Furthermore, barriers to call the Rapid Response Team can cause delay in escalating care.
The Rapid Response Call (RRC) is a system designed to escalate care to a specialised team in response to the detection of patient deterioration.
The first national emergency laparotomy audit (NELA) has since been published demonstrating a 30-day mortality of 11%% and recommending access to pathways that identify need to escalate care (2).
Among the reasons for not admitting a patient to the ICU are: patient or family wishes for not escalating care, the futility of higher-level care (patient does not actually require intensive care, there are no expected benefits from critical care treatment or end-of-life planning).
However, at any time during the study the physician can override and escalate care.
One possible explanation is the failing to escalate care in the presence of competing demands from multiple comorbidities [ 29, 30].
Less experienced midwives may fail to recognise or escalate care when safety problems arise and they need an ongoing supervision and training for continuous professional career development.
Adherence to simple processes of escalating care as necessary, in line with existing guidelines, would result in safer, more effective treatment [ 32].
However, the purpose of PIERS scoring is to calculate the probability of severe maternal morbidity associated with PE in order to escalate care.
Clinicians are asked to wait 2 to 3 hours prior to escalation of care, however, if they are more concerned, their clinical judgement can override the protocol if a decision is made to escalate care.
Consistent with our focus on the DAS28, results from a preference analysis found that RA disease activity score (also measured using the DAS28) was the most important factor in rheumatologists' decisions to escalate care [ 29].
