Critical Care Outreach lead nurse Alex Barclay (pictured, below right) talks about the real-life impact of a patient safety initiative designed to give a voice to patients and their loved ones
“I am part of the team who have been rolling out a national patient safety initiative called Martha’s Rule. If you have a concern about a patient who isn’t getting better and you aren’t being listened to, this initiative will help you. Martha’s Rule or Call for Concern, as we call it locally, provides a way for your concerns to be acted on.
The trust was one of the first to roll out Martha’s Rule two years ago across the wards, maternity, children’s services, and the children’s and adults’ emergency departments at the Lister. It is named after Martha Mills, a young teen who died in a London hospital after developing sepsis. Martha wasn’t getting better and no one listened to the family. A coroner ruled that she would probably have survived had she been moved to intensive care earlier.
There are three elements to Martha’s Rule. The first provides a way to raise a concern about a patient who doesn’t seem to be improving. If you think the ward team aren’t listening to you, you can call a number which is advertised on posters throughout the hospital and talk to the Critical Care Outreach Team.
We will listen to every call and make sure that the right person addresses your concern. If the patient is getting worse, we will provide a rapid clinical review. The review is independent of the ward team who are caring for the patient and is not a criticism of them.
Over 90% of the patients we review have a very low score on our clinical observation charts, where a low score indicates no cause for concern. Yet following a review, over 70% of these patients then receive a change in their treatment plan. Clinical observations don’t always capture a change in a patient’s behaviour, and our experience reflects the research which says patients and families are often the first to notice when something isn’t right.
The third element of Martha’s Rule is the patient wellness questionnaire which we are rolling out across our wards. We ask patients every dayhow they are feeling and whether they feel worse or better than the day before. When patients chat with staff, it gives them the chance to share worries and feel listened to.
I feel very privileged to be delivering this safety initiative. It ensures we are listening to our patients, staff and relatives and brings me closer to the true purpose of my role, which is to improve patients’ outcomes and spend time listening to them.”
