Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review

Abstract

Aims and objectives: This review investigated the impact of consumer participation in recognition of patient deterioration and response through call activation in rapid response systems.

Background: Nurses and doctors have taken the main role in recognition and response to patient deterioration through hospital rapid response systems. Yet patients and visitors (consumers) have appeared well placed to notice early signs of deterioration. In response, many hospitals have sought to partner health professionals with consumers in detection and response to early deterioration. However, to date, there have been no published research-based reviews to establish the impact of introducing consumer involvement into rapid response systems.

Design: A critical research-based review was undertaken.

Methods: A comprehensive search of databases from 2006-2014 identified 11 studies. Critical appraisal of these studies was undertaken and thematic analysis of the findings revealed four major themes.

Results: Following implementation of the consumer activation programmes, the number of calls made by the consumers following detection of deterioration increased. Interestingly, the number of staff calls also increased. Importantly, mortality numbers were found to decrease in one major study following the introduction of consumer call activation. Consumer and staff knowledge and satisfaction with the new programmes indicated mixed results. Initial concerns of the staff over consumer involvement overwhelming the rapid response systems did not eventuate. Evaluation of successful consumer-activated programmes indicated the importance of: effective staff education and training; ongoing consumer education by nurses and clear educational materials.

Conclusions: Findings indicated positive patient outcomes following introduction of consumer call activation programmes within rapid response systems. Effective consumer programmes included information that was readily accessible, easy-to-understand and available in a range of multimedia materials accompanied by the explanation and support of health professionals.

Relevance to clinical practice: Introduction of consumer-activated programmes within rapid response systems appears likely to improve outcomes for patients experiencing deterioration.

Keywords: call initiation; consumer call activation; consumer participation; deteriorating patient; family; literature review; medical emergency team; patient; rapid response system.