Who makes up the Critical Care Team?
Critical Care Outreach
Our Critical Care Outreach Teams are a group of highly specialised, multi-disciplinary staff who deliver the highest quality of care to acutely unwell patients and those patients recovering from critical illness on wards and within other areas of our hospitals.
Across L&SC Critical Care Network, as well as the name 'Critical Care Outreach Team' (CCOT), these teams are also known as Acute Care Team (ACT) and Acute Response Team (ART).
These vital teams are the bridge between our Critical Care Units and the wards, offering advice and support to the ward staff, reassuring patient's and their families, liaising with our Critical Care Units and most importantly, ensuring the timely and effective treatment of some of our most vulnerable patient's.
They also have other roles integrated within their duties, such as Acute Kidney Injury (AKI) Specialist Nurses, core members of the cardiac arrest team, tracheostomy team, education, among others.
Our teams regularly complete audits to evaluate patient outcomes and quality of care.
They practice in line with GPICS standards and recommendations and the National Outreach Forum (NOrF) guidance.
Information for Healthcare professionals interested or working in Critical Care Outreach is available by clicking on this link
Allied Health Professionals (AHPs)
Allied Health Professionals (AHPs) include all the other professional groups that make up the multi-disciplinary team (MDT) that together provide comprehensive care to the patients within critical care. The main groups include:
Dietitians
Occupational Therapists
Physiotherapists
Speech & Language Therapists
Dietitians
Dietitian work as part of the MDT team to ensure optimal nutrition in critically ill patients. When patients are extremely unwell, their nutritional needs may change on a daily basis. Critical care dietitians are specially trained to adapt nutrition plans as appropriate for each individual patient. If patients are unable to eat and drink, the dietitian will advised the MDT on the optimum way to get nutrition into the body. This may be through a tube - either into your gut or straight into your blood supply. Once patients are able to eat and drink again they may have ongoing problems with reduced appetite, taste changes or swallowing difficulties. The dietitian can provide support, advise and information on how to get the nutrition you need to optimise recovery.
Occupational Therapists
Occupational therapists (OT) have specialized expertise to enable people to perform meaningful "occupations" that support health, well-being, and participation in life roles. Given the physical, cognitive, and psychologic disability experienced by ICU survivors, occupational therapists play an important role in their recovery. The OTs can help delirium management and person-centred care e.g. Getting to know me boards. In the rehabilitation phase of the recovery, the OT’s work closely with the MDT and provide goal orientated therapy for patients to manage more of their daily living tasks independently. OTs can provide equipment to allow for more independence e.g., with hair brushing, feeding, drinking.
Physiotherapists
Physiotherapists are an integral part of the multi-disciplinary team in critical care, they are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, and neuromuscular and musculoskeletal conditions. Respiratory physiotherapy interventions may include positioning, education, manual and ventilator hyperinflation, weaning from mechanical ventilation, non-invasive ventilation, percussion, vibration, suctioning, respiratory muscle strengthening, breathing exercises and mobilisation. Physiotherapy is an important intervention that prevents and mitigates adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on conscious state, psychological status and physical strength. It incorporates any active and passive therapy that promotes movement and includes mobilisation.
Speech & Language Therapists
Speech & Language Therapists (SLTs) have a vital role in optimising the care, experience, safety and outcome of patients whilst they are on critical care through to their ongoing rehabilitation. They provide specialist assessment and treatment of any communication problems which may happen as a result of a condition. They also provide specialist assessment and management of swallowing problems that would include: too much or too little saliva, difficulty drinking fluids, eating textured foods and taking medications. They work with the MDT team to problem-solve complex communication or swallowing difficulties, especially for those with tracheostomy and/or ventilation. SLTs can use a range of assessments, to support the clinical decisions for weaning someone off their ventilator or tracheostomy tube, identifying the best therapy for swallowing problems and voice production. SLTs will teach patients techniques, strategies and methods to improve their swallowing and speech, which helps their road to recovery.
Dietitians
Occupational Therapists
Physiotherapists
Speech & Language Therapists
Dietitians
Dietitian work as part of the MDT team to ensure optimal nutrition in critically ill patients. When patients are extremely unwell, their nutritional needs may change on a daily basis. Critical care dietitians are specially trained to adapt nutrition plans as appropriate for each individual patient. If patients are unable to eat and drink, the dietitian will advised the MDT on the optimum way to get nutrition into the body. This may be through a tube - either into your gut or straight into your blood supply. Once patients are able to eat and drink again they may have ongoing problems with reduced appetite, taste changes or swallowing difficulties. The dietitian can provide support, advise and information on how to get the nutrition you need to optimise recovery.
Occupational Therapists
Occupational therapists (OT) have specialized expertise to enable people to perform meaningful "occupations" that support health, well-being, and participation in life roles. Given the physical, cognitive, and psychologic disability experienced by ICU survivors, occupational therapists play an important role in their recovery. The OTs can help delirium management and person-centred care e.g. Getting to know me boards. In the rehabilitation phase of the recovery, the OT’s work closely with the MDT and provide goal orientated therapy for patients to manage more of their daily living tasks independently. OTs can provide equipment to allow for more independence e.g., with hair brushing, feeding, drinking.
Physiotherapists
Physiotherapists are an integral part of the multi-disciplinary team in critical care, they are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, and neuromuscular and musculoskeletal conditions. Respiratory physiotherapy interventions may include positioning, education, manual and ventilator hyperinflation, weaning from mechanical ventilation, non-invasive ventilation, percussion, vibration, suctioning, respiratory muscle strengthening, breathing exercises and mobilisation. Physiotherapy is an important intervention that prevents and mitigates adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on conscious state, psychological status and physical strength. It incorporates any active and passive therapy that promotes movement and includes mobilisation.
Speech & Language Therapists
Speech & Language Therapists (SLTs) have a vital role in optimising the care, experience, safety and outcome of patients whilst they are on critical care through to their ongoing rehabilitation. They provide specialist assessment and treatment of any communication problems which may happen as a result of a condition. They also provide specialist assessment and management of swallowing problems that would include: too much or too little saliva, difficulty drinking fluids, eating textured foods and taking medications. They work with the MDT team to problem-solve complex communication or swallowing difficulties, especially for those with tracheostomy and/or ventilation. SLTs can use a range of assessments, to support the clinical decisions for weaning someone off their ventilator or tracheostomy tube, identifying the best therapy for swallowing problems and voice production. SLTs will teach patients techniques, strategies and methods to improve their swallowing and speech, which helps their road to recovery.
Pharmacists
The ICU Pharmacists role is to review, ensure safe use of, and optimise the medication treatments delivered to patients, to ensure they achieve the best possible outcomes. They also make complex decisions around therapies required for life-threatening illnesses. They're responsible for medicines reconciliation, confirming patients are taking the right medicines on admission and discharge from the ICU. They can also prescribe medicines for the patient. This is crucial to maintaining the safe operations of an ICU.
Nursing Staff
ICU nurses are highly specialised, educated and trained healthcare personnel who undertake complex work utilising critical thinking, crisis management, and situational awareness to provide nursing care to patients with life-threatening illnesses.
They work very closely with patients and as part of a diverse multi-professional team they ensure each patient gets the care they need when they need it. They will also often liaise with the family, friends, and loved ones of their patients.
They work very closely with patients and as part of a diverse multi-professional team they ensure each patient gets the care they need when they need it. They will also often liaise with the family, friends, and loved ones of their patients.
Doctors
Doctors play a very important role in caring for critically ill patients, including diagnosing illnesses, carrying out procedures, managing organ support, and supporting loved ones. They work as part of a multi-professional team, and many will also be trained in another specialty , usually anaesthesia or emergency medicine. The Doctors who work on Intensive Care are at various points in their postgraduate training.
Doctors working in intensive care have input into the sickest patients throughout the hospital, responding to cardiac arrests and medical emergencies on the wards and those seriously unwell from injury in the emergency department. They have specific skills that allow them to manage these patients. Intensive care doctors are highly skilled and very well trained, and intensive care units could not function at such a high level without them.
The medical team is led by Intensive Care Consultants. They formally review patients at least two times a day on ward rounds, and often more frequently than that. Doctors are always present on the Intensive Care Unit and a Consultant is on duty, day and night.
Many Intensive Care Units have follow up clinics and access to Doctors is available here as well
Doctors working in intensive care have input into the sickest patients throughout the hospital, responding to cardiac arrests and medical emergencies on the wards and those seriously unwell from injury in the emergency department. They have specific skills that allow them to manage these patients. Intensive care doctors are highly skilled and very well trained, and intensive care units could not function at such a high level without them.
The medical team is led by Intensive Care Consultants. They formally review patients at least two times a day on ward rounds, and often more frequently than that. Doctors are always present on the Intensive Care Unit and a Consultant is on duty, day and night.
Many Intensive Care Units have follow up clinics and access to Doctors is available here as well
Support Staff
In critical care support staff assist registered health care professionals in the delivery of patient care, or provide administrative duties. In critical care some of the support staff you may see are listed below.
Health Care Support Workers (Healthcare Assistants) work under the guidance and supervision of a Registered Nurse, Physiotherapist, Occupational Therapist, Pharmacist or Dietitian (dependent on their role) to help provide direct patient care within defined parameters. They will have training to carry out specific tasks and elements of care.
Assistant practitioners (sometime known as associate practitioners) have skills and experience in a particular area of clinical practice such as critical care. Although they are not registered healthcare professionals, they develop a high level of knowledge and skill through their experience and additional training and have previously worked in the NHS, often in a clinical role. Assistant Practitioners can become members of the professional association for their speciality, for example Royal College of Nursing, Chartered Society of Physiotherapy. Their level of training and experience means they may work alone, without supervision carrying out agreed procedures, referring to a registered professional for guidance when necessary.
Administrative staff are key team members who undertake non-clinical roles that mean the clinical staff can concentrate on providing direct patient care. Their role may be as a data clerk, ward clerk, unit receptionist or housekeeper.
Health Care Support Workers (Healthcare Assistants) work under the guidance and supervision of a Registered Nurse, Physiotherapist, Occupational Therapist, Pharmacist or Dietitian (dependent on their role) to help provide direct patient care within defined parameters. They will have training to carry out specific tasks and elements of care.
Assistant practitioners (sometime known as associate practitioners) have skills and experience in a particular area of clinical practice such as critical care. Although they are not registered healthcare professionals, they develop a high level of knowledge and skill through their experience and additional training and have previously worked in the NHS, often in a clinical role. Assistant Practitioners can become members of the professional association for their speciality, for example Royal College of Nursing, Chartered Society of Physiotherapy. Their level of training and experience means they may work alone, without supervision carrying out agreed procedures, referring to a registered professional for guidance when necessary.
Administrative staff are key team members who undertake non-clinical roles that mean the clinical staff can concentrate on providing direct patient care. Their role may be as a data clerk, ward clerk, unit receptionist or housekeeper.