Recognising early deteriorating signs a project at kapooka health centre pocius

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Recognising early deteriorating signs a project at kapooka health centre pocius

  1. 1. 1 Recognition of Early Deteriorating Signs (REDS) A project conducted OCT 09 to APRIL 10 at Kapooka Health Centre JOINT HEALTH COMMAND
  2. 2. 2 Presentation Objectives • Background • Demographics of project • Project justification • Project implementation • Initial findings • Monitoring of project • Outcomes of trial JOINT HEALTH COMMAND
  3. 3. 3 Background • National push to recognise the deteriorating patient • To comply with national standards • Develop a suitable trial chart for ADF JOINT HEALTH COMMAND
  4. 4. 4 Demographics of Project • Project implemented at Kapooka Health Centre – 50 bed capacity, Level 2 facility (Wagga Wagga NSW) • ARTC 500 -1500 recruits in training: 700 ADF staff • 17 – 60 years of age (predominately male) • Contracted health staff • Hospital separations – approx 1200 per annum JOINT HEALTH COMMAND
  5. 5. 5 Project Justification • Incident occurred • Quality improvement activity initiated • Approval from SHO JOINT HEALTH COMMAND
  6. 6. 6 Project Implementation • Researched information on deteriorating patient • Trial obs chart REDS developed, MEWS scoring system utilised, Traffic Light system developed • Education of health care staff • 6 month trial • Audits - Pre-audit of PM 013, Audits of REDS chart compliance JOINT HEALTH COMMAND
  7. 7. 7 Go to handout sheet 1 Current Defence observation chart PM 013 JOINT HEALTH COMMAND
  8. 8. 8
  9. 9. 9 Initial Findings • Many variations of charts available within Australia • Majority of charts for acute care patients • Most escalation plans require 24 hr on-site medical cover • Most require MO notification of a single vital sign reaching a particular trigger point • Need to develop a Defence specific chart JOINT HEALTH COMMAND
  10. 10. 10 Our REDS chart • Based on the ACT Health Compass program • System of scoring individual vital signs to achieve overall score ( MEWS ) • MEWS score linked to Traffic Lights escalation plan (designed to meet ADF requirements) • All link together to provide overall picture of deterioration JOINT HEALTH COMMAND
  11. 11. 11 Monitoring of Project • Ongoing education & support for staff to ensure sustainability • Auditing to maintain compliance • Listen to user related difficulties • Chart adapted several times to improve usability • Staff survey at trial completion JOINT HEALTH COMMAND
  12. 12. 12 Go to handout sheet 2 Final version of REDS observation chart JOINT HEALTH COMMAND
  13. 13. 13
  14. 14. 14 Outcomes of Trial • Audits demonstrate improved compliance • Staff survey indicate preference to continue using chart • Greater awareness of early signs of deterioration, traffic lights system prompts earlier MO review and intervention • MEWS scores demonstrates when patients require to transfer to civilian facilities JOINT HEALTH COMMAND
  15. 15. 15 JOINT HEALTH COMMAND
  16. 16. STAFF SURVEY RESULTS (end of project) 0 10 20 30 40 50 60 70 80 90 100 Poor opion of REDs chart at beginning of project Poor opion of REDs chart at end of project Rate of satisfaction with chart Understanding of MEWs RED chart assists with patient assessments
  17. 17. JOINT HEALTH COMMAND
  18. 18. JOINT HEALTH COMMAND Conclusion The trial chart was effective and meets national standards for recognising and responding to clinical deterioration in acute health care Improved patient outcomes and enabled nursing and medical staff in our facility to provide a safer level of care, and earlier recognition of the deteriorating patient.
  19. 19. Where to from here? Further trials are needed across the AHS, before any potential introduction across ADF Education must be intensive and ongoing inclusive of all nursing & medical staff Continued organizational support of JOINT HEALTH COMMAND
  20. 20. JOINT HEALTH COMMAND THANKYOU

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