intensive care service model · intensive care services are a precious and costly resource, which...
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Intensive Care Service Model
CURRENT SERVICES: LEVEL 3 & 4 INTENSIVE CARE UNITS
VARIABILITY IN PRACTICES AND SERVICE PROVISION
RECOMMENDED STANDARDS FOR NSW LEVEL 4 ADULT INTENSIVE CARE SERVICES
POTENTIAL BENEFITS OF IMPLEMENTATION
NSW Level 4 Adult Intensive Care Units
“There is evidenceof poor care
planning,coordination and
delivery ofpatient care.”
Average 13,000 separations annuallyProjected to grow by13% over next �ve years
Lack of governanceand leadership
LEADERSHIP AND GOVERNANCE
– Networked intensive care services across Level 4 and 5/6 intensive care services.– Unit-level governance by designated specialist medical and nursing staff.
PATIENT SAFETY AND EXPERIENCE,QUALITY SYSTEMS AND DATA
– Monitoring of standardised quality measures. – Regular review of morbidity data, clinical audits and clinical incidents.– Regular review of patient, carer and staff experiences.
WORKFORCE MANAGEMENT AND SUPPORT SERVICES
– The right team, working together: medical, nursing, allied health and support staff.
STANDARD PROTOCOLS AND PROCEDURES
– Standardisation across networked intensive care services.– Formal escalation process in place to upgrade patient care.
CARE PLANNING, COORDINATION AND DELIVERY
– Intensive care team primarily responsible for coordinating patient care in consultation with admitting team.– Access to senior critical care advice 24/7.
Ambiguity in role / function of ICUs
Poorly coordinated care
Variations in practice Transfer and retrieval issues
Reduced unplannedadmissions, hospitalLOS and transfersto other hospitals
Access to intensive servicesclose to wherepatients live
Improved patient, carer and staff
experience
Better coordination of patient care
Improved quality and
safety processes
Improved delivery and utilisation of intensive
care services
Improved delivery and utilisation of intensive care services90,000 beddays annuallyProjected to grow by15% over next �ve years
$11,812 per patient separationProjected to grow by 5% per annum over next �ve years
Intensive care services are a precious and costly resource, which need to be consistently, safely and e�ciently provided. Implementation of the Intensive Care Service Model across NSW will improve delivery of intensive care services and the care of the critically ill patient in rural, remote and metropolitan hospitals.
EDUCATION, TRAINING AND SUPERVISION
– Structured orientation and education programs in place to support the professional development of staff.– Documented scope of practice and clinical supervision frameworks.
EQUIPMENT
– Essential equipment required to provide intensive care.