Escalating Deteriorating Patients’ Care in the Emergency Department: Characteristics and Safety Culture

Failure to escalate the care of deteriorating Emergency Department (ED) patients is a significant patient safety issue. The aims of the research were to describe the relationships between dynamic emergency department characteristics, organisational culture and the care of the deteriorating ED patient. Escalation of deteriorating ED patient care was not significantly impacted by fluctuations in workload, staffing levels/skillmix or ED patient casemix. Failure to escalate care was significantly impacted by the experience and expertise of the person documenting signs of deterioration. This study provides key recommendations for emergency practice and research priorities to improve the recognition and response to deteriorating ED patients related to cultural change, the expertise and experience of staff, effective education and adapting the systems for recognising and responding to deterioration.

Author requested conversion to open access 3 Mar 2023