Mr Nathan Ross1
1St John Ambulance Western Australia, Australia
Biography:
Nathan Ross is Manager of Clinical Quality and Governance for the St John Ambulance WA Industry Medical Services. Nathan has 20+ years in health service delivery and the co-design of validated improvement systems specific to emergency, law and public health.
Abstract:
Authors
Nathan Ross: Manager Clinical Quality and Governance IMS EHS, Charron Bruce: Head of Nursing, Mark Pascual: Clinical Education Specialist, Jamie Stewart: Medical Director Community
Introduction
Watchhouse detainees represent a vulnerable population with a high incidence of acute physiological and mental health deterioration within the first phase of the custodial system – The Watchhouse. Our purpose is to develop an Early Warning Score (EWS) System aligned with NSQHS – Standard 8: Recognition and Response to Acute Deterioration for safe escalation of care.
Design
Exploratory Factor Analysis amongst cross-jurisdictional Health providers based in custodial systems.
Setting
WA Custodial Systems.
Intervention
Inter-rater reliability analysis seeking agreement on the key indicators of acute deterioration via survey analysis.
Outcomes/Measurement
Identification of agreement amongst clinicians involved in Watch House care provision as to what the dominant indicators of acute physiological deterioration are.
Statistical methods
Krippendorff’s Coefficient will quantify the extent of agreement between raters of known indicators of deterioration.
Results/hypothesis
We hypothesise independent raters (clinicians) agreement on indicators of acute deterioration are strongly aligned with Tertiary and Emergency indicators justifying the development of a tailored escalation pathway.
Conclusion
The team’s vision is ensuring an EWS system, tailored to the custodial system is aligned with National Standards and validated for safe and effective healthcare in the custodial system allowing early and appropriate escalation of care.