New patient chart to save 6,000 lives a year in the UK

Two Royal Medical Colleges introduce a new way to record patients' vital signs

For more than a century doctors have been recording patients' "vital signs" – temperature, blood pressure, heart rate – on the chart at the foot of the hospital bed, and then failing to act on what they found.

Yesterday, two UK Royal Medical Colleges became the first in the world to introduce a new way of displaying the measurements to compel action which is expected to halve avoidable deaths in hospital, saving at least 6,000 lives a year in the UK.

The simple innovation was described yesterday as a "step change" in patient safety. As well as saving lives it is expected to shorten hospital stays, improve the experience for patients and lower costs.

Experts compared it to the introduction of the surgical checklist in 2010 – a series of basic questions ("Is this the right patient?" "Is this the right limb?") – which has been shown to cut deaths after operations by a third, and complications by half. But producing the new chart with a National Early Warning Score – a composite measure of six vital signs that indicates when a patient needs urgent help – involved "banging heads together" across the NHS to get doctors to agree, according to Bryan Williams, the chair of the group that developed it. The professor of medicine at University College London, who first proposed the innovation in an earlier report in 2007, said there were at least 100 different hospital charts in use throughout the NHS with different scoring systems.

Doctors and nurses who moved between NHS trusts – or even between different wards in the same trust – found themselves confronted with a new chart and a different scoring system which they did not understand, putting patients at risk.

"Colleagues in various specialities developed early-warning systems of which they were justifiably proud and to which, in some cases, they were firmly wedded. But this was not just about 'What is the best system?' It was also about recognising the huge advantage of everyone using the same system," he said.

The six vital signs that comprise the score are temperature, pulse, breathing rate, blood pressure, blood-oxygen level and consciousness. The charts are colour-coded and any single measure that falls in a red zone – such as respiration below nine breaths a minute – should trigger a call to the medical team.

If the composite measure falls in the red zone, emergency assessment of the patient should be carried out by senior staff. A study published earlier this month found 1,000 patients a month were dying in NHS hospitals as a result of bungled care, most often because medical staff failed to spot or act on signs that patients were deteriorating.

Professor Williams said: "I think we could expect a 50 per cent reduction in morbidity and mortality as a result of implementing this.

"It is the first time in the world that anyone has tried to standardise the measurements [across all hospitals] in a healthcare system to drive up standards of care."

How the chart works

The observation chart records six vital signs, scored zero (low risk) to 3 (high risk), and is colour-coded to indicate when a danger level has been reached. If any single measure, e.g. temperature, is in the red zone, nurses must call a senior doctor to assess the patient.

In addition to recording each individual vital sign, the chart also displays a composite measure of all six – the National Early Warning Score. A patient with an overall score of zero to four is designated low risk and should be checked by a nurse every four to six hours. A score of seven or more indicates an emergency with immediate intervention by a specialist required.

VIDEO
News
Strange 'quack' noises could be undersea chatter of Minke whales
science
Voices
voices Furore is yet another example of shameful Westminster evasion, says Nigel Farage
News
weird news... and film it, obviously
Arts & Entertainment
tv
Sport
sport
News
Matthew Mcnulty and Jessica Brown Findlay in 'Jamaica Inn'
mediaHundreds complain over dialogue levels in period drama
News
peopleJay Z and Beyoncé to buy £5.5m London townhouse
Voices
voicesMoyes' tragedy is one the Deputy PM understands all too well, says Matthew Norman
Arts & Entertainment
Rocker of ages: Chuck Berry
musicWhy do musicians play into old age?
News
Jilly's jewels: gardener Alan Titchmarsh
peopleCountry Life magazine's list of 'gallant' public figures throws light on what it means to be a gentleman in the modern world
Sport
John Terry goes down injured in the 70th minute
sportAtletico Madrid 0 Chelsea 0: Blues can finish the job at Stamford Bridge, but injuries to Terry and Cech are a concern for Mourinho
Student
student
News
<b>Rebecca Adlington</b>
<br />This, the first British swimmer to win two
Olympic gold medals in 100 years, is the eversmiling
face of the athletes who will, we're
confident, make us all proud at London 2012
peopleRebecca Adlington on 'nose surgery'
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition iPad app?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    English Teacher

    £450 - £750 per annum: Randstad Education Leicester: English teacher required ...

    Humanities Teacher

    £90 - £160 per day: Randstad Education Leicester: Randstad Education is curren...

    Learning Support Assistant for EBD

    £60 - £70 per day: Randstad Education Leicester: Randstad Education is current...

    Learning Support Assistant for Moderate Learning Difficulties

    £60 - £70 per day: Randstad Education Leicester: Randstad Education are curren...

    Day In a Page

    Brits who migrate to Costa del Sol more unhappy than those who stay at home

    It's not always fun in the sun: Moving abroad does not guarantee happiness

    Brits who migrate to Costa del Sol more unhappy than those who stay at home
    Migrants in Britain a decade on: They came, they worked, they stayed in Lincolnshire

    Migrants in Britain a decade on

    They came, they worked, they stayed in Lincolnshire
    Chris Addison on swapping politics for pillow talk

    Chris Addison on swapping politics for pillow talk

    The 'Thick of It' favourite thinks the romcom is an 'awful genre'. So why is he happy with a starring role in Sky Living's new Lake District-set series 'Trying Again'?
    Why musicians play into their old age

    Why musicians play into their old age

    Nick Hasted looks at how they are driven by a burning desire to keep on entertaining fans despite risking ridicule
    How can you tell a gentleman?

    How can you tell a gentleman?

    A list of public figures with gallant attributes by Country Life magazine throws a fascinating light on what it means to be a gentleman in the modern world
    Pet a porter: posh pet pampering

    Pet a porter: posh pet pampering

    The duo behind Asos and Achica have launched a new venture offering haute couture to help make furry companions fashionable
    A History of the First World War in 100 moments: The mutiny that sent a ripple of fear through the Empire

    A History of the First World War in 100 moments

    The mutiny that sent a ripple of fear through the Empire
    Hot stuff: 10 best kettles

    Hot stuff: 10 best kettles

    Celebrate St George’s Day with a nice cup of tea. Now you just need to get the water boiled
    Sam Wallace: Why Giggs is perfect fit as Manchester United boss... in the longer term

    Sam Wallace

    Why Ryan Giggs is perfect fit as Manchester United boss... in the longer term
    Renaud Lavillenie: The sky's the limit for this pole vaulter's ambitions

    Renaud Lavillenie: The sky's the limit for this pole vaulter's ambitions

    Having smashed Sergei Bubka's 21-year-old record, the French phenomenon tells Simon Turnbull he can go higher
    Through the screen: British Pathé opens its archives

    Through the screen

    British Pathé opens its archives
    The man behind the papier mâché mask

    Frank Sidebottom

    The man behind the papier mâché mask
    Chris Marker: Mystic film-maker with a Midas touch

    Mystic film-maker with a Midas touch

    Chris Marker retrospective is a revelation
    Boston runs again: Thousands take to the streets for marathon as city honours dead and injured of last year's bombing

    Boston runs again

    Thousands of runners take to the streets as city honours dead of last year
    40 years of fostering and still holding the babies (and with no plans to retire)

    40 years of fostering and holding the babies

    In their seventies and still working as specialist foster parents