Ensuring that patients at risk of critical illness or a serious adverse event receive appropriate and timely care is a key safety and quality challenge. All patients at risk should receive comprehensive care irrespective of their location in the hospital or the time of day. Even though a range of systems have been introduced locally to better manage patients at risk, this area needs to remain a priority while patients continue to experience preventable adverse events because their deterioration is not identified or managed properly.
The Australian Commission on Safety and Quality in Health Care has commenced a new program of work regarding patients at risk of critical illness and serious adverse events. There are three initiatives in this program that support work at a national level:
Initiative 1: development of a standardised and validated observation chart that supports recognition of deterioration and prompts action (PDF 141 KB)
Initiative 2: development of minimum standards for rapid response systems, looking particularly at the needs of rural and remote areas (PDF 138 KB)
Initiative 3: examination of the way which concepts arising from the work on patients at risk apply in primary care (PDF 141 KB)
A background leaflet (PDF 139 KB) summarising the current state of work in this area is also available for download.
National Innovation Workshop: Development and use of observation charts to identify patients at risk
The Commission held a National Innovation Workshop on 14 November 2008, as part of the first initiative to develop an evidence-based observation chart. The workshop was designed to provide information about the main activities in Australia to improve observation charts and the identification of deterioration.
The workshop was well attended by over 100 health professionals interested in the area or related activities in managing patients at risk. The information presented at the workshop, and the discussions of participants will inform the development of specific research questions to be addressed as part of further work to gather evidence about the use of observation charts to identify deterioration.
Workshop presentations, a summary of the issues raised and some information papers are now available for download:
Workshop Summary Notes (PDF 59 KB)
Presentations
Dr Nicola Dunbar – Development and use of observation charts to identify patients at risk (PDF 590 KB)
Associate Professor Marcus Watson - Design and Evaluation: Getting the Human Factors Right in Healthcare (PDF 191 KB)
Professor Clifford Hughes - Recognition and Management of the Deteriorating Patient (PDF 333 KB)
Dr Imogen Mitchell - Patients at Risk of Critical Illness and the Observation Chart (PDF 232 KB)
Ms Linda Peel - Early Recognition of the Deteriorating Patient (PDF 2201 KB)
Dr Jill Kealley - Observation Charts as Point of Care Clinical Resources (PDF 3019 KB)
Dr Kevin McCaffery - Improving the Safety of Children Admitted to Hospital: Use of a Human Factors Approach to Redesign (PDF 4641 KB)
Ms Anna Green - Victorian Travelling Fellowship Program (PDF 869 KB)
Papers
Harrison GA, Jacques TC, Kilborn G, McLaws M. The prevalence of recordings of the signs of critical conditions and emergency responses in hospital wards – the SOCCER study. Resuscitation. 2005;65:149-157. (PDF 97 KB)
Jacques TC, Harrison GA, McLaws M, Kilborn G. Signs of critical conditions and emergency responses (SOCCER): A model for predicting adverse events in the inpatient setting. Resuscitation. 2006;69(2):175-83. (PDF 117 KB)
Page M, Blaber I, Snowden P. Implementing a modified early warning system for critically ill patients in an acute private hospital. The World of Critical Care Nursing. 2008;6(3):57-64. (PDF 790 KB)
Paper prepared by the Lyell McEwin Hospital (LMH) Documentation Working Party regarding their documentation evaluation and review process. (PDF 91 KB)
Contact
Dr Nicola Dunbar, Program Manager
(02) 9263 3633
Email: mail@safetyandquality.gov.au
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