All patients admitted to a critical care unitmust be included in a national clinical audit programme in which Levels of Care data are collected.
Level of Care classification must not be used in isolation to decide upon a patient’s staffing requirements.
The UK intensive care community should encourage and develop a validated methodology to review referralsto intensivecare and evaluate decisionmakingand subsequent outcomesrelating to intensivecare admission and refusal.
Units should develop a consistent approach to patient-centred decision making, evaluating burdens and benefitsof admission to intensivecare, and be able to demonstrate thisthrough the audit of pre-admission consultation, agreed ceilings oftherapy, and time-limited treatmenttrials.
Longer-termmortality should be collected on all patients admitted to critical care.
The UK intensive care community should encourage and develop validated measures of longerterm patient- and family-centred outcomes beyond mortality, including measures of functional ability,socioeconomic consequences, and carerburden.
Hospitals must have local policies in place for the identification, support and safeguarding of vulnerable adults.60
Critical care unitsmust holdmulti-professional clinical governance meetings, including analysisof mortality andmorbidity.
The unit must participate in a National Audit Programme forAdult Critical Care.
Critical care units must participate in a mortality review programme using appropriate methodology tomaximise learning and improvementsin care5,6 .
