Managing clinical deterioration

If you would not be surprised if your patient died in the next 6 to 12 months, you should review current treatment and planning so your patient receives optimal care.

Responses to clinically deteriorating patients rely on:

  • Your knowledge of the patient and their needs
  • Available treatment options; as well as
  • Location and availability of support services

Consider the following:

  • Referral for specialist assessment if symptoms or needs are difficult to manage
  • Review or develop current and future care goals / plan with the patient, their Substitute Decision Maker (SDM) - which may be someone beyond the immediate family, and family
  • Review the patient’s wishes for future reference. See advance care planning
  • Document an agreed care plan, including what to do if the patient deteriorates (hospitalisation avoidance)
  • Organise a case conference to ensure that the patient, family and other paid health providers are 'all on the same page'

The trajectory to death varies greatly between patients. It is important to approach each case proactively.

Helpful resources

Page updated 22 May 2017

palliAGED is funded by the Australian Government Department of Health.