SPECIAL SESSION: Partnering With Clinicians to Improve Recognition and Response to Patient Clinical Deterioration

Description/Overview: Failure by clinicians to recognise and respond to clinical deterioration contributes to adverse events (AEs) for patients. AEs are often preventable, life-threatening occurrences that can result in death, prolonged hospitalisation, disability or incapacity, in-hospital cardiac arrest and/or admission to intensive care. Rapid response teams, led by physicians and/or nurses have been implemented throughout many hospitals to support clinicians manage patient clinical deterioration. However evidence suggests these systems are often not activated or used effectively at the point-of-care. AEs have significant social and financial ramifications for patients and their loved ones. AEs also represent a major economic burden for individual health services and the wider community. More evidence about what helps and hinders clinicians to recognise and respond to patient clinical deterioration is needed to understand how rapid response systems can be better utilised and AEs avoided. There are no quick fixes to changing professional practice. However recognition of context and consultation with those professionals who work within it, are essential for effective and sustained change. In this study we have used knowledge translation processes to explore the barriers and facilitators to effective management of patient clinical deterioration. The primary aim of this pilot study is to determine whether timely recognition and response to patient clinical deterioration can be improved through the implementation of a local, tailored, multifaceted, behaviour-change intervention developed in partnership with clinicians. A pre-post intervention design will explore the effectiveness of a behaviour-change intervention to improve the timely care of patients experiencing clinical deterioration. A knowledge translation framework will guide this project in three phases. In Phase 1 we will: survey participating clinicians in the study site to assess their readiness to implement change and collect demographic information; conduct one-on-one and group interviews with participating clinicians in the multidisciplinary team as well as health consumer and family member representatives, to explore behaviours that help or hinder change within the specific context and; undertake regular prospective audits of patient charts and collection of patient demographics. In Phase 2 we will: use results from focus group and individual interviews to develop a multifaceted behaviour change intervention in partnership with clinicians to be implemented in the ward and; continue regular prospective chart audits and collection of patient demographics. In Phase 3 we will: repeat interviews with clinicians; continue regular prospective chart audits and collection of patient demographics and then use process evaluation and time series design and to evaluate the effectiveness of the intervention in relation to effective management of patient clinical deterioration. This presentation will provide an overview of the study, including the challenges and successes experienced along the way, as well as the findings to date.