[The complexity of the implementation of an observation and tracking chart for critical illness]

Critically ill patients on wards are identified too late. At Aarhus University Hospital, Aarhus Sygehus, staff did not act appropriate to unacceptable values. The solution presented is development and implementation of a Track and Trigger System: a standardised observation chart encompassing frequency of vital signs measurement combined with a decision algorithm based on scores dictating skill level of decision-making. Educational programmes and specialist function for ward staff as well as action cards containing identification, situation, background, analysis, and advice and an airway, breathing, circulation, disability and environment approach to support clinical decision-making are introduced.