The five-year national patient deterioration programme aims to reduce harm from failures to recognise or respond to acute physical deterioration for all adult inpatients by July 2021.

A maternity early warning system (MEWS) is also being implemented in all DHBs – find out more about MEWS.

  • About acute physical deterioration

    Acute physical deterioration can happen at any point during a patient’s admission to hospital.

    Many patients show signs and symptoms of physiological instability for some time before events such as cardiac arrest or unplanned admission to an intensive care unit (ICU). This means there are opportunities to intervene and prevent these events from occurring.

    A patient whose clinical condition is deteriorating needs timely recognition and appropriate expert care. In New Zealand, there is currently variation in:

    • vital sign charts and early warning scores
    • skills and knowledge of responders
    • availability of responders in hospitals
    • clinical governance and monitoring arrangements.

    Patients, families and whānau often recognise subtle signs of patient deterioration, even if vital signs are normal, but clinicians respond variably to these concerns. Acting on these concerns, discussing patients’ preferences for care early, and making shared decisions about the goals of an episode of care can improve communication, provide better experiences for all involved and ensure appropriate responses to acute deterioration.

  • Background

    In late 2014, Sapere Research Group developed an investment case for a patient deterioration quality improvement programme.

    Between October 2015 and April 2016, we spoke with people in the sector to inform the development of the programme and reviewed the evidence in the literature and work being done internationally. See the following reports:

    In March 2016 we hosted a workshop with Associate Professor Jeanne Huddleston in partnership with the Health Roundtable. Presentations are available here.

  • The programme team

    The programme team includes clinical, consumer, quality improvement, measurement and project management expertise. Dr Alex Psirides, an intensive care consultant at Capital and Coast DHB, is the clinical lead for the programme. An expert advisory group provides advice to the programme and includes consumer and clinical representatives.

  • About the programme

    The programme will work with hospitals to establish recognition and response systems for managing the care of acutely deteriorating patients. The initial focus has been on getting the basis of the system in place (workstream one: recognition and response systems).

    The focus is now on locally co-designing patient, family and whānau escalation processes (workstream two: Kōrero mai) and developing a national approach to shared goals of care (workstream three).

    See the programme charter for more information.


Last updated 19/06/2020