Improving how we detect patients of concern

Date: 10 November 2016

Catherine Plowright Ralphy Hayes and Emma Woodhams
Members of the Deteriorating Patient Programme team

As part of the Trust Recovery Plan, last month saw the introduction of the Deteriorating Patient Programme to help us better detect and treat patients of concern while they are in hospital. Nurses and doctors here at the Trust are collaborating to improve ways of identifying these patients early so that we can give them more effective clinical care within a set time-frame.

The programme also seeks to understand some of the underlying factors that may be causing this to happen. Getting a better understanding of this group of patients will help us to improve how we care and treat them while they are here at the Trust.

Under the Deteriorating Patient programme, we are developing an Acute Response Team to be able to deliver timely care to patients 24 hours a day, seven days a week. This will allow a more co-ordinated approach to care and response by the right person with the right skills at the right time.

The programme, under the oversight of Medical Director Diana Hamilton-Fairley and Director of Nursing Karen Rule, supported by Consultant Anaesthetist Dr Priya Krishnan and Assistant Director of Nursing Alison Hendron, comprises three improvement work streams:

Recognition
Recognition of the acutely ill patient through focussed training, promoting electronic solutions for recognising and escalating care. We have introduced safety briefs and board rounds on the wards by senior nurses to support hospital staff at night.

Response
We are expanding the number of nurses on duty to allow us to respond effectively to all patients earlier and escalate care to the most appropriate doctor. We are also developing professional clinical standards for identifying and responding to patients whose condition worsens.

Reporting
To improve staff engagement with the work we carry out as a programme, we are developing an Acute Deterioration Dashboard. The dashboard will allow us to track specific monthly quality metrics that relate to patients of concern such as compliance with sepsis bundles, and delays in transfer to the intensive care unit. This will help patients and staff understand the current issues facing deteriorating patients, and improve our care of acutely ill patients at the Trust.

‘For the patient whose condition is getting worse, this approach will allow a highly skilled team of nurses and doctors to respond to them more quickly, with access to senior medical support,’ explains Catherine Plowright, Consultant Nurse for Critical Care and one of the programme’s clinical champions. ‘The result will be that the patient will then get the care they need quickly and safely.’

  • Summary:

    As part of the Trust Recovery Plan, the introduction of the Deteriorating Patients Programme will help us better detect and treat patients of concern while they are in hospital.