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dc.contributor.authorRotella, Joe-Anthonyen
dc.contributor.authorYu, Wen
dc.contributor.authorFerguson, Jen
dc.contributor.authorJones, Daryl Aen
dc.identifier.citationAnaesthesia and Intensive Care; 42(6): 723-9en
dc.description.abstractPatients can acutely deteriorate unexpectedly. Junior medical officers (JMOs) are often first to review patients who become unwell. Opportunities to escalate care to a senior colleague may exist prior to the need for a rapid response team review. Little is known about the factors that influence JMO decisions to escalate care. In this study, our objective was to investigate the self-reported factors that influence escalation of care by JMOs in a university-affiliated, tertiary level hospital. We designed a face-to-face questionnaire of JMOs using standardised introduction to minimise interviewer bias. Fifty JMOs participated in the study (a 100% response rate). Most (63.3%) felt that they would be able to identify a clinically deteriorating patient. They would be more likely to escalate care if they were not familiar with the patient's clinical problem. If handover plans were seen to be adequate, JMOs felt it was less necessary to escalate care. Few JMOs (12%) agreed that they limited escalation due to fear of criticism or fear of conflict with senior medical staff. Although 36% agreed that they were concerned about waking seniors overnight, only 6% feared that escalating care overnight would affect their future career prospects. Escalation of care appears to be mostly influenced by the confidence and familiarity of the JMO with the cause of deterioration. JMOs identified clear handover with documented goals of treatment and suggested actions in event of clinical deterioration as the best means by which to improve the process of escalation of care for clinically deteriorating patients.en
dc.subject.otherclinical deteriorationen
dc.subject.otherescalation of careen
dc.subject.otherjunior medical officeren
dc.subject.otherAttitude of Health Personnelen
dc.subject.otherClinical Competence.statistics & numerical dataen
dc.subject.otherCritical Illnessen
dc.subject.otherDisease Progressionen
dc.subject.otherHospitals, University.statistics & numerical dataen
dc.subject.otherIntensive Care.methods.statistics & numerical dataen
dc.subject.otherInternship and Residency.statistics & numerical dataen
dc.subject.otherMedical Staff, Hospital.statistics & numerical dataen
dc.subject.otherTertiary Care Centers.statistics & numerical dataen
dc.titleFactors influencing escalation of care by junior medical officers.en
dc.typeJournal Articleen
dc.identifier.journaltitleAnaesthesia and Intensive Careen
dc.identifier.affiliationEmergency Medicine, Austin Health, Heidelberg, Victoria.en
dc.identifier.affiliationIntensive Care, Austin Health, Heidelberg, Victoria.en
dc.identifier.affiliationAustin Health, Heidelberg, Victoria.en
dc.type.austinJournal Articleen, Daryl A
item.openairetypeJournal Article-
item.fulltextNo Fulltext- Care-
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