Impact of critical care outreach on cardiac arrest rates and readmission rates in an adult cardiothoracic centre

Introduction

Following the recommendations of Comprehensive Critical Care [1], outreach services have been implemented nationally with the remit of avoiding admission to intensive care; facilitating discharge of critically ill patients from Level 3 areas and educating ward staff in critical care skills. This initiative consumes significant resources, and to date there has been disappointing evidence that this investment has been worthwhile in terms of improving outcomes, reduction in cardiac arrests, and unplanned admissions to intensive care.

Objective

This audit aims to identify whether the implementation of an outreach team has had an impact on inhospital cardiac arrest rates and readmission rates to ICU.

Methods

A retrospective analysis of the ICU and outreach database was performed to quantify the readmission rate within 48 hours due to organ failure and the inhospital cardiac arrest rate. This analysis was performed 1 year pre and post the implementation of a dedicated nurse-led outreach team.

Results

Cardiac arrest rate has reduced by 40% since the introduction of the outreach service. The readmission rate within 48 hours with organ failure was less than 2%.

Conclusion

We report a reduction in the cardiac arrest rate post implementation of outreach, although this may be due to other external factors. The readmission rate within 48 hours of ICU discharge is low, reflecting an appropriate and effectively facilitated discharge practice.