REACH Out is an independent patient and family activated response system for small sites. The REACH response is provided by on off-site patient flow team via Telehealth.
Aim
By 30 June 2018, 100% of patient and resident carers and families will know how to escalate any concerns they may have about the care received at Nyngan Health Service.
Benefits
- Families and carers of patients will know how to raise concerns about the standard of care delivered.
- Access to an independent review will provide an additional safety net for deteriorating patients.
- Improved outcomes for family activated clinical reviews.
Background
REACH stands for Recognise, Engage, Act, Call, Help is on its way. It is an initiative of the Clinical Excellence Commission’s Partnering With Patients Program.1
Previously, due to limited resources, small sites were not able to offer patients and their families and carers, an independent review of the clinical care received. This meant that the clinical staff member who initially assessed the patient was often also tasked with reviewing the REACH response. Clinicians were not able to meet the requirements outlined in action 8.7 of the National Safety Quality Healthcare Standards, which require a formal process for patients, families and carers to directly escalate care.
Implementation
Following an analysis of clinical cases across the state, the project team recommended that an independent body should receive escalation calls off-site and a virtual review should be managed by an offsite team.
The project team evaluated several models for managing the off-site process and decided to direct escalation calls to the patient flow team in Dubbo, who would then provide a clinical review for the patient.
The setting-up stage of the new process included virtual education sessions about the REACH response with the Dubbo patient flow team and the clinical local team.
The project team also worked with local media (newspaper and radio) to create community awareness about the new process.
Status
Implementation - the initiative is ready for implementation, is currently being implemented, piloted or tested.
Implementation site
Nyngan
Partnerships
The patient flow and transport teams in Dubbo already provide our critical call and patient referral calls. The rapport between the teams has enabled this unique partnership for a family activated response system.
Evaluation
- The program launched in June 2018. Over the coming months, several project outcomes will be measured. These include patient awareness, the ability of clinical staff to explain the process, and the number of family activated responses received.
- Since launching, there have already been several positive results: a REACH call was received within the first 24 hours of going live; and within the first month, two calls were received, including a potentially life-saving call from a concerned husband.
Lessons learnt
It takes a lot of time to get a form into the electronic medical health records (eMR) system, even if the form is being used by other local health districts. This caused significant delays for the project and the REACH response is still paper-based while the eMR request progresses. In hindsight this should have been the first step in the project!
References
Clinical Excellence Commission. REACH
Contact
Jenny Griffiths
Health Service Manager - Nyngan Health Service
Phone: 02 68351 700
jennifer.griffiths@health.nsw.gov.au
