A nurse going through the Ryan's Rule brochure with a patient and their mother.
No matter your age or condition, every Queenslander has the right to ask for help and Ryan’s Rule makes it easier if health care concerns arise in a hospital setting.
Ryan’s Rule is a three-step process that enables patients, families or carers to raise concerns about a patient if their condition is believed to be deteriorating or not improving as well as expected.
Firstly, patients, families or carers are encouraged to discuss their concerns with their doctor or nurse.
If they are not satisfied, then they progress to step 2, talking to the nurse in charge of the shift.
If they are still not satisfied, they can call 13 HEALTH and request a Ryan’s Rule to enact a clinical review of the treatment they are receiving.
Ryan’s Rule has been in place since 2013, in response to the tragic death of Ryan Saunders. Sadly, Ryan died in 2007 from an undiagnosed streptococcal infection, which led to toxic shock syndrome.
His parents felt their concerns were not heard as Ryan’s condition worsened.
As a result, Queensland Health made a commitment to introduce an escalation process to reduce the possibility of a similar event happening again, and Ryan’s Rule came into being.
Today, Ryan’s Rule is considered the gold standard for patient-led safety and has been used more than 17,000 times in the state’s public hospitals.
Queensland Health Executive Director Kirstine Sketcher-Baker said the rule applies to all patients, not just children, that are admitted to any Queensland Health public hospital, including the emergency department, and some Hospital in the Home services.
“Some people believe the rule is only for children because Ryan’s Rule was named after a little boy, and there is a picture of him on the back the brochure,” Kirstine said.
“This rule is for everyone because any patient within a hospital can deteriorate. This provides a clear way to get attention if staff are not necessarily aware of new symptoms or concerns.
“Family members and carers can escalate on behalf of their loved ones because sometimes patients don’t feel comfortable ‘making a fuss’ about their health condition.
“Patients and parents are the expert in the room when we talk about baseline health status and clinicians change every eight or so hours.”
Kirstine said she was an advocate for Ryan’s Rule to support patients in knowing how, and feeling confident, to discuss their concerns and ensure patient safety.
“I firmly support patients in feeling confident to flag with any clinician if they are concerned that their condition or the condition of their loved one is getting worse,” Kirstine said.
“It is really important for adult patients and parents to communicate with clinicians if their symptoms are changing, and it really important for clinicians to listen and act.
“We want everyone who comes to our hospitals to know about this process, and welcome patients or their families to ask questions about the care we’re providing.”
Kirstine said it had been a privilege for her and her team to work with Ryan’s parents, consumers and clinicians in creating and implementing Ryan’s Rule, and see the rule work as intended across the state’s hospitals.
“Ryan’s Rule has made a significant contribution to making patients feel heard and respected, and maintaining their safety while recovering from their respective health conditions,” Kirstine said.
“Queensland Health has received countless messages of feedback claiming their family member was saved due to Ryan’s Rule.”
Ryan’s Rule has also served as a model for the United Kingdom’s Martha’s Rule, which has been implemented in more than 100 hospitals across England.
How to initiate Ryan's Rule
- Talk to a nurse or doctor about your concerns. If you are not satisfied, go to the next step.
- Talk to the nurse in charge of the shift. If you are not satisfied, go to the next step.
- Phone 13 HEALTH (13 43 25 84) or ask a nurse to call the number for you and request a Ryan’s Rule clinical review. You will need to provide the following:
- hospital name
- patient’s name
- ward and bed number (if known)
- your contact number.
Once Ryan's Rule is enacted, a clinical review of the patient and treatment they have received will be undertaken.
When not to use Ryan's Rule
Ryan’s Rule should only be used for concerns related to the patient’s condition getting worse or not improving as expected.
It is only used while the patient is in hospital or receiving care via a Hospital in the Home service.
It is not for general complaints. For general complaints, visit complaints and compliments about health services.
For more information, Ryan's Rule | Health | Queensland Government