431 Electronic Structured Response Tool for Deteriorating Surgical Patients

Abstract

Abstract Aim The Scottish Patient Safety Programme created the National Early Warning Score to have early recognition of deteriorating patients. Clear communication and documentation during and after episodes were found to improve outcomes. SIGN guidance recommended 9-component that should be included in structured response, creating a paper-based structured response tool (SRT). We aimed to review medical assessments of deteriorating patients in general surgical wards and compare to a formulated electronic SRT in promoting best practice. Method Patients scoring over NEWS 4 were identified at eight 2-week time points over a 18-month period and initial assessments evaluated. Results 101 patients were identified with a NEWS ≥ 4 between July 2018-Feb 2019. Implementation of electronic SRT occurred in Nov 2018 and Feb 2019. Average NEWS was 5.9 (range 4-12). Comparing collection periods, following electronic SRT implementation, documentation of re-review times rose from 37.5% to 79.5%. Documentation of frequency of observations and management plans increased from 24.5% to 65% and 79% to 97% respectively. There was a statistically significant rise in recording of escalation plans following implementation of electronic SRT from 35% to 94% (p = 0.008). Conclusions Usage of electronic SRT promoted documentation of all components recommended by SIGN. There is further scope to extend usage outside of surgical wards for all junior doctors by introducing electronic SRT at medical induction.