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Enhancing Deteriorating Patient Management at Eastern Health: A Comprehensive Analysis

The analysis focuses on deteriorating patient management across Eastern Health's facilities, with an emphasis on inconsistencies in patient responses and lack of early detection systems. A point prevalence study identified missed MET criteria, revealing high rates of incomplete observations. Interventions are aimed at improving detection through standardized observation charts, consistent MET responses, and enhanced data collection. Preliminary results indicate a reduction in ICU and hospital mortality for patients admitted due to deterioration. This initiative seeks to establish a uniform and effective response framework across Eastern Health.

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Enhancing Deteriorating Patient Management at Eastern Health: A Comprehensive Analysis

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  1. The Deteriorating Patient at Eastern HealthCurrent State Analysis Elective surgery ED patients Ward patients deteriorating Increased Demand for Critical Care beds • Point Prevalence Study • Box Hill • 14 patients with MET criteria • 38 breaches MET criteria in those patients in 24 hrs • 35% observations incomplete • 6% of patients breached MET criteria • Maroondah • 18 patients with missed MET criteria • 26 missed MET criteria in those patients in 24 hrs • 24% of observations incomplete • 11.9% patients with missed MET criteria • Angliss • 1 patient with MET criteria • 1 missed MET criteria in 24 hours • 20% observations incomplete • 2% of patients with missed MET criteria No early detection system for deteriorating patients Inconsistent rapid response system for deteriorating patients

  2. Gap identified: • Inconsistent detection of deterioration • Inconsistent response systems for deterioration • – MET in place at Maroondah & Angliss but different MET criteria • – no MET at BHH - only Code Blue response • Inconsistent data collection across acute sites The Deteriorating Patient at Eastern Health • Expected Outcome: • Improve detection of deterioration by introduction of National Observation & Response charts for adults, obstetric and paediatric patients • Improve & ensure consistent response system for deterioration by standardisation of MET across EH and introduction of MET at BHH • Reduce risk of clinical deterioration for EH patients • Improve data collection & ensure consistent by introduction of standardised forms & database

  3. The Deteriorating Patient at Eastern Health Changes Implemented: • Adopted principles of the National Consensus Statement - essential elements for recognising and responding to clinical deterioration • Education sessions for nursing and medical staff focussing on the deteriorating patient • Development of observation and response charts for paediatric, obstetric and adults to assist with early detection of deterioration • Standardisation of rapid response systems across Eastern Health • Standardised dataset, data collection form and database at each site • Introduction of Medical Emergency Team (MET) response at BHH

  4. The Deteriorating Patient at Eastern Health BHH ICU Data • Results: • Use of observation & response charts – adults, children, obstetrics • Consistent rapid response systems across acute sites • Consistent data collection • Preliminary results reveal reduced ICU & hospital mortality at BHH for ICU patients, including patients admitted from ward due to deterioration

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