title: Raising the Alarm: A Cross-Sectional Study Exploring the Factors Affecting Patients' Willingness to Escalate Care on Surgical Wards.
abstract: BACKGROUND
  Delays in escalation of care for patients may contribute to poor outcome. The factors that influence surgical patients' willingness to call for help on wards are currently unknown. This study explored the factors that affect patients' willingness to call for help on surgical wards; how patients call for help and to whom; how to encourage patients to call for help, and the barriers to patients calling for help.
  
  
  METHODS
  A cross-sectional study was conducted in three London hospitals using a questionnaire designed through expert opinion and the published literature. A total of 155 surgical patients (83% response rate) participated.
  
  
  RESULTS
  Patients were more willing to call for help using the bedside buzzer or by calling a nurse compared to a doctor (p < 0.001). The prompts to calling for help patients were most likely to act on were bleeding and pain. Patients were more willing to call for help if encouraged by a healthcare professional than a relative or fellow patient (p < 0.01). Patients were more likely to worry about taking up too much time when calling for help than being perceived as difficult (p < 0.001). For some prompts, male patients were more willing to call for help (p < 0.05).
  
  
  CONCLUSIONS
  This is the first study to identify factors affecting patients' willingness to call for help on surgical wards. Interventions that take these factors into account can be developed to encourage patients to call for help and may avoid delays in treatment.
authors.affiliation: Patient Safety Translational Research Centre, Department of Surgery & Cancer, Imperial College London, London, W2 1PG, UK, m.johnston@imperial.ac.uk.
authors.forename: Maximilian J
authors.initials: MJ
authors.lastname: Johnston
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Davis
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
authors.forename: Dominic
authors.initials: D
authors.lastname: King
authors.forename: Yannis
authors.initials: Y
authors.lastname: Reissis
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006470:Hemorrhage / Q000523:psychology*; D006761:Hospitals; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult