ICU’s initiative recognised at the WA Health Excellence Awards

Photograph of Doctor treating patient
October 19, 2017

Armadale Health Service’s (AHS) Rapid Response to Clinical Deterioration (RRCD) initiative has been recognised as a finalist in Category six: Innovative solutions for improving safety and quality in this year’s WA Health Excellence Awards.

The initiative was developed in 2011 when it was identified there were opportunities to improve the hospital’s existing systems used to recognise and respond to patient deterioration.

This resulted in a new three-pronged approach that incorporated:

  1. Recognition
    Introduction of an early warning system using service-specific multi-parameter charts.
  2. Response
    Structured escalation protocols established and an ICU-led Medical Emergency Team (MET) along with a multidisciplinary education program rolled out for all clinical staff.
  3. Critical care advice and support
    A Critical Care Outreach Team was created which provides the wards with multidisciplinary advice, post ICU follow-up and support in the management of patients with acute illnesses.

ICU Head of Department Dr David Blythe said The initiative has improved the communication between ICU and other departments, such as general medicine and surgery.

“One of the aims was to change the thinking that the MET team was only to be called when the patient had stopped breathing or had gone into cardiac arrest,” David said.

“We now prefer patient’s receive senior medical attention much earlier.”

Since the initiative has been implemented, the number of cardiac arrests has dropped by 85 per cent while MET calls have more than tripled. This indicates that better patient outcomes were achieved when calls for help were made earlier.

A significant positive change in hospital culture was also achieved. Ward staff better understand and recognise deterioration, they are more confident to manage deteriorating patients, and are more willing to initiate a MET call without fear of being criticised.

“The initiative has also improved the communication between ICU and other departments, such as general medicine and surgery,” Dr Blythe said.

“The staff on the ward feel safer knowing that we are there as a backup, should they require it.”

As part of the RRCD initiative, the Recognising and Responding to Adult Inpatient Deterioration (RRAID) education program was successfully implemented.

This course provides staff with structured learning in the management of patient deterioration.

Planning is now in progress to ensure the sustainability of the RRCD initiative. This includes:

  • increasing the capability of current staff for data collection to enable ongoing audits and education
  • exploring further education opportunities through the use of the hospital’s resuscitation simulation suite
  • broader implementation of the RRAID program which is currently being revised for potential use at Royal Perth Hospital.

Winners will be announced at the WA Health Excellence Awards dinner on Wednesday 8 November 2017. We wish ICU all the very best.