Northampton General Hospital NHS Trust Quality Account 2016-2017

In December 2016 a change to the process was adopted whereby each member
of the Bard made a ward visit on a monthly basis.
We said we would:
Provide care that is safe by reducing harm through improving the early identification &
management of the deteriorating patient.
What we achieved:
What: Failure to identify areas of deterioration in patient observations can potentially
lead to delayed or missed escalation and treatment. The 2012 report “Time to
Intervene”, published by the National Confidential Enquiry into Patient Outcome
and Death (NCEPOD) indicated that for many acutely ill people better assessment
and action early in their hospital admission may have led to:
Intervention that may have prevented progression to cardiorespiratory
arrest, or
Recognition that the person was dying and that attempted resuscitation
would be inappropriate
The NCEPOD report also states that in a substantial number of cases a patient’s
condition was not ‘escalated’ appropriately for assessment by a senior doctor.
That assessment may have led to intervention to try to reverse deterioration, or
may have led to recognition that the treatment would not result in recovery and to
a decision that attempted CPR would be clinically inappropriate.
How much:
The NCEPOD report reflects that many in-hospital cardiac arrests are predictable
events, often following a period of slow and progressive physiological
derangement that is often poorly recognised and treaded. Therefore it was
recommended that each hospital should set a local goal for reduction in cardiac
arrests leading to CPR attempts. It has been reported that up to a third of hospital
cardiac arrests could be preventable.
We have aimed to reduce the number coded preventable cardiac arrest calls by
15% from the previous year.
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