Ryan’s Rule is a hospital safety process in Queensland, Australia that lets patients, families, or carers escalate concerns if they feel a patient is getting worse or not improving and staff are not responding adequately. It was created after the preventable death of a young boy, Ryan Saunders, to make sure worries from families are taken seriously and trigger a fresh clinical review.

What is Ryan’s Rule?

  • Ryan’s Rule is a 3‑step escalation process used in Queensland public hospitals (including emergency) and some Hospital in the Home services.
  • It allows any patient of any age, or their family or carer, to request a clinical review when concerned the condition is worsening or not improving as expected.

Why it was introduced

  • In 2007, nearly three‑year‑old Ryan Saunders died from an undiagnosed streptococcal infection that progressed to toxic shock syndrome in a Queensland hospital.
  • A coronial investigation found his death was likely preventable and that his parents’ concerns were not acted on in time, leading Queensland Health to create an escalation system now known as Ryan’s Rule in 2013.

How Ryan’s Rule works (the 3 steps)

Exact details can vary slightly by hospital, but the core steps commonly are:

  1. Step 1 – Talk to the current team
    • Raise your concern directly with the nurse or doctor caring for the patient and clearly say you are worried they are getting worse.
 * Ask for a review or for your concerns to be explained and documented.
  1. Step 2 – Escalate to a senior staff member
    • If you still feel something is wrong or not being addressed, ask to speak to the nurse in charge or a senior doctor on the ward.
 * They can arrange a more urgent review or involve other specialists.
  1. Step 3 – Request a Ryan’s Rule clinical review
    • If you remain unsatisfied or the patient keeps getting worse, you formally “call” Ryan’s Rule (often via a listed ward number, switchboard, or a 13 HEALTH number in Queensland).
 * A senior clinician independent from the original team conducts a prompt clinical review of the patient and their treatment.

When to use Ryan’s Rule (and when not to)

  • Use it when:
    • The patient seems sicker, in more pain, more confused, or is not improving, and you feel your concerns are not being heard or understood.
* Communication has broken down and you need a second, more senior opinion within the hospital.
  • It is not meant for:
    • Complaints about general service issues (e.g., food, cleaning, parking) or purely administrative problems.
* Situations outside hospital care or Hospital in the Home services.

Relation to “Martha’s Rule” and wider patient safety

  • Ryan’s Rule is often discussed internationally as an early model for patient‑ and family‑initiated escalation systems, including Martha’s Rule in the UK.
  • Experience in Queensland shows that most calls are about communication gaps, and that families are unlikely to use the process for trivial issues because invoking Ryan’s Rule takes confidence and persistence.

Bottom note: Information gathered from public forums or data available on the internet and portrayed here.