CRF: From Clinical Deterioration to Policy Failure - Continuity Risk Framework

Preventable harm in complex clinical systems most often arises from breakdowns in recognition, communication, and response processes rather than from deficits in clinical knowledge or technical capability (Agency for Healthcare Research and Quality [AHRQ], 2023). This work introduces Continuity Risk Framework (CRF) - a nine-stage mode framework - Detection, Recognition, Interpretation, Prioritization, Communication, Escalation, Action, Reassessment, and Validation - that defines the required sequence of functional transitions through which early risk signals must pass to achieve timely intervention and harm prevention. CRF emphasizes continuity, feedback, and closed-loop monitoring as central determinants of patient safety (World Health Organization [WHO], 2022).