Critical Care in Critical Access Hospitals

Abstract

What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care. For hospitals located near the required minimum of 35 miles from a tertiary care center, management of critically ill patients may be a matter of stabilization and transfer. Critical access hospitals in more rural areas are often much farther from tertiary care; some of these hospitals are situated within frontier areas of the United States. This article describes the development of critical access hospitals, provision of care and services, challenges to critical care in critical access hospitals, and suggestions to address gaps in research and collaborative care. (Critical Care Nurse. 2015;35[5]:62-67)

What Are Ethical Implications of Regionalization of Trauma Care?

“…More widely distributed critical access hospitals provide 24-hour emergency care to rural communities, are at least 35 miles from other hospitals, and require patient transfer agreements with other acute care hospitals [5]. Although the treatments they deliver range from stabilization of life-threatening injuries to management of chronic illnesses, their resources are limited.…”

“…Although the treatments they deliver range from stabilization of life-threatening injuries to management of chronic illnesses, their resources are limited. Facilities designated as critical access hospitals must have no more than 25 beds [5]. Critical access hospitals are responsible for diagnosing and treating a broad range of presentations and must triage appropriate cases to higher levels of care.…”

The Effect of a Three-Level Remote Alliance on Critical Care in Grassroot Areas: A Multi-Center, Retrospective Study

“…Rural health care institutions demand that medical staffs perform as skilled generalists because they often provide treatment to patients with a variety of diseases during the same shift. 1 , 2 Critical care physicians working in rural or distant locations may not have the chance to polish these more complicated skills or exercise them as often given that rural patients can be just as complex as those presenting in more metropolitan health care settings. 2 All medical staffs working in rural or distant locations must care for the severely sick when the circumstance requires it since there is sometimes a limited number of critical care units.…”

“… 1 , 2 Critical care physicians working in rural or distant locations may not have the chance to polish these more complicated skills or exercise them as often given that rural patients can be just as complex as those presenting in more metropolitan health care settings. 2 All medical staffs working in rural or distant locations must care for the severely sick when the circumstance requires it since there is sometimes a limited number of critical care units. The regional development was uneven, with some remote and poor areas still utilising archaic medical technology, particularly for critically ill patients.…”