This is a secondary driver from safe clinical and care processes for reliable recognition of deterioration and standardised structured response within the Deteriorating Patient driver diagram
Change ideas
The examples below show how this secondary driver can be implemented in practice. Additional change ideas can be found in the Deteriorating Patient driver diagram
- Practitioner: Use assessment tools (for example Clinical Frailty Scale, 4AT) to identify people whose deterioration may present atypically or without changes in NEWS2
- Team: Process to identify people with significant co-morbidities, frailty or complex care needs at higher risk of deterioration
Evidence and resources
- Academy of Medical Royal Colleges. Statement on the initial antimicrobial treatment of sepsis [online]. Version 2.0. 2023
- Healthcare Improvement Scotland. Ageing and frailty standards [online]. 2024
- Maclullich A, Ryan T, Cash H. 4AT – Rapid Clinical Test For Delirium [online]. 2019
- Scottish Intercollegiate Guidelines Network. SIGN 157: risk reduction and management of delirium. A national clinical guideline [online]. 2019
- Surviving Sepsis Campaign. International guidelines for management of sepsis and septic shock 2026 [online]. 2026