Patient activated rapid response – the ‘999’ for patients admitted to hospital

Author:

Ngoya Ntumba Merveille1,Edwards Eirian2,Haegdorens Filip1,Walsh Peter3,Subbe Christian P4

Affiliation:

1. Nursing and Midwifery Sciences, Antwerp University, Antwerp, Belgium

2. Critical Care Outreach, Ysbyty Gwynedd, Bangor, UK

3. AvMA, South Croydon, UK

4. School of Medical Sciences, Bangor University, Bangor, UK

Abstract

Background Patient activated rapid response (PARR) services allow patients and family members to escalate care in hospital without agreement by their primary care team. Methods This paper explores the evidence base for PARR and examines the experience of a sample of patients to identify barriers and opportunities for PARR. These are then used to develop a framework for the measurement of PARR that can be applied to quantify clinical impact and develop new research. Results The observed number of escalation events by patients and family members is small. Interviews with patients suggested concerns of patients in undermining staff and difficulties to recall the mechanics of escalation during periods of acute illness. The Quadruple aim could be used as a framework to quantify impact: In a functioning PARR system earlier recognition of illness can be facilitated by patients and this should lead to 1. a reduction in cardiac arrests and preventable deaths, 2. timely admission to critical care with shorter (cheaper) length of stay, 3. better patient engagement and Patient Reported Experience measures and 4. flatter hierarchies with higher staff satisfaction. Conclusion PARR services are in the early stages of implementation. We present a framework to measure improvement of services and research.

Publisher

SAGE Publications

Subject

Health Policy,Health (social science),Leadership and Management

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4. Ockenden D. Emerging findings and recommendations from the independent review of maternity services at The Shrewsbury and Telford Hospital NHS Trust; Our First Report following 250 Clinical Reviews, 2020.

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