the demand for critical care skills is likely to increase, and aims to extend the service. “Our first priority is to expand into providing a 24-hour service. Patients discharged from intensive care at night may have up to a 70 per cent increased risk of mortality. With the establishment of outreach, I hope to be able to improve the care of patients previously not under my direct influence.”