Recognition of the deteriorating patient.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Clinical Medicine

Background:

• Buckinghamshire NHS Trust identified higher mortality rates compared to the England average.
• A quality improvement project was initiated to address clinical responses to deteriorating patients.

Purpose of the Study:

• To evaluate and improve the clinical response to deteriorating patients using the National Early Warning Score (NEWS).
• To assess the effectiveness of interventions in improving patient care and reducing mortality.

Main Methods:

• Utilized the National Early Warning Score (NEWS) for patient observations and escalation.
• Collected data on clinical responses for episodes with NEWS score 5 or above.
• Implemented interventions including education, increased medical staff, grand rounds, and outreach over 6 months.

Main Results:

• Initial assessment showed only 57% of high NEWS cases were escalated, with 50% reviewed by a doctor and 33% within an hour.
• Post-intervention, 87% of cases were reviewed by a doctor of appropriate seniority.
• Indicated successful interventions for improving clinical response to deteriorating patients.

Conclusions:

• Quality improvement initiatives can significantly enhance clinical responses to deteriorating patients.
• Improved response rates suggest a positive impact on patient care and safety.
• The project established a cycle for continuous quality improvement with new junior doctors.