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REACH: Patient and Family Escalation

Learn about the REACH escalation system for early patient deterioration recognition and response. Engage with patients, families, and carers to reduce adverse events and promote shared decision-making.

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REACH: Patient and Family Escalation

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  1. REACH: Patient and Family Escalation

  2. Outline of presentation • Background and rationale for REACH • What is REACH? • The consumer voice – patient story • Plan for xxx Hospital Tip: describe your facility / unit’s ‘burning platform’ for implementing REACH Clinical Excellence Commission

  3. Person Centred Care 92% of patients said that they wanted to be involved in decisions about their hospital care and treatment (n= 20,489, BHI 2018) ‘consumer activation’ ‘nothing about me without me’ ‘partnering with patients, carers and families’ ‘consumer engagement’ ‘shared decision making’ Clinical Excellence Commission

  4. Deteriorating patients Clinical Excellence Commission

  5. Our goal • To improve early recognition, escalation and response to clinical deterioration (physical and mental health) by partnering with patients, families and carers. • ↓ potentially preventable deaths and serious adverse events. Clinical Excellence Commission

  6. REACH • Patient, family and carer activated escalation system • Aims to ↑ consumer engagement and ↓ adverse outcomes • Promotes inclusion of pts, and their families and carers as partners in the healthcare team • Principle of ‘speaking up for safety’ / pts/families/carers know themselves best/ ‘expert’ • One part of the safety net for deteriorating patients December 2018 170+ hospitals November 2013 11 hospitals

  7. Action 8.7: The health service organisation has processes for patients, carers or families to directly escalate care. Clinical Excellence Commission

  8. Clinical Excellence Commission

  9. The evidence about impact REACH calls in NSW public hospitals(1 Jan 2018–30 June 2018) • Range: average of 2 calls/yr to 2 calls/mth • ‘Family concern’ continues to be reason for activation of rapid response in 5-6% of total calls. • Reasons for calls mirror those identified by staff (e.g. shortness of breath). • Over 50% of family activated cases require transfer to ICU

  10. Consumer feedback ‘REACH is a great system...it gave me reassurance and confidence to say “Hey, I don’t think this is right”. I felt isolated with no other family members to help in questioning the doctor. REACH gave me confidence to do this.’ Feedback from patient’s husband, 2018

  11. Day family video https://youtu.be/3gxsCgOpThQ Tip: add own patient story

  12. Information and resources http://www.cec.health.nsw.gov.au/

  13. Take home message • REACH is a patient, family and carer activated escalation system • Aims to reduce adverse events by partnering with patients, families and carers in recognising and escalating deterioration • It’s about valuing (listening, acknowledging and acting on) the patient voice • Its about engaging with the local team first before escalating to a REACH call • It’s not about complaints – there are existing pathways to make complaints and these do not change

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