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Patient-activated escalation in hospital: patients and their families are ready!
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  • Published on:
    Acknowledging the socio-technical nature of patient-led escalation systems
    • Nicola Mackintosh, Professor in Social Science applied to Health University of Leicester
    • Other Contributors:
      • Elizabeth Sutton, Research Associate
      • Mudathir Ibrahim, Surgical Resident
      • Lesley Booth, Deputy Director
      • Mark Sujan, Professor of Safety Science
      • William Plath, Clinical Research Fellow
      • Peter McCulloch, Professor of Surgical Science & Practice

    We thank Subbe et al for engaging with our paper ‘Understanding the enablers and barriers to implementing a patient-led escalation system: a qualitative study’ in their editorial. The editorial highlights the importance of having a system-led response to patient-led escalation. The editorial also draws attention to the patient and family level trauma and distress that can result from having concerns about a deteriorating condition dismissed by staff, as evidenced by the personal experience provided by one of the co-authors, Alison Phillips. Indeed, in one of our earlier publications from the same study, we similarly highlight the potential for epistemic injustice to arise when patients’ concerns are ignored or dismissed, particularly when in a condition of extreme vulnerability.(1) Our paper and the linked editorial by Subbe et al share the aim of supporting patients in being heard and receiving timely responses when their condition is deteriorating.

    Despite the increased interest, policy activity and enthusiasm for patient-led escalation, there are still significant gaps in the evidence base around implementation of such systems, particularly with regard to how they work in relation to wider socio-cultural rescue systems and across different clinical settings.(2) The premise of our paper was not to undermine the importance of patient-led escalation systems but rather to explore and take learning from the factors that shaped implementation of one particular pilot sy...

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    Conflict of Interest:
    None declared.