Critical care outreach: creating a safe culture.

Critical care 'outreach' and early warning scoring tools have become fundamental in identifying patients at risk of clinical deterioration and promoting their optimization within the ward environment. Outreach has been implemented in various ways, ranging from the 'flying squad' (staff attending to a patient at risk of deterioration on the ward) approach to an educational model. This article describes the unique approach taken within the cardiothoracic directorate at South Manchester University Hospital Trust. The authors' approach focused on linking critical care outreach to the clinical governance agenda through incident reporting. This enabled the authors to demonstrate the effectiveness of the critical care outreach service by producing both quantitative and qualitative data in respect of patients who had deteriorated following cardiothoracic surgery, and required intervention from the outreach service.