Recognising and responding to deteriorating patients: what difference do national standards make?

Abstract

Background The Australian Commission on Safety and Quality in Health Care released a set of national standards which became a mandatory part of accreditation in 2013. Standard 9 focuses on the identification and treatment of deteriorating patients. The objective of the study was to identify changes in the characteristics and perceptions of rapid response systems (RRS) since the implementation of Standard 9. Methods Cross-sectional study of Australian hospitals. Baseline data was obtained from a pre-implementation survey in 2010 (220 hospitals). A follow-up survey was distributed in 2015 to staff involved in implementing Standard 9 in public and private hospitals (276 responses) across Australia. Results Since 2010, the proportion of hospitals with formal RRS had increased from 66 to 85. Only 7% of sites had dedicated funding to operate the RRS. 83% of respondents reported that Standard 9 had improved the recognition of, and response to, deteriorating patients in their health service, with 51% believing it had improved awareness at the executive level and 50% believing it had changed hospital culture. Conclusions Implementing a national safety and quality standard for deteriorating patients can change processes to deliver safer care, while raising the profile of safety issues. Despite limited dedicated funding and staffing, respondents reported that Standard 9 had a positive impact on the care for deteriorating patients in their hospitals. Electronic supplementary material The online version of this article (10.1186/s12913-019-4339-z) contains supplementary material, which is available to authorized users.

In-hospital outcomes among older medical inpatients admitted to aged care wards after activation of a 2-tier rapid response system

“…The 2-tier RRS is not a universal system, and the composition of RRTs, and criteria for review, vary between settings and papers [ 9 , 10 ], and are likely ‘influenced by available expertise, patient case-mix and resources in each hospital’ [ 14 ]. While the need for RRS has been embraced in Australia and in other jurisdictions [ 11 , 34 ], the make-up of these has not been standardised even at a national level [ 35 ].…”

Expectation and perception of nursing students in caring for patient with deteriorating: A descriptive qualitative study

“…Expectations and perceptions play a crucial role in improving health outcomes, patient compliance, and clinical results (Ardey & Ardey, 2015), although they might be misconstrued by healthcare workers due to the complexity of patient conditions. It's important to note that the findings are not generalizable, as they are limited to a single population from a local university in Kuantan.…”

“…Nursing students and recently graduated nurses are likely to be required to care for patients with numerous severe comorbidities, as many hospital patients have high acuities and are at a heightened risk of experiencing clinical deterioration during their stay (Anstey, 2019). Educating undergraduate nursing students to become proficient and safe practitioners to support our existing healthcare systems poses significant challenges.…”