Patient deterioration preparation and implementation guide

This is a guide to preparing and implementing a recognition and response system, for recognising and responding to patient deterioration.

Patients deteriorate for many reasons. Failures to recognise, escalate and respond appropriately can cause preventable harm. To address this, hospitals are encouraged to establish a system for managing the care of patients who deteriorate in hospital. Recognition and response systems should include:

• a nationally standardised vital signs chart with New Zealand early warning score (or electronic equivalent)
• a localised escalation pathway
• effective clinical governance and leadership
• appropriate clinical and non-technical education and training
• ongoing measurement for improvement
• Kōrero mai (patient, family and whānau escalation) processes
• approaches to discussing and documenting shared goals of care.