Project Lead

Dr Anne Harrison

Lead partner

Mercy Health

MacHSR Future Leaders Fellowship Program (cohort 1).

The REACH (Recognise, Engage, Act, Call, Help) patient/carer-activated escalation process for concerns about inpatient clinical care or health status is important because research suggests that empowering patients and their carers to engage with health professionals may result in earlier identification of deterioration and improved outcomes.

This project will explore the attitudes and perceptions of patients and their carers to this escalation process, using their lived experience to identify barriers and enablers to its uptake and develop evidence-informed improvements to the pathway with the goal of increasing engagement.

Read more about the importance of this project to Mercy Health from Prof Stephen Tong.

The REACH (Recognise, Engage, Act, Call, Help) process at Mercy Health aims to empower patients and carers to escalate a concern about clinical deterioration and supports three of the National Safety and Quality Health Service Standards (Standard 2 – Partnering with Consumers, Standard 6 – Communicating for Safety, and Standard 8 – Recognising and Responding to Acute Deterioration).

Between September 2020 and September 2022 no escalation calls were received relating to clinical care and Point of Care Audit data indicated that 50% of patients and carers were unaware of the process. During the fellowship a two-part mixed methods study was co-designed with consumers and key stakeholders, and surveys to explore the awareness and perceptions of nursing staff and patients/carers of the REACH process were completed (nursing staff) or are ongoing (patients/carers).

Recommendations from the survey of nursing staff have been submitted to the Standard 8 Committee and will inform improvements to the escalation process. The findings of this project are directly relevant to other health services, with benchmarking from six public hospitals also indicating low rates of engagement with their escalation processes.