Critical care service

Critical care service

Critical Care Service

Critical care services are defined as discrete care services organised specifically for the management of critically ill patients and involving the grouping of special facilities and specially trained staff. All services that are provided by the organisation, such as high dependency units, critical care, coronary care, or paediatric intensive care units and also for recovery, post procedure, need to complete the relevant criteria from this standard. For the purpose of this standard, levels of care for adults are defined as: Level 1: Patients at risk of their condition deteriorating, or those recently relocated from higher levels of care, whose needs can be met on an acute ward with additional advice and support from the critical care team. Level 2: Patients requiring more detailed observation or intervention, including support for a single failing organ system, or post-operative care and those ‘stepping down’ from higher levels of care. Level 3: Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi-organ failure.

The location of patients should not determine their level of care and clinical judgement should be used to determine the level of care. All acute hospitals carrying out elective surgery must be able to provide level 2 care. They should either have level 3 care available on site or they should have protocols in place to arrange transfer to a suitable unit. Hospitals admitting emergencies should normally have all levels of care available, although in a limited number of cases, protocols may be agreed for safe transfer to an adjacent hospital for level 3 care.

This standard includes the following:

• Management and risk
• Staffing
• Treatment and care
• Equipment and facilities
• Environment
• Quality improvement

The CHKS Standards criteria address these elements through succinct criteria statements that are supported by guidance which helps the organisation understand the intent of the criteria, so that it can be applied in the local context.

Additionally, references are provided to direct further reading on the relevant topic.

Throughout the standards the criteria are linked to key assessment frameworks including ISO 9001, the Care Quality Commission, Quality Statements and the Health Information and Quality Authority, (Ireland) National Standards.