This action states

The workforce uses the recognition and response systems to escalate care

Intent

Members of the workforce take prompt action to deal with acute deterioration.

Reflective question

How does the health service organisation ensure that the workforce knows how and when to use the recognition and response systems?

Key task

Escalate care when acute deterioration is recognised.

Strategies for improvement

Hospitals

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as ward clerks, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available.

Provide education and training for responders about expected professional behaviours, and effective teamwork and communication skills, to foster positive experiences for members of the workforce who escalate care.

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Day Procedure Services

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as reception workforce, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Examples of evidence

Select only examples currently in use:

  • Training documents about the roles, responsibilities and accountabilities of the workforce for using the recognition and response systems
  • Examples of communication prompts and tools used for escalating care
  • Audit results of the use of communication prompts and tools when escalating care
  • Quality improvement system that includes analysis of feedback on the workforce’s experiences of escalating care, to improve escalation protocols
  • Feedback provided on the recognition and response systems
  • Audit results of compliance with the use of recognition and response systems
  • Reports on investigations into incidents associated with failure to use recognition and response systems, and associated quality improvement projects.

MPS & Small Hospitals

MPSs and small hospitals should ensure that care is escalated when acute deterioration is recognised. If possible, use the resources developed by the Local Hospital Network, state or territory health department or nearby larger hospital to support the education of clinicians working in the small hospital or MPS.

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as ward clerks, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available

Provide education and training for responders about expected professional behaviours, and effective teamwork and communication skills, to foster positive experiences for members of the workforce who escalate care.

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Hospitals

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as ward clerks, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available.

Provide education and training for responders about expected professional behaviours, and effective teamwork and communication skills, to foster positive experiences for members of the workforce who escalate care.

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Day Procedure Services

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as reception workforce, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Examples of evidence

Select only examples currently in use:

  • Training documents about the roles, responsibilities and accountabilities of the workforce for using the recognition and response systems
  • Examples of communication prompts and tools used for escalating care
  • Audit results of the use of communication prompts and tools when escalating care
  • Quality improvement system that includes analysis of feedback on the workforce’s experiences of escalating care, to improve escalation protocols
  • Feedback provided on the recognition and response systems
  • Audit results of compliance with the use of recognition and response systems
  • Reports on investigations into incidents associated with failure to use recognition and response systems, and associated quality improvement projects.

MPS & Small Hospitals

MPSs and small hospitals should ensure that care is escalated when acute deterioration is recognised. If possible, use the resources developed by the Local Hospital Network, state or territory health department or nearby larger hospital to support the education of clinicians working in the small hospital or MPS.

Provide orientation, education and training for the workforce so that they understand their individual roles, responsibilities and accountabilities in the recognition and response systems. Use evaluation data to identify trends and potential training gaps, so that training and education can be effectively targeted.

Topics to cover in education for non-clinical members of the workforce (such as ward clerks, porters, cleaners and food service workers) include how to escalate care if they are concerned about a patient, and how to respond if a patient or family member asks for help.

Topics to cover in education for clinicians include:

  • Recognising parameters and thresholds that indicate acute deterioration, including criteria for patient pain and distress, and clinician concern or worry
  • Identifying escalation actions when thresholds indicating acute deterioration are reached
  • Processes and mechanisms for escalating care
  • The role and capacity of responders
  • What to do if the expected response is delayed or does not adequately deal with the problem
  • Communication skills such as graded assertiveness
  • Professional behaviours in successfully operating recognition and response systems.

Effective escalation of care relies on effective communication. A large amount of information may be communicated to many clinicians when acute deterioration occurs. There are risks to patient safety if information is not comprehensive, relevant and clearly understood.1 Develop standardised and structured communication prompts and tools for clinicians to use when escalating care, in accordance with the requirements of the Communicating for Safety Standard.

Resources to support handover of critical information are available

Provide education and training for responders about expected professional behaviours, and effective teamwork and communication skills, to foster positive experiences for members of the workforce who escalate care.

Provide processes for members of the workforce to routinely give feedback about their experiences of escalating care, and use this information to improve escalation protocols.

Reference

  1. Australian Commission on Safety and Quality in Health Care. OSSIE guide to clinical handover improvement. Sydney: ACSQHC; 2010.