From one question to system-wide change
Connections made at the Healthcare Improvement Forumˆ helped the project grow from a local initiative into a national collaboration.
2020 | Starting at Monash Health
Monash Health began working with families and clinicians to improve recognition of deterioration in children. Together, they developed a question to ask routinely when monitoring vital signs:
“Are you worried your child is getting worse?”
Early testing showed strong engagement from families. Further research found that parental concern was associated with critical illness.
2022 | A Forum connection builds momentum
Preliminary findings were presented at the Healthcare Improvement Forum in Sydney. During the Forum, an introduction to the chief paediatrician of New South Wales led to the creation of a national community of practice.
Clinical leaders began sharing evidence and experience, and exploring how the approach could work across Australia.
2022-26 | From local project to statewide adoption
The question is now part of routine monitoring of children’s vital signs in Victoria, New South Wales, Western Australia, and Queensland. Others are also working towards statewide implementation.
The community of practice continues, with representatives from seven of Australia’s eight states and territories.
The approach is also extending to adults. Monash Health has routinely asked adult patients the question for the past two years, with early findings awaiting publication. New South Wales has already introduced the question as part of routine vital sign monitoring for adult patients statewide.
Towards national standards
Australia is updating its National Safety and Quality Health Service Standards, which all Australian health services are expected to implement by 2030.
The current draft includes a requirement for clinicians to “routinely ask patients, families and carers about their concerns, to support early recognition of deterioration.”
The work has also attracted international interest. The International Society for Rapid Response Systems has featured it in its newsletter and at a meeting. In the UK, Martha’s Rule similarly aims to strengthen the role of patients and families in recognising deterioration.
“Someone who’d previously done a fellowship at Safer Care Victoria heard me speak [at the Forum] and introduced me at morning tea to the chief paediatrician of New South Wales, and out of that conversation a nationwide community of practice was started.”
Dr Erin Mills, paediatric emergency physician and quality advisor
Monash Health and clinical lead for Safer Care Victoria’s Safer Care for Kids ViCTOR Project
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