Patients, carers and families
On this page you will find resources and answers to frequently asked question for patients, carers and families. The information is intended to help understanding and engagement with the Between the Flags program.
The Clinical Excellence Commission (CEC) works to establish trusted and respectful relationships with patients, carers, and families, through the Partnering with people program. The aim is to enable people to feel safe, empower their voice and support a sense of agency.
What is 'Between the Flags'?
The 'Between the Flags' system helps healthcare staff to recognise early signs when a patient becomes more unwell and to respond appropriately. The system was developed by the CEC and mirrors the way Surf Life Savers keep watch over us at the beach to ensure we remain safe.
How does Between the Flags work?
In New South Wales, we use the 'Between the Flags' observation charts which can be a paper form or viewed on a computer. The healthcare staff will regularly record your breathing and heart rate, blood pressure and temperature on the chart as well as other observations. The observations are graphed on colour-coded observation charts so the healthcare staff can quickly see if you are getting worse and can get additional help.
What are the different colours on the charts?
Blue, yellow and red coloured zones are used on the Between the Flags observation charts and have different levels of response.
- If a patient's observations are in the Blue Zone, they may be unwell and the healthcare staff will monitor them more closely.
- If a patient's observations are in the Yellow Zone, they may be more unwell and the healthcare staff may call a doctor or senior nurse/midwife to complete a Clinical Review assessment. A Clinical Review means that the patient will be seen within 30 minutes to ensure that they are safe.
- If the observations are in the Red Zone, the patient may be seriously unwell and the healthcare staff will call a Rapid Response. This means that a team of experienced staff will come to the patient's bedside quickly.
A brochure is available in a range of languages to provide information on Between the Flags.
Between the Flags – keeping patients safer: Information for patients, carers and families
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Please note that Between the Flags is a registered trade mark of the CEC.
What can I do if I notice a change in myself or someone I know in hospital?
If you see a worrying change first talk to the nurse, midwife or doctor. If you are still worried, ask to speak to the person in charge and request a 'Clinical Review'. A Clinical Review means that the patient will be seen within 30 minutes by a senior staff member to assess and ensure that they are safe.
If you are still worried, call your hospital's REACH number. You can find the number on REACH posters or flyers at your hospital.
What is 'REACH'?
REACH is a system that helps patients, carers and their family escalate their concerns with staff about worrying changes in a patient's condition. It stands for Recognise, Engage, Act, Call, Help is on its way.
REACH was developed by the CEC in collaboration with local health districts and consumers. It builds on the surf life‐saving analogy for recognition and appropriate care of deteriorating patients by encouraging patients, carers and their families to 'put their hands in the air' to signal they need help.