Action 8.08

Provide mechanisms to escalate care and call for emergency assistance, and ensure that these are consistent and effective. Multiple mechanisms may be necessary in escalation systems to allow different responses to varying levels or types of deterioration. These mechanisms may include:

• Paging systems
• Dedicated mobile, on-call and emergency telephone numbers
• Electronic alerting systems
• Bedside or centralised alarms.

Consider the following issues when deciding on the mechanisms to use:

• Avoid changes in the system at different times of the day and on different days of the week
• Develop processes for responders to hand over shared equipment, such as pagers or mobile phones, between shifts
• Provide backup systems in the event of equipment failure
• Develop processes for maintaining equipment
• Provide training about how to use the mechanisms for escalating care, including for new, casual, locum and agency members of the workforce.

Provide mechanisms to escalate care and call for emergency assistance, and ensure that these are consistent and effective. Multiple mechanisms may be necessary in escalation systems to allow different responses to varying levels or types of deterioration. These mechanisms may include:

• Paging systems
• Dedicated mobile, on-call and emergency telephone numbers
• Bedside or centralised alarms.

Consider the following issues when deciding on the mechanisms to use:

• Avoid changes in the system at different times of the day and on different days of the week
• Develop processes for responders to hand over shared equipment, such as pagers and mobile phones, between shifts
• Provide backup systems in the event of equipment failure
• Develop processes for maintaining equipment
• Provide training about how to use the mechanisms for escalating care, including for new, casual, locum and agency members of the workforce.

Examples of evidence

Select only examples currently in use:

• Policy documents about escalating care and calling for emergency assistance
• Audit results of equipment functionality and maintenance, including paging systems, electronic alerting systems, alarms and dedicated mobile phones
• Training documents about mechanisms for escalating care and calling for emergency assistance
• Audit results of compliance with the mechanisms for escalating care and calling for emergency assistance
• Evidence of investigations into failures of the mechanisms for escalation and emergency assistance calls, and associated quality improvement projects.

MPSs and small hospitals should provide the workforce with mechanisms to escalate care and call for emergency assistance, and ensure that these are consistent and effective. Multiple mechanisms may be necessary in escalation systems to allow different responses to varying levels or types of deterioration. These mechanisms may include:

• Paging systems
• Dedicated mobile, on-call and emergency telephone numbers
• Electronic alerting systems
• Bedside or centralised alarms.

Consider the following issues when deciding on the mechanisms to use:

• Avoid changes in the system at different times of the day and on different days of the week
• Develop processes for responders to hand over shared equipment, such as pagers or mobile phones, between shifts
• Provide backup systems in the event of equipment failure
• Develop processes for maintaining equipment
• Provide training about how to use the mechanisms for escalating care, including for new, casual, locum and agency members of the workforce.

In remote small hospitals, it may be helpful to develop processes for obtaining emergency advice from specialist providers – such as emergency or psychiatric services, or intensive care clinicians – online or using video link.