Managing Deterioration and Martha’s Rule Programme

About the programme

The aim of the Managing Deterioration and Martha’s Rule Programme is to reduce deterioration-associated harm by improving the prevention, identification, escalation, and response to physical deterioration, through better system co-ordination and as part of safe and reliable pathways of care by 2027.

The two areas of focus for this year’s programme will be:

• Support the implementation of Martha’s Rule
• Work with systems to implement the prevention, identification, escalation, response (PIER) improvement toolkit.

Who we are working with

We will be working with ten teams across eight acute trusts who have been accepted into the pilot phase of Martha’s Rule and colleagues across all three Integrated Care Systems.

Main deliverables

We will support the identified teams to implement Martha’s Rule. Working collaboratively with the local Paediatric Critical Care Operational Delivery Networks (PCC ODNs) and Adult Critical Care Operational Delivery Networks (ACC ODNs), we will use a systematic approach to test and scale up Martha’s Rule.

The model for support will be agreed locally between us and the local ODNs. This will be aided by the release of a roles and responsibilities guide agreed by the commissioners of the PSCs and ODNs.

We will support by:

• Providing expertise and coaching in Quality Improvement (QI) methods.
• Maintaining effective stakeholder engagement with key colleagues
• Bringing together teams and all relevant system stakeholders to nurture learning via a dynamic learning community, webinars, workshops and rapid insights sessions.
• Working with all those involved in this programme (from those site-based to system/region-based), providing a safe space to think, acting as a critical friend and mentor.
• Providing enhanced support to those teams requiring it.
• Supporting systems to use methodologies for sustaining change and improvement, and share the learning across sites, systems, regions and with the National Martha’s Rule and Manging Deterioration Programme team.
• Supporting systems to identify and understand the impact of Martha’s Rule using measurement methods.

In addition, we will support at least one of our three Integrated Care System (ICS) to implement the PIER Improvement toolkit and share the approach and learning across all three ICSs.

How to get involved

Please contact Dr Lizzie Sweeting Managing Deterioration and Martha’s Rule Workstream lead elizabeth.sweeting@yhia.nhs.uk