“ Worried They Are Getting Worse? ”
Suzanne Glover
A Simple Question That Can Make a Big Difference Proactively asking parents, families and carers if they are worried their child is getting worse is now part of the Standard Paediatric Observation Chart (SPOC) across NSW. This clinician proactive escalation prompt is designed to ensure parental, family, carer concerns are heard early and acted on. The question “ Are you worried they are getting worse? ” is asked by clinicians during routine observations. It doesn ’ t replace existing escalation
systems like REACH but strengthens early detection of clinical deterioration by creating an earlier opportunity for parents, families, carers to raise concerns before a child ’ s condition deteriorates further.
This is part of the Clinical Excellence Commission (CEC) Deteriorating Patient Safety Net system informally known as the Between the Flags system which includes standard calling criteria, clinical emergency response systems, education and evaluation. In addition, this change is backed by growing evidence. Recent research from Monash Health demonstrated that parent, family and carer concern is often the earliest and most accurate indicator that something isn ’ t right, sometimes even before changes in vital signs appear (reference below).
NSW Health has also updated the “ We are here for you ” webpage with new resources to support families and carers to inform them regarding the change.
For more information, please contact : Suzy Glover MHDA Standard 8 Lead at Suzanne.Glover1@health.nsw.gov.au
MHDA Standard 8 Recognising and Responding to Acute Deterioration
Qi Wang CNC and Jamie Jeon CNE from Brolga which has been championing this initiative
https://youtu.be/KPyqlOWMSWc
Page 17| NSLHD Mental Health Drug and Alcohol News | August 2025
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