Recognising and responding to deteriorating patients: what difference do national standards make?

Area of Science:

• Healthcare quality and safety
• Patient deterioration management
• Health services research

Background:

• The Australian Commission on Safety and Quality in Health Care mandated national standards in 2013, including Standard 9 for deteriorating patients.
• Standard 9 aimed to improve the identification and treatment of patients experiencing clinical deterioration.
• Rapid Response Systems (RRS) are critical for managing deteriorating patients.

Purpose of the Study:

• To assess changes in the characteristics and perceptions of Rapid Response Systems (RRS) following the implementation of Standard 9.
• To evaluate the impact of national standards on patient safety processes in Australian hospitals.

Main Methods:

• A cross-sectional study design was employed, utilizing surveys of Australian hospitals.
• Baseline data collected in 2010 from 220 hospitals prior to Standard 9 implementation.
• Follow-up survey in 2015 gathered responses from 276 staff involved in implementing Standard 9 across public and private hospitals.

Main Results:

• The proportion of hospitals with formal RRS increased from 66% in 2010 to 85% in 2015.
• Only 7% of hospitals reported dedicated funding for RRS operations.
• 83% of respondents believed Standard 9 improved recognition and response to deteriorating patients, with significant perceived improvements in executive awareness (51%) and hospital culture (50%).

Conclusions:

• Implementing national safety standards can enhance patient care processes and elevate the importance of safety issues.
• Standard 9 positively impacted the care of deteriorating patients, despite challenges with dedicated funding and staffing.
• National standards are effective in driving improvements in patient safety and hospital practices.