Recognising and responding to patient deterioration – a culture shift

This presentation was given at the Health Quality & Safety Commission's event, patient deterioration New Zealand: current state and future developments, held on 29–30 November 2018.

Taranaki DHB’s success in implementation of the National Recognition and Response system for deteriorating patients has been influenced by many factors aligning together. This involved redesigning the pathways of escalation and response including designing a whole new service – the ‘Patient at Risk nurse’, ongoing audits that were owned by the wards undertaking them and adapting many delivery systems of education to the needs identified in the audits.

A challenge to improving patient safety identified in literature is bridging the gap between steps to improvement identified by research experts and the current clinical context. This is where the culture shift toward recognition and response to deteriorating patients that happened throughout the organisation has been so crucial. Standout factors influencing the culture shift included the engagement in the project from stakeholders at the implementation and progress phases and simulated deteriorating patient scenarios that were inclusive and multidisciplinary.