Celebrating Haelo – Deteriorating Patient Collaborative


It’s day 4 of Celebrating Haelo, and we’re looking back at the Deteriorating Patient Collaborative!

In August 2014, the Deteriorating Patient Collaborative was launched at Leeds Teaching Hospital Trust (LTHT). The collaborative involved 14 pilot wards and the teams were asked to contribute on how they thought avoidable deterioration could be reduced on wards.

In June 2015, five successful interventions were developed and tested at scale across the 14 wards to form an “intervention bundle”. Following this, in March 2016, the collaborative was scaled up across the Trust.

About the programme


Aim: Reduce avoidable deterioration by 50% on pilot wards by October 2015

The structure of the collaborative was based on a breakthrough series model. Between June 2014 and 2015, teams were invited to 3 learning sessions which were combined with action periods.

Plan, Do, Study, Act cycles were continuous throughout the process to develop and test intervention ideas.

The below driver diagram was developed for the programme to demonstrate how collaborative practices would achieve the aim.

Following collaborative learning, the “intervention bundle”, made up of five successful interventions, was developed, which could then be integrated into daily ward working.

The bundle included:

  • High NEWS sticker
  • Treatment escalation plan sticker
  • ‘Obs made easy’
  • Safety huddles
  • Post ‘2222’ call debrief



The intervention bundle has been proven across all collaborative wards to reduce harm and improve the quality and reliability of care. By November 2015 analysis showed a significant step reduction in 2222 calls on the wards, with earlier response to deterioration and earlier identification of patients approaching end of life.

The implementation of the intervention bundle also showed massive statistical changes. Cardiac arrest calls were reduced by 51% on the pilot wards, whilst Trust wide calls were reduced by 24%.

Day 5 of our Haelo celebration will be looking back at Making Safety Visible. Keep up with the conversation on twitter, using @_Haelo #celebratinghaelo


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