The Implementation of an Early Warning System to a Sub-Acute Unit

Changes in legislation and regulation inIrelandhave resulted in significant care of the elderly beds being incompatible with Health Information and Quality Authority (HIQA) standards regarding aging infrastructure. To ensure organisational viability, alternative deployment of these beds to sub-acute care, in line with Government policy is necessary. Additionally, hospitalised patients are in danger of experiencing deterioration at many points during their stay, a fact further compounded by this change in designation with lack of policy, procedure or protocol further exasperating patient risk. This change project outlines the introduction and implementation of an Early Warning System (EWS) to a twelve bedded sub-acute unit, utilising the Health service Executive (HSE) change model, based on the organisational development approach. A transformational leadership system is employed to establish this concept, progressing the team through training, development and reflection whilst engaging externally utilising an appropriate improvement framework. The change is then evaluated via a multi-method approach, outlining action necessary for future, further dissemination. The implementation of the EWS facilitated recognition of abnormal physiological considerations and prioritisation of care, enveloping the concept of continuous quality improvement by means of improved clinical reasoning skills and interdisciplinary communication. However, the success of the initiative was heavily dependent on considerable training, development and support over a two month period. To facilitate subsequent successful implementation elsewhere, will necessitate the allocation of specific resources, ensuring context driven interventions, training and evaluation. Such evidence will determine the effectiveness of the EWS in improving patient safety and preventing unsavoury patient outcomes, demonstrating the hospital’s ability to adequately care for this category of patient, standardising patient care and ensuring organisational sustainability in line with present Government strategy.