High dependency unit
A high dependency unit is an area in a hospital, usually located close to the intensive care unit, where patients can be cared for more extensively than on a normal ward, but not to the point of intensive care. It is appropriate for patients who have had major surgery and for those with single-organ failure. Many of these units were set up in the 1990s when hospitals found that a proportion of patients was requiring a level of care that could not be delivered in a normal ward setting. This is thought to be associated with a reduction in mortality. Patients may be admitted to an HDU bed because they are at risk of requiring intensive care admission, or as a step-down between intensive care and ward-based care.
In 2000 the UK Department of Health issued the report "Comprehensive Critical Care", which set out the number of high dependency ("level 2") beds a hospital should have to deliver care appropriately. By this time, two thirds of UK hospitals had beds identified as "high dependency". The report defines level 2 care as "more detailed observations or intervention including support for a single failing organ system or postoperative care and those 'stepping down' from higher levels of care".
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- Day V, Adam S, Asbridge J, et al. (2000). Comprehensive critical care: review of adult critical care services (PDF). London: Department of Health.