Call 4 Concern : Patient and Relative Initiated Critical Care Outreach

Winner of Patient Safety Award 2011 in the category: Critical/Intensive Care

The aim of the project was to introduce and evaluate a Call for Concern (C4C) service that provides patients and relatives with direct access to the Critical Care Outreach (CCO) team, to give patients and relatives more choice about who they can consult with about their care, and facilitate the early recognition of the deteriorating ward patient. C4C was inspired by the Condition H(elp) system at the University of Pittsburgh Medical Centre. What little has been published on the subject is largely descriptive, but supporting literature reports the value of patients and relatives input into early recognition of deterioration. It is thought that this is the first such service introduced in the UK.

The project involved two phases:

• a six month pilot phase to evaluate the C4C service for feasibility, and its effects on patients, relatives and the health care teams
• a three month phase implementing the C4C service onto two surgical wards to test and evaluate the findings of the feasibility phase in preparation for expansion to all hospital wards

Between 1 Sept 2009 and 23 Sept 2010, the CCO team received 37 C4C referrals representing 0.5% of total CCO activity. Critical deterioration of a patient was prevented in at least two cases, and the service received positive feedback from patients and relatives. In the words of a relative, C4C provided: ‘…a better quality of care…and…reduces the risk of death.’

This project was supported by the FoNS Patients First Programme in partnership with The Burdett Trust for Nursing.