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.

News
people

Top Gear presenter is no stranger to foot-in-mouth controversy

Arts and Entertainment
Imelda Staunton as Dolores Umbridge in the Harry Potter films
books

New essay by JK Rowling went live on Pottermore site this morning

Arts and Entertainment
Charlie Sheen said he would
tv

Charlie Sheen could be set to revive his role as a hedonistic womaniser

Life and Style
Jamie Oliver’s version of Jollof rice led thousands of people to post angry comments on his website
food + drink
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

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

    iJobs Job Widget
    iJobs General

    KS1 Teacher Cornwall

    £20000 - £45000 per annum: Randstad Education Plymouth: Randstad Education Ltd...

    Early Years Teacher - Jan 2015 - China

    Negotiable: Randstad Education Group: Position: Early Years TeacherRequired: J...

    KS1 and KS2 Primary NQT Job in Lancaster Area

    £85 - £140 per day: Randstad Education Preston: Randstad Education is urgently...

    Trainee Recruitment Consultants

    £20000 - £25000 per annum + OTE £35K: SThree: We consistently strive to be the...

    Day In a Page

    The drugs revolution starts now as MPs agree its high time for change

    The drugs revolution starts now as MPs agree its high time for change

    Commons debate highlights growing cross-party consensus on softening UK drugs legislation, unchanged for 43 years
    The camera is turned on tabloid editors in Richard Peppiatt's 'One Rogue Reporter'

    Gotcha! The camera is turned on tabloid editors

    Hugh Grant says Richard Peppiatt's 'One Rogue Reporter' documentary will highlight issues raised by Leveson
    Fall of the Berlin Wall: It was thanks to Mikhail Gorbachev that this symbol of division fell

    Fall of the Berlin Wall

    It was thanks to Gorbachev that this symbol of division fell
    Halloween 2014: What makes Ouija boards, demon dolls, and evil clowns so frightening?

    What makes ouija boards and demon dolls scary?

    Ouija boards, demon dolls, evil children and clowns are all classic tropes of horror, and this year’s Halloween releases feature them all. What makes them so frightening, decade after decade?
    A safari in modern Britain: Rose Rouse reveals how her four-year tour of Harlesden taught her as much about the UK as it did about NW10

    Rose Rouse's safari in modern Britain

    Rouse decided to walk and talk with as many different people as possible in her neighbourhood of Harlesden and her experiences have been published in a new book
    Welcome to my world of no smell and odd tastes: How a bike accident left one woman living with unwanted food mash-ups

    'My world of no smell and odd tastes'

    A head injury from a bicycle accident had the surprising effect of robbing Nell Frizzell of two of her senses

    Matt Parker is proud of his square roots

    The "stand-up mathematician" is using comedy nights to preach maths to big audiences
    Paul Scholes column: Beating Manchester City is vital part of life at Manchester United. This is first major test for Luke Shaw, Angel Di Maria and Radamel Falcao – it’s not a game to lose

    Paul Scholes column

    Beating City is vital part of life at United. This is first major test for Shaw, Di Maria and Falcao – it’s not a game to lose
    Frank Warren: Call me an old git, but I just can't see that there's a place for women’s boxing

    Frank Warren column

    Call me an old git, but I just can't see that there's a place for women’s boxing
    Adrian Heath interview: Former Everton striker prepares his Orlando City side for the MLS - and having Kaka in the dressing room

    Adrian Heath's American dream...

    Former Everton striker prepares his Orlando City side for the MLS - and having Kaka in the dressing room
    Simon Hart: Manchester City will rise again but they need to change their attitude

    Manchester City will rise again but they need to change their attitude

    Manuel Pellegrini’s side are too good to fail and derby allows them to start again, says Simon Hart
    Isis in Syria: A general reveals the lack of communication with the US - and his country's awkward relationship with their allies-by-default

    A Syrian general speaks

    A senior officer of Bashar al-Assad’s regime talks to Robert Fisk about his army’s brutal struggle with Isis, in a dirty war whose challenges include widespread atrocities
    ‘A bit of a shock...’ Cambridge economist with Glasgow roots becomes Zambia’s acting President

    ‘A bit of a shock...’ Economist with Glasgow roots becomes Zambia’s acting President

    Guy Scott's predecessor, Michael Sata, died in a London hospital this week after a lengthy illness
    Fall of the Berlin Wall: History catches up with Erich Honecker - the East German leader who praised the Iron Curtain and claimed it prevented a Third World War

    Fall of the Berlin Wall

    History catches up with Erich Honecker - the East German leader who praised the Iron Curtain and claimed it prevented a Third World War
    How to turn your mobile phone into easy money

    Turn your mobile phone into easy money

    There are 90 million unused mobiles in the UK, which would be worth £7bn if we cashed them in, says David Crookes