Care of the deteriorating patient

Sign up to Safety LogoAim: Improve patient outcomes and reduce the incidence of deterioration in the acutely ill through early identification and timely treatment. By March 2017 we will reduce avoidable harm caused by failure to rescue or failure to recognise the deteriorating patient by 50% from our 2015 baseline of ‘Failure to Rescue’ 2222 calls.

Patients who are admitted to hospital believe that they are entering a place of safety, where they and their families and carers have a right to believe that they will receive the best possible care (NICE 50).

Should their condition deteriorate, we should be able to provide prompt and effective treatment provided by staff with the right competencies.

Recent publications have highlighted the importance of effective early management of this cohort of patients in ensuring better outcomes (NCEPOD 2007). This reinforces previous literature identifying the need to embed Track and Trigger systems based on aggregated scoring systems ie Early Warning Scoring (EWS) inextricably linked to a Graded Response Strategy (GRS).

The aging population and increasing complexity of medical and surgical intervention combined with shorter lengths of stay can pose increasing risks of patients becoming acutely unwell and may require admission to critical care.

hrough the Critical Care Outreach service in collaboration with other key personnel, the Trust has developed a robust strategy for identifying the deteriorating patient and as part of the GRS, in July 2011 launched the unique ‘600 baton bleep’ carried 24/7 providing rapid access to support for the deteriorating patient.

Through annual audit, system analysis allows us to identify compliance failure and has also identified other areas for scrutiny, namely notes review of all 2222 cardiac arrest calls, these being the ultimate manifestation of ‘failure to rescue’ episodes.

We have been able to demonstrate a reduction in calls and low numbers of failure to rescue events. Provision of education and training through R&A allows for reinforcement of lessons learned via RCA and audit trails.

This work is monitored via the Care of the Acutely Ill Patient Committee

View the Driver Diagram and Table