A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.

<h4>Background</h4>The knowledge, confidence, and skills of healthcare consumers to identify acute clinical deterioration and appropriately escalate concerns remain largely undetermined. This gap is despite the widespread international introduction of consumer escalation systems intended...

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Main Authors: Lisa Thiele, Arthas Flabouris, Campbell Thompson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0319546
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author Lisa Thiele
Arthas Flabouris
Campbell Thompson
author_facet Lisa Thiele
Arthas Flabouris
Campbell Thompson
author_sort Lisa Thiele
collection DOAJ
description <h4>Background</h4>The knowledge, confidence, and skills of healthcare consumers to identify acute clinical deterioration and appropriately escalate concerns remain largely undetermined. This gap is despite the widespread international introduction of consumer escalation systems intended to provide patients and family an avenue to escalate their concerns if worried about deterioration in their own or relative's condition during a hospital stay.<h4>Aim</h4>To explore patient and family knowledge of acute clinical deterioration, and their confidence and perceived barriers to escalating their concerns.<h4>Design</h4>Cross-sectional, in-person, consumer surveys across an Australian acute adult hospital. The study specific survey tool was developed through a multistage process with healthcare consumer input during creation and testing.<h4>Methods</h4>Questions explored healthcare consumer knowledge, confidence, and perceived barriers in association with acute clinical deterioration, recognising deterioration, and escalating concerns. Descriptive and inferential analysis was completed, and knowledge, confidence, and barrier scores established. Association between scores and consumer type, gender, age, education level, prior experience with clinical deterioration or rapid response team review, and hospitalisation history in the last 12 months were assessed using multivariable linear regression.<h4>Results</h4>133 surveys were completed. Knowledge scores varied across respondents. Awareness of the local consumer escalation system was low. A positive association was identified between knowledge and confidence that diminished with increasing barrier scores. A strong negative correlation was present between barriers and confidence. No significant difference existed in knowledge, confidence, or barrier scores based on consumer type, gender, education level, previous experience with deterioration or rapid response team review, or hospitalisation history.<h4>Conclusions</h4>Limitations in patient and family knowledge may impede consumer escalation system success. Increasing knowledge may enhance patient and family confidence to identify deterioration and escalate concerns. However, barriers to consumer escalation decrease this potential. Interventions to increase consumer knowledge should therefore be accompanied by strategies to minimise barriers.
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spelling doaj-art-9322464661464d54b818c17818dde52c2025-08-20T02:33:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01203e031954610.1371/journal.pone.0319546A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.Lisa ThieleArthas FlabourisCampbell Thompson<h4>Background</h4>The knowledge, confidence, and skills of healthcare consumers to identify acute clinical deterioration and appropriately escalate concerns remain largely undetermined. This gap is despite the widespread international introduction of consumer escalation systems intended to provide patients and family an avenue to escalate their concerns if worried about deterioration in their own or relative's condition during a hospital stay.<h4>Aim</h4>To explore patient and family knowledge of acute clinical deterioration, and their confidence and perceived barriers to escalating their concerns.<h4>Design</h4>Cross-sectional, in-person, consumer surveys across an Australian acute adult hospital. The study specific survey tool was developed through a multistage process with healthcare consumer input during creation and testing.<h4>Methods</h4>Questions explored healthcare consumer knowledge, confidence, and perceived barriers in association with acute clinical deterioration, recognising deterioration, and escalating concerns. Descriptive and inferential analysis was completed, and knowledge, confidence, and barrier scores established. Association between scores and consumer type, gender, age, education level, prior experience with clinical deterioration or rapid response team review, and hospitalisation history in the last 12 months were assessed using multivariable linear regression.<h4>Results</h4>133 surveys were completed. Knowledge scores varied across respondents. Awareness of the local consumer escalation system was low. A positive association was identified between knowledge and confidence that diminished with increasing barrier scores. A strong negative correlation was present between barriers and confidence. No significant difference existed in knowledge, confidence, or barrier scores based on consumer type, gender, education level, previous experience with deterioration or rapid response team review, or hospitalisation history.<h4>Conclusions</h4>Limitations in patient and family knowledge may impede consumer escalation system success. Increasing knowledge may enhance patient and family confidence to identify deterioration and escalate concerns. However, barriers to consumer escalation decrease this potential. Interventions to increase consumer knowledge should therefore be accompanied by strategies to minimise barriers.https://doi.org/10.1371/journal.pone.0319546
spellingShingle Lisa Thiele
Arthas Flabouris
Campbell Thompson
A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
PLoS ONE
title A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
title_full A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
title_fullStr A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
title_full_unstemmed A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
title_short A cross-sectional survey analysis of patient and family knowledge, confidence, and perceived barriers to reporting patient deterioration.
title_sort cross sectional survey analysis of patient and family knowledge confidence and perceived barriers to reporting patient deterioration
url https://doi.org/10.1371/journal.pone.0319546
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