Call for Concern: A Patient and Relative Activated Critical Care Outreach Workshop

Back in 2009 the Royal Berkshire Hospital was the first in the country to empower patients and relatives in a really innovative way utilising a well established Critical Care Outreach Team by implementing a Patient and Relative Activated Critical Care Outreach service. We implemented the ‘Call 4 Concern’ (C4C) system whereby patients and their relatives can directly access the critical care outreach team if they have concerns about the patient's condition that they feel is not being acknowledged by the ward teams.

The Critical Care Outreach team and an early warning scoring system has been in place in the RBH since 2001, with the remit to support and assist ward staff in the early detection and appropriate management of deteriorating ward patients. The introduction of the C4C service was an additional safety net to ensure the highest quality of care for the patients. C4C was inspired by the Condition H(elp) system developed at the University of Pittsburgh’s Medical Centre in the United States. Condition H(elp) was set up there in 2005 as a result of the case of an 18 month old child, Josie King who died in 2001 due to hospital errors and poor communication. Josie’s mother and others have campaigned tirelessly in the USA to give patients and relatives more involvement in patient care issues.

Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately. Nurses often notice deterioration intuitively because of their knowledge of individual patients.

Patients and their relatives have the greatest knowledge of patients, and can often pick up subtle signs of physiological deterioration before this is identified by staff or monitoring systems. However, this ability has been largely overlooked. Call 4 Concern (C4C) is a scheme where patients and relatives can call critical care teams directly if they are concerned about a patient's condition

Are you wanting to set up a similar service within your hospital? Do you have any questions about the implementation and or running of a Call for Concern Service? Why not join Dr Mandy Odell (Nurse Consultant) and Karin Gerber (Advanced Nurse Practitioner, Critical Care Outreach) from the Royal Berkshire Hospital and learn from their experience.  They'll be sharing their journey, data and passion for this essential patient safety service.

@mandy_odell & @karin_gerber