5Rs to Rescue - Phase 2

5Rs to Rescue

In this phase we hope to continue to develop on the work from phase I and co-design interventions to improve the recognition and treatment of deteriorating patients after surgery.

We will work with our local counterparts in Ethiopia, Uganda, South Afric and Tanzania, to identify the main concerns with regards to recognising and treating patients. We can then develop interventions based on these issues and test them to see if they are reasonable (i.e., the staff can maintain a high compliance) and effective.

5Rs to Rescue Intervention

The 5Rs are interventions aiming to tackle each stage of recognising and managing a deteriorating patient following a complication after surgery.

The 5Rs are:

  1. Risk Identification
  2. Recognize
  3. Respond
  4. Reassess
  5. Reflect

ASOS Risk Calculator

For the risk identification stage, we intend to use the ASOS risk calculator to determine whether a patient is at high risk of complications and mortality. This will be calculated by the surgical or anaesthetic team, and relayed to the ward team when patients are transferred.


  • 5Rs to Rescue is currently being implemented in 9 hospitals across Ethiopia, South Africa, Tanzania and Uganda.
  • All hospitals are reliably implementing the first R (risk identification) using the ASOS risk score
  • All hospitals have chosen the early warning system they would like to use for the second R (recognize) to monitor patients. Most hospitals have chosen to use the NEWS2 score or a modified version and a few hospitals have chosen to use the Vital Signs Directed Therapy (VSDT)
  • We are working on implementing “daily huddles” using the visual boards to improve handovers between the night and day teams
  • We are now working on implementing the 3rd R (respond) and the 4th R (reassess) in all hospitals 
Simplified version of the interventions involved in 5Rs to Rescue
To learn more about Phase 3