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New service enables patients to 'Call 4 Concern'

A new approach to patient safety at Ysbyty Gwynedd is ensuring that the voices of patients and their families are heard if they raise concerns about their deteriorating health.

The Call 4 Concern Service enables patients at the hospital and their families to call for immediate help and advice if they are worried that the health care team has not recognised their changing condition. 

The service is run by Betsi Cadwaladr University Health Board’s Acute Intervention Team, a group of highly skilled and experienced Advanced Nurse Practitioners available 24/7 to support ward teams in the care of acutely ill patients.

Upon receiving a Call 4 Concern, a member of the Acute Intervention Team visits and reviews the patient on the ward. After assessing the situation and liaising with the medical team and other healthcare professionals as needed, the team will ensure the necessary intervention is implemented.

The team initially launched the service as an 18-month pilot, firstly for patients discharged to wards from ICU before expanding to one of the hospital’s surgical wards.

After joining the Safe Care Collaborative, which provides teams with tailored coaching and support from Improvement Cymru and the Institute for Healthcare Improvement (IHI) to accelerate improvement projects aiming to deliver national patient safety priorities, the Call 4 Concern service was formally launched across Ysbyty Gwynedd’s adult inpatient services in April 2023.

Interventions through the service have had a significant impact on patient safety, which has included preventing patients requiring escalation to intensive care.

The team now has its sights set on working with colleagues to further spread the service to Wrexham Maelor Hospital and Ysbyty Glan Clwyd

Eirian Edwards, ANP Lead for the Call 4 Concern Service, said: “It’s been an exciting time becoming the first team in Wales to implement a patient and relative activated rapid response system at Ysbyty Gwynedd, introducing a valuable safety net for our patients.

“Involving patients in decisions about their treatment through approaches like the Call 4 Concern Service improves patient safety, reduces harm and rebalances the relationship between individuals and health professionals.

“Being part of the Safe Care Collaborative has provided us with expert guidance and coaching to successfully implement the service from the pilot stage to launch, using improvement tools such as driver diagrams and receiving guidance on data collection and analysis.

“It has also been a seal of approval within our health board for delivering the service and provided an opportunity to share our successes and learning with other health boards across Wales that are looking at implementing similar services.

“Our aim is to establish the Call 4 Concern service at all acute sites across Betsi Cadwaladr University Health Board and we look forward to continuing to work with the Safe Care Collaborative to strive for that.”

Angela Wood, Executive Director of Nursing and Midwifery at Betsi Cadwaladr University Health Board, added: “I have been really impressed by the hard work undertaken by the Acute Intervention Team in establishing the first Call 4 Concern Service at Ysbyty Gwynedd.

“I was proud to see the team share their story with colleagues across Wales as part of the Safe Care Collaborative, which I hope is helping to inspire and encourage similarly great work elsewhere.”

The Safe Care Collaborative is bringing together health boards and trusts across Wales to accelerate improvement projects that will improve patient safety throughout the NHS in Wales.

Over a focused 15-month period, Improvement Cymru and IHI are providing services and teams throughout NHS Wales with tailored coaching and support. This will help to accelerate existing improvement projects to enhance safe and effective care across the country.

The Call 4 Concern Service is part of the collaborative’s Safe and Effective Acute Care workstream, which focuses on supporting improvement projects addressing structures and processes in response to the deteriorating patient in acute settings.  ‚Äč

Alongside workstreams focusing on community and ambulatory care, it is underpinned by a Leadership for Patient Safety Improvement workstream that is supporting the adoption of the organisational learning systems, culture and working environments required for improvement to flourish.

Dominique Bird, Deputy Director and Head of Quality Improvement at Improvement Cymru, said: “I am delighted that the Safe Care Collaborative has provided a catalyst for the Acute Intervention Team at Ysbyty Gwynedd. The team has done excellent work to launch the Call 4 Concern Service, which is having a real positive impact on patient safety.  

“We’re looking forward to continuing to support the accelerated delivery of projects like the Call 4 Concern Service throughout Wales through the collaborative’s community, ambulatory and acute workstreams, alongside our work with leaders across NHS Wales through the leadership workstream to create optimal conditions within health systems so that improvement can flourish into the future.”  

You can find out more about the Call 4 Concern Service on the Betsi Cadwaladr University Health Board website.

For detail on the Safe Care Collaborative visit our webpages, here.

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