Co-design of a patient and family-initiated escalation of care intervention to detect and refer patient deterioration in the acute adult ward setting

The study was conducted over three phases using a variety of methods to collect data to inform the development and implementation of a patient and family-initiated escalation of care intervention. <br><br>-Phase 1 established the evidence base by undertaking a systematic review and creating the steering group.<br>-Phase 2 involved collecting data from key stakeholders, patients [n=12], relatives [n=11] and healthcare professionals [n=32], using individual and focus group interviews.

A review of patients’ records also informed the development of a co-designed patient and family escalation of care intervention and implementation plan.<br>-Phase 3 involved co-ordinating the co-design of the intervention and implementation plan through steering group meetings and by undertaking feedback interviews with key stakeholders, patients [n=5], relatives [n=4] and healthcare professionals [n=20], from each hospital site and undertaking a cost analysis.<br><br>The study findings highlighted that patients and relatives can detect deterioration however calling for help can be challenging for some.

To address these challenges a co-designed intervention was developed to provide greater signposting regarding the main signs of deterioration and the key steps to take when calling for help. Feedback interviews on the developed intervention were positive, indicating that most participants felt that it was a valuable and empowering resource for patients and relatives. However, there was clear evidence that deeply embedded socio-cultural, organisational, and economic constraints may influence its introduction into practice.

These factors were considered in the development of an implementation plan and cost analysis to promote future uptake and sustainability of the intervention in the clinical setting. <br><br>Thesis embargoed until 31 December 2026.<br> <br>