Patients admitted to hospital with acute illness deserve the best possible care and need to feel confident that if their condition deteriorates they will receive prompt effective treatment. Unfortunately, there is evidence to the contrary indicating that there can be failure to recognise patients at risk or who are deteriorating. The failure to recognise and respond to acute patient illness and deterioration results in severe consequences for patients.
The National Institute for Health and Clinical Excellence (NICE) published NICE clinical guideline 50; Acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital in July 2007. The report contained practical guidance with recommendations for the measurement and recording of a set of physiological observations, linked to a ‘track and trigger’ system. There was emphasis on the importance of a full clinical assessment and the need for improved training in the necessary competencies.
The RRAPID approach is now taught throughout all years of the MBChB curriculum at the University of Leeds. It uses simulation based methods to allow medical students a safe environment to acquire and practice the skills required in recognising and responding to the acutely ill and deteriorating patient.
The principles not only encompass the management of the episode of acute illness but also encourages the students to determine how the episode could have been prevented and the longer term management objectives. Within the curriculum RRAPID encourages the students to learn the physiology of health and the pathophysiology of illness in the context of acutely ill patients. There is the opportunity to practice clinical assessment, communication skills, decision making, infection prevention, time management, patient safety and prescribing in the protected environment of simulated scenarios.