Interventions to increase patient and family involvement in escalation of care for acute life threatening illness in community and hospital settings


Key points

  • Increasingly patients are encouraged to become active partners in improving the safety, quality and efficiency of health service delivery
  • One such contributory role is patient involvement in escalation of care for acute (serious) life threatening conditions (i.e. helping secure a step-up to urgent or emergency care)
  • This Cochrane review assesses the effectiveness of different interventions designed to increase patient and family involvement in escalation of care

Background to the project

Service users and families have a valuable role in recognising signs of acute illness and helping to secure timely and appropriate help from professionals, however, this role is often difficult to undertake in practice. Research into the effectiveness of interventions aimed at patient and family involvement in safety has often focused at the patient level rather than at the point of interaction between patients and staff.

An overview of the research study

This Cochrane review will focus not only on the evidence base for interventions designed to help service users and families contribute to their safety, but whether these interventions enable an appropriate response from health professionals, and the influence of context on outcomes. The review focuses on the negotiation work that patients and families undertake across the emergency care escalation pathway, once contact has been made with healthcare professionals. It includes patients presenting with new onset of conditions as they make contact with community health and hospital services for urgent / emergency care and timely treatment, and patients already in the healthcare system who are negotiating a step up in care to receive urgent / emergency treatment

Research team

Dr Nici Mackintosh - SAPPHIRE, University of Leicester
Prof Jane SandallKing’s College London
Prof Nick SevdalisKing’s College London
Dr Rachel DavisKing’s College London
Dr Sophie WilsonKing’s College London
Dr Abigail Easter King’s College London
Dr Mary AdamsKing’s College London
Hannah Rayment-Jones King’s College London


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