School of Medicine, University of Notre Dame, Sydney Children’s Hospital Randwick, Wagga Wagga Base Hospital
Introduction
Between the Flags (BTF) was designed to assist the prompt recognition and response to early signs of deterioration. Vital signs outside of reference range trigger a clinical review or rapid response accordingly. In tools like BTF, there is a consistently high false alarm rate and alert fatigue when responding to an increased volume of reviews.
Aim
To explore clinician’s perspectives on whether the paediatric BTF program is generating a large volume of clinical reviews, resulting in a detrimental impact on patient safety.
Method/Description
A mixed-methods design was employed. Semi-structured interviews of 23 medical and nursing staff at Sydney Children’s Hospital and Wagga Wagga Base Hospital were conducted. Inductive thematic analysis was used to ascertain clinician’s perspectives on workload and patient safety. A survey was generated based on interview themes and distributed to medical and nursing staff on general paediatric wards.
Results
There were largely positive attitudes towards BTF. Participants recognised the potential for clinical review burden and a reduction in patient safety, but that was not their experience of the program. Participants described factors which appeared to reduce workload, including team familiarity, clinical judgement and streamlined communication between nursing and medical staff. Results of the survey are pending.
Consclusions
Preliminary findings support the use of BTF but highlighted areas for further research into factors supporting its success in clinical settings.