Patient and Family Escalation

REACH is a patient and family activated rapid response program that was developed by the Clinical Excellence Commission in 2013. It builds on the surf lifeā€saving analogy for recognition and appropriate care of deteriorating patients by encouraging patients and family to 'put their hands in the air' to signal they need help. This is consistent with the emergency response systems already in use in NSW health services.

Unlike other models, REACH actively promotes engagement with the treating team prior to further escalation steps taken by the patient and family. It encourages patients, family and carers to initially engage with their nurse or medical team, if they are concerned that 'something is not right'. If they continue to be worried they can then escalate their concerns by requesting a clinical review knowing that this should occur within 30 minutes.

Finally, if they are still concerned and all other avenues have been exhausted, an independent review or rapid/emergency response can be activated by the patient, family or carer by calling a unique number made available by the facility. REACH casts the safety net wider and provides assurance that help is on its way.

For further resources, visit the CEC's REACH program page.

TOP 5 Communication Tool

For patients with dementia or cognitive impairment who are removed from their usual place of residence and are experiencing pain or discomfort, anxiety levels are often high. It may not be easy for staff to communicate effectively or understand the often subtle signs that may indicate that a patient's anxiety is escalating. The value of carer information cannot be under estimated.

TOP 5 is a simple process that encourages health professionals to engage with carers to gain valuable non-clinical information to help personalise care. This information is documented on a TOP 5 form and made available to every member of the care team to improve communication between the patient, the carer and the health care team.

Up to five strategies may be recorded, however, in some cases there may only be one or two relevant strategies.

For further resources, visit the CEC's TOP 5 project page.