We’re already home to one of the leading critical care services in the UK, serving six million people in the South East, but we’re planning to do things even better. The new King’s Critical Care Centre is key to our vision of establishing a new global standard in the care of critically ill patients that's based around their physical and psychological needs.
Under one roof and in an environment designed to promote healing, we'll treat the full range of life-threatening conditions needing life support. Whether it’s a cancer complication, a brain injury, a heart attack or an organ failure, we’ll be providing care that not only saves lives but also gives people back their lives. The support of companies through partnerships and sponsorships will be vital to helping us to raise the funds we need to realise our vision for the future of critical care.
Critical care: now
Although we primarily treat patients’ physical condition, their stay in critical care can have long-term effects on their cognitive, psychological and emotional state, too.
Nearly all suffer from transient mental illness, something that can make a big difference to the success of their treatment and long-term rehabilitation. This is caused not only by their injury or illness but also by spending weeks in the intensely clinical environment of the conventional critical care unit. They can feel isolated and even intimidated by the wall of technical equipment, as well as by the noise and activity around them. As a result, up to 80% of our patients suffer delirium, which can increase both the short-term and the six-month risk of death.
Although we know that patients benefit hugely from wider holistic care, our staff often spend much of their time recording and replicating data rather than having one-to-one contact with the people they're treating.
Relatives and friends are also part of the equation. They can struggle to get the information and support they need at a time when they may be in a state of shock and finding it hard to cope with the serious physical and mental changes they see in their loved one.
" We already have the best survival rate of any critical care service in the UK. But we want more than survival: we want more time to spent with our patients, in a bright and airy space, and to help them to recover better."
King's Critical Care consultant
Critical care: future
When King’s Critical Care Centre opens it will enable us to do things that are not possible anywhere else in the world. It will allow us to develop a new way of caring in a new environment that gives staff time to provide the enhanced support that our patients need to survive, to recover and to get back their lives.
We’ll be making fundamental changes to the design of patients’ surroundings, to how our staff provide care and to how we support relatives and friends.
And once we’ve developed this new model of care, we want it to influence intensive care treatment around the world, with the focus firmly on what’s most important for each individual patient.
Healing by design
Research has shown that environmental factors can cut the incidence and duration of delirium by helping patients to feel safe and supported. So the design of King’s Critical Care Centre aims to reduce noise pollution and make their surroundings more familiar, by adding pictures, music and more homely furnishings.
All of their rooms will have windows with a view, and will make extensive use of glass interior walls, so patients can enjoy natural light and a normal day-night variation.
To help overcome feelings of isolation and so speed up recovery, they will have access to interactive entertainment and communications technology via a large-format high-definition bedside touchscreen. This will mean they can stay connected to and interact with the outside world from their hospital bed as well as keep in touch with their family and friends.
Our plans don't only cover the inside of King's Critical Care Centre: to improve patients' recovery we want them to have access to the outside as well. Usually, they can go outside only near the end of their stay on critical care, but to enable them to spend time in the fresh air sooner, we’re planning to build the world's first outdoor critical care unit set within a rooftop garden.
The unit will make innovative use of outdoor power points, medical gases and monitoring systems to provide the support patients need, while the garden will be specially designed to remind them of what everyday life is like, so helping to orientate them, reduce the risk of delirium and shorten their recovery period.
We've had initial discussions about our plans with Nigel Dunnett, designer of the Olympic Park Gardens and prolific Chelsea Garden Flower Show exhibitor. Nigel is Professor of Planting Design, Urban Horticulture and Vegetation Technology at The University of Sheffield, so we also hope to collaborate with him on research into the impact of environmental factors on health.
Ensuring time to care
We want to ensure our staff can spend more of their valuable time with patients, providing stimulating interventions such as early mobilisation, closer and constant verbal communication, and reorientation with the outside world.
So we're using the latest medical and communications technology to speed up diagnoses, to make keeping and sharing records quicker and easier, and to enable our team to consult with fellow clinicians worldwide in real time, using apps such as Skype. A new-generation clinical information system (CIS), developed with Philips, will provide automatic updates of vital signs, minimising redundancy and duplication, and playing a central role in helping to make King's Critical Care Centre completely paperless.
"Having IT equipment at the patient's bedside doing a lot of the data work for us means we can spend more time - more quality time - with our patients. That's what it's all about."
King's Critical Care staff nurse
Supporting relatives and friends
Patients’ relatives and friends often struggle to cope with what's happening to their loved ones. They will benefit from our plans, too.
We'll be making sure that our team has more time to spend with relatives, explaining face to face what’s happening and offering reassurance and support. And we'll provide resources which enable families to find out more about their loved one’s condition, the treatment they’re receiving and how to plan for their rehabilitation and eventual return home.
Relatives will be able to use the patient’s bedside touchscreen to create a profile that includes person's likes, dislikes, hobbies and personal photos. This will not only help humanise the unconscious patient for all clinical staff but it will also give the patient much-needed reminders of their everyday life once they are awake.
Leading on bench to bedside research
Research is at the heart of our plans for King’s Critical Care Centre. We will study the entire patient journey, from admission to discharge and reintegration, to monitor the effects of our new facilities and approach.
For example, the rooftop garden presents a brand new area of research. We will test the feasibility of delivering level III intensive care outside. We will also be able to evaluate the optimal design for delivering critical care in a constrained urban NHS setting, and to collect data for the first time on accelerated rehabilitation and improved psychological recoveries.
In addition, we will research the benefits to patients, relatives and staff of an enhanced internal environment, including digital and physical art; sound and light improvements; and more dynamic accessible informatics. We aim to demonstrate the positive effects of these innovations on both physical and psychological recovery, as well as on end-of-life care where this is needed.
Our aim is bold: we want to test whether simple yet high-quality enhancements to the environment and informatics improve patient outcomes, with the potential to work better than novel treatments or technological interventions.
Promoting embedded education
Critical care is becoming increasingly important in the training of all specialties and healthcare professionals, including undergraduates. A key strength of the design of King's Critical Care Centre is that it will enable us to deliver world-class embedded education.
We’re creating two central seminar rooms equipped with simulation equipment . The rooms will allow digital links with King's Health Partners (KHP) organisations, including direct access to clinicians, bedside physiology and patients. This will give healthcare professionals extraordinary training opportunities in the world’s most case-mix-rich critical care centre.