Problem Statement

International research has identified that families often note changes in their family member’s condition before health professionals. Local research commenced in 2015 identified that our patients and their whaanau supported the development of a Call for Concern service. This coincided with the Health Quality and Safety Commission’s Deteriorating Patient Programme: having patient and whaanau escalation mechanisms is a key step in this programme, which aims to reduce harm from failure to recognise and respond to patient deterioration.

In 2016, we introduced the Call for Concern programme in our adult inpatient wards. 

What are we trying to achieve?

Our goal is to provide a clear, accessible and responsive pathway for patients and whaanau to escalate their concerns about deterioration in their own or their whanau member’s condition, if they believe these concerns have not been heard by ward medical and nursing staff.

What have we done?

Following an initial pilot in 2016, the Call for Concern service (offered by the Patient at Risk team) is now in 17 adult inpatient wards. By October 2019, it will be established throughout all adult inpatient settings at Middlemore Hospital.

In 2018, following a review and analysis of referrals to the service, it was noted that the number of Maaori and Pacific patients and their whaanau using the service did not reflect our population. We then collaborated with the Maaori and Pacific units to ensure our service was responsive to their needs.

What did we find?

From 1 July 2018 to 10 June 2019 we have received 30 Call for Concern referrals. Of these, 22 were from family, six from patients and two from staff. Most used the 0800 number to contact the service.

Collaboration with the Maaori and Pacific units has led to an increase in the number of referrals from Maaori patients and their whaanau. Call for Concern referrals, based on ethnicity, are outlined in the chart below.


How did we make a difference?

Yes, we made a difference. Our data shows the Call for Concern service helps reduce inequity. By addressing patient and whaanau concerns in a timely manner, it improves their confidence in the healthcare we provide to our community. 

Where to from here?

We will now:

  • continue to promote the service organisation wide
  • explore ways to further promote awareness of the service
  • collaborate further with the Maaori and Pacific units, to ensure our service is meeting their needs
  • formally evaluate the type of calls being received to determine if the Patient at Risk team is the most appropriate team to respond to all of these calls.

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