P RYANS RULE V MARTHAS RULE

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Summary Bullet Points:

Learning from Ryan’s Rule in Australia
By Professor Nitin Kapur

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• Patient-Centric Care:

  • Modern healthcare models emphasize patients as active partners, respecting their concerns and preferences.

  • Patient-activated escalation systems like Ryan’s Rule (Australia) and Martha’s Rule (UK) embody this shift.

• What is Ryan’s Rule?

  • A 3-step escalation system allowing patients, families, or carers to request a clinical review if a patient’s condition deteriorates.

  • Introduced in Queensland after Ryan Saunders’ preventable death in 2007 to enhance timely recognition and response to clinical deterioration.

• Outcomes After a Decade:

  • Over 13,900 activations in Queensland with steadily increasing use.

  • Most calls (52%) did not alter clinical care, but about 2.7% led to urgent escalations, potentially preventing harm.

  • Higher rates of management change seen in pediatric activations.

• Key Learnings:

  • Clear communication and education about the process are crucial; it is an escalation tool, not a complaint mechanism.

  • Language barriers and cultural inequities were mitigated with multilingual resources and culturally tailored materials.

  • Strengthening early communication steps reduced the need for full activations.

• Challenges and Adaptations:

  • Initial fears of patients misusing the system ("weaponizing" it) were largely unfounded.

  • Over time, activation responses shifted from full rapid response teams to specialized Ryan’s Rule teams to better allocate resources.

• Comparison with Martha’s Rule (UK):

  • Martha’s Rule allows both patients and staff to activate reviews, unlike Ryan’s Rule.

  • Early UK data show a higher proportion of activations leading to urgent care changes (~10%) compared to Australia.

• Implementation Advice:

  • Successful rollouts require cultural shifts within institutions, not just procedural changes.

  • Ongoing consultation, feedback, and resource investment are essential for Martha’s Rule to succeed in the NHS.

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Would you also like a "key differences between Ryan’s Rule and Martha’s Rule" table for even quicker reference? 📋

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Here’s a simple comparison table for quick reference:

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Feature	Ryan’s Rule (Australia)	Martha’s Rule (UK)
Who can activate	Patients, families, carers	Patients, families, and staff
Introduced	After Ryan Saunders' death in 2007 (Queensland)	After Martha Mills' death in 2021 (NHS England)
Activation process	3-step escalation through a dedicated number or staff	Direct request for an external Critical Care Outreach Team
Typical outcomes	52% no change; ~2.7% urgent escalation	Early data: ~10% of activations result in urgent intervention
Key focus	Empowering families to raise concerns when deterioration is suspected	Ensuring external review when care concerns arise, even if clinical team disagrees
Support tools	Multilingual resources, culturally tailored materials	In early rollout phase; emphasis on awareness and access planned
Challenges	Early concern over misuse (not realized); resource allocation for responses	Anticipated challenges in capacity, training, and cultural change within NHS

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Would you also like a quick pediatrician-specific takeaway version (e.g., 1–2 lines) for sharing in a group chat? 📱

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"Ryan’s Rule (Australia) and Martha’s Rule (UK) empower families — and now staff — to escalate care when deterioration is suspected. Early data shows these systems can catch critical cases early, but success depends on team culture, training, and clear communication."

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Here are alternative phrasing options depending on the tone you want:

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🔵 Casual/Supportive:
"Ryan’s Rule and Martha’s Rule remind us: families often spot early deterioration. Empowering them — and staff — to escalate saves lives when team culture supports it."

🔵 Urgent/Call to Action:
"Don’t wait for formal signs of decline. Ryan’s Rule and Martha’s Rule show that when families and staff are empowered to escalate concerns early, critical outcomes can improve dramatically."

🔵 Academic/Professional:
"Ryan’s Rule and Martha’s Rule illustrate the vital role of family- and staff-activated escalation pathways in early recognition of clinical deterioration, emphasizing the need for cultural, educational, and systemic support."

🔵 Ultra-brief (for a text blast):
"Empowered families and staff = safer patients. Ryan’s Rule & Martha’s Rule are models for early escalation saving lives."

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Would you also like a short infographic idea for posting or sharing visually? 🎨📊 (It would fit nicely if you're planning to spread this further!)

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Here’s a simple infographic idea for sharing visually:

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🏥 Spot Early. Act Early. Save Lives.

Ryan’s Rule (Australia) & Martha’s Rule (UK)

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👩‍⚕️ What?

• A 3-step pathway (Ryan’s Rule) or direct outreach (Martha’s Rule) to escalate concerns about patient deterioration.

🧑‍🤝‍🧑 Who can activate?

• Ryan’s Rule: Families, carers

• Martha’s Rule: Families, carers, and staff

🛎️ Why?

• Empower early action when patients show subtle signs of decline.

• Bypass hierarchy when urgent review is needed.

• Proven to catch critical cases earlier.

📈 Impact:

• Australia: ~2.7% urgent escalation after Ryan’s Rule calls.

• UK Early Data: ~10% Martha’s Rule activations needed urgent intervention.

🛡️ Key to success:

• Supportive team culture

• Clear communication

• Family and staff education

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✨ "Empower families and teams to notice early, speak up early, and act early."

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Would you like me to sketch a very simple text-based visual layout too (e.g., showing how you could arrange this in Canva or PowerPoint)? 🎨🖌️
It could save you a few minutes if you're making a poster!

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