Department of Health & Human Services

2014 Evidence-based care project – Emergency Care Clinical Network

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. © State of Victoria, February, 2015. Except where otherwise indicated, the images in this poster show models and illustrative settings only, and do not necessarily depict actual services, facilities or recipients of services. This publication may contain images of deceased Aboriginal and Torres Strait Islander peoples. Printed by Digital House, Port Melbourne (1412013)

Project lead: Sue Anderton

Project team: Cat Gervis, Laura Conn, Julie Dawson, Carole Holman and Emily Batt

In February 2014 the Emergency Care Clinical Network began its sixth round of evidence-based improvement projects in emergency departments. The aim of these projects is to enhance the use of evidence-based care, reduce unwarranted variation in clinical practice and improve consistency of care within emergency departments.

Why this project was important to our emergency department• To have a consistent approach to recognising deteriorating patients in the emergency department• To have a consistent response to deteriorating patients in the emergency department • To improve patient care• To address the National Safety and Quality Health Service Standard 9 Recognising and responding

to clinical deterioration in acute health care.

What we did• Consulted with clinical expert Professor Julie Considine • Two staff members attended an external training session on managing the deteriorating patient in

the emergency department • Developed and implemented clinical deterioration parameters within the department • Developed and implemented a medical emergency team (MET) response process• Established clinical champions • Developed posters and displayed them in the department • Improved medical emergency team documentation• Provided education to 43 staff members through 10 formal and informal education sessions.

Our results • The proportion of unstable patients where this was reported for action increased from 33 per cent

to 100 per cent• The proportion of patients where escalation pathways were followed was 100 per cent.

What we learnt about improving quality of care • Use of clinical experts’ knowledge stimulated robust staff discussion• Small adjustments to the existing informal clinical practice made a difference to practice • Constant updates by clinical champions and nurse unit mangers provided staff with information to

assist in changing practice • Providing clarity on the criteria to activate a response to deteriorating patients increased

staff confidence • The project lead not having adequate time and conflicting rosters impacted on engaging staff in the

improvement project• Allocating project team members’ roles and responsibilities early in the project enhanced the

project’s success.

Impact on patients, staff and the health system • Improved patients care in line with best practice • Increased staff confidence in managing deteriorating patient • Improved documentation and communication• A consistent approach to management of the deteriorating patients in the emergency department.

‘Fantastic we now have a process’ – staff member

Warrnambool Base Hospital Emergency Department

Recognition and response to the deteriorating patient

A2 Warrnambool (det Patient) ECCN storyboard poster V1.indd 1 16/02/2015 12:13 pm