Action 8.07

Use the actions about health literacy from the Partnering with Consumers Standard to guide the development of a system for patients, family members and carers to access help when they are concerned that a patient is acutely deteriorating. It is important that the system enables patients, carers and family members to access help independently of the team that is directly providing care for the person of concern.

Work with consumer advisors and clinicians to identify the criteria for escalating care, the mechanism for calling for help, and the response that will be provided. Examples of criteria for escalating care are:

• Concern about a patient who is getting worse, not doing as well as expected or not improving
• Concern that ‘something is not right’.¹

Ensure that the system can be activated easily and independently. Methods for activating the system might include calling an emergency number from internal facility telephones or from a mobile telephone, using an emergency call button, or using a designated phone number that is only for patient, carer and family escalation.

Provide written and verbal information about the system for patient, carer and family escalation on admission, and display details about when and how to use the system in public areas.

Depending on the mechanisms used for patients, carers and families to escalate care, it may be necessary to train non-clinical members of the workforce (such as ward clerks and switchboard operators) to ensure that calls are directed to the appropriate responder(s). Developing scripted questions can help non-clinical members of the workforce triage calls correctly.

Responders may need extra training to manage patient and family escalation calls. For example, skills in communication and conflict resolution may be needed to manage situations where communication between the patient, family or carer, and the team that is providing care has become problematic.

Several Australian states have established patient, carer and family member escalation systems, such as the New South Wales REACH program and Queensland’s Ryan’s Rule.

Develop a system for patients, carers and families to obtain access to help when they are concerned that a patient is acutely deteriorating.

Work with consumer advisors and clinicians to identify the criteria for escalating care, the mechanism for calling for help, and the response that will be provided. Examples of criteria for escalating care are:

• Concern about a patient in the service who is getting worse, not doing as well as expected or not improving
• Concern that ‘something is not right’.¹

Ensure that the system can be activated easily and independently. Methods for activating the system might include using an emergency call button, or using a designated phone number that is only for patient, carer and family escalation.

Provide written and verbal information about the system for patient, carer and family escalation on admission, and display details about when and how to use the system in public areas.

Depending on the mechanisms used for patients, carers and families to escalate care, it may be necessary to train non-clinical members of the workforce (such as reception workforce) to ensure that calls are directed to the appropriate responder(s). Developing scripted questions can help non-clinical members of the workforce triage calls correctly.

Several Australian states have established patient, carer and family member escalation systems, such as the New South Wales REACH program and Queensland’s Ryan’s Rule.

Examples of evidence

Select only examples currently in use:

• Observation of an escalation system that supports patients, carers and families to directly escalate care
• Consumer and carer resources that outline how they can directly escalate care
• Relevant documentation from committees with consumer advisors and clinicians in which the criteria for, mechanism of, and response to, direct patient, carer and family escalation of care were decided
• Evaluation of the effectiveness and usability of the patient, carer and family escalation protocol and associated quality improvement projects
• Training documents about the system for patients, carers and families to directly escalate care, including how the non-clinical workforce should forward calls for assistance.

MPSs or small hospitals that are part of a local health network or private hospital group could base the patient and family escalation protocol on one that was developed by the Local Hospital Network, state or territory health department or nearby larger hospital. However, it will need to be adapted to reflect the organisation’s available services and resources.

Small hospitals that are not part of a local health network or private hospital group should use the actions about health literacy from the Partnering with Consumers Standard to guide the development of a system for patients, carers and family members to seek help when they are concerned that a patient is acutely deteriorating.

Work with consumer advisors and clinicians to identify the criteria for escalating care, the mechanism for calling for help, and the response that will be provided. Examples of criteria for escalating care are:

• Concern about a patient in the service who is getting worse, not doing as well as expected or not improving
• Concern that ‘something is not right’.¹

Ensure that the system can be activated easily and independently. Methods for activating the system might include calling an emergency number from internal facility telephones or from a mobile telephone, using an emergency call button, or using a designated phone number that is only for patient, carer and family escalation.

Provide written and verbal information about the system for patient, carer and family escalation on admission, and display details about when and how to use the system in public areas.

Depending on the mechanisms used for patients, carers and families to escalate care, it may be necessary to train non-clinical members of the workforce (such as ward clerks and switchboard operators) to ensure that calls are directed to the appropriate responder(s). Developing scripted questions can help non-clinical members of the workforce triage calls correctly.

Responders may need extra training to manage patient and family escalation calls. For example, skills in communication and conflict resolution may be needed to manage situations in which communication between the patient, carer or family and the team that is providing care has become problematic.

Several Australian states have established patient, carer and family member escalation systems, such as the New South Wales REACH program and Queensland’s Ryan’s Rule.