Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

Comparison of policies for recognising and responding to clinical deterioration across five Victorian health services

Julie Considine , Anastasia Hutchinson , Helen Rawson , Alison Hutchinson , Tracey Bucknall , Trisha Dunning , Mari Botti , Maxine Duke , Maryann Street

Abstract

Objectives: To describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia. Methods: Guidance documents were obtained from five health services comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Thematic analysis of the content of the documents was conducted. Results: A total of 22 guidance documents and five graphic observation and response charts were reviewed. Variation was observed in terminology, content and recommendations between the health services. Almost all health services’ definitions of physiological observations fulfilled National Standards in terms of minimum parameters and frequency of assessment. All health services had three tier rapid response systems (RRS) in place at both acute and subacute care sites, consisting of activation criteria and an expected response. RRS activation criteria varied between sites, with all sites requiring modifications to RRS activation criteria to be made by medical staff. All sites had processes for patient and family escalation of care. Conclusions: Current guidance documents related to the frequency of observations and escalation of care omit nurses’ vital role in these processes. Inconsistencies between health services may lead to confusion in a mobile workforce and may reduce system dependability.

AH16265  Accepted 12 April 2017

© CSIRO 2017