Critical care is a need, not a place

Fall 2017

Celebrating 10 years of critical care outreach

The level of care required for patients in acute care hospitals such as London Health Sciences Centre (LHSC) is complex. Many patients have multiple health issues and are at a higher risk of sudden physical decline.

Ten years ago, Ontario’s Ministry of Health and Long-Term Care established funding for Critical Care Outreach Teams (CCOT) in acute care hospitals around the province.

CCOTs bring critical care support to high-risk patients located in units outside of an intensive care or critical care trauma unit.

LHSC is home to three teams, one CCOT at each of University and Victoria hospitals, as well as the Paediatric CCOT permanently established in 2011 at LHSC’s Children’s Hospital.

The teams are made up of critical care physicians, nurses and respiratory therapists, who bring their specialized skills to other patient care units to support and assist staff in managing at-risk patients.

“The implementation of CCOT has improved patient safety and patient outcomes,” says Dr. Wael Haddara, LHSC Chief of Critical Care Medicine. “Early intervention has reduced the number of cardiac arrests, for example, and providing preventative care before a patient becomes critically ill reduces the need to transfer patients to intensive care beds.”

Any member of the health-care team can call CCOT when there is a serious concern about a change in the patient’s medical condition. This is different from a code blue, where the response team is called to resuscitate a patient.

“About a third of our calls in CCOT are for respiratory issues such as breathing or airway obstruction. Another third of the calls are cardiac or heart-related issues, and the final third are neurological issues such as a decreased level of consciousness in the patient,” says Dr. Haddara.

The CCOT motto is that critical care is a need, not a place.

“There is a benefit for patients to stay on the same ward or unit where the staff and physicians know them and have been providing care. However, there are times when CCOT arrives and in five minutes the patient is transferred to the intensive care unit, in which case they are receiving the critical care they need in this specialized unit,” says Susan Whitehouse, RN, Intensive Care Unit and CCOT Clinical Co-Lead at University Hospital.

Our dream world is one in which patients get the care they need where they are – we come to them, says Dr. Haddara.

“If we can find a way that brings expertise and diagnostic testing to the bedside so patients do not need to be moved from their bed or unit - that is the way of the future.”

 

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CCOT conducts simulation training.