Sepsis

The sepsis patient safety collaborative aims to measurably improving timely recognition, treatment and chances of survival for patients with sepsis.

Sepsis is a syndrome representing an inflammatory response to an infectious process triggered by an infectious agent (bacterium, virus, fungus or parasite) which is severe enough to cause organ dysfunction. Sepsis affects all age groups and can present in any clinical area.

Sepsis was chosen as one of UCLPartners’ priorities because of its high prevalence and mortality rates, the seriousness of its physical and mental consequences, as well as the potential to significantly improve patient outcomes through appropriate and timely recognition and treatment. An NHS England Patient Safety Alert in 2014 estimated that 37,000 people die from sepsis in England per year, and that reliable delivery of care could save 11,000 lives a year – and £150 million annually. The relevance of this has since been further confirmed by the cross-system action plan “Improving Outcomes for Patients with Sepsis” in 2015 and most recently the UK Sepsis Trust report “The Cost of Sepsis Care in the UK” in 2017.

What are we doing?

We are supporting 13 hospital trusts to improve the care for patients with sepsis, by applying the Institute for Healthcare Improvement Breakthrough Series Collaborative approach. It provides a robust framework for scaled improvement across a variety of teams and multiple organisations. Teams learn from and inspire each other by sharing and adopting measurable and tested improvements, as well as build improvement capability and patient safety leadership, to become foremost providers of safe and equitable sepsis care.

The programme focuses on improving timely recognition of patients with sepsis, immediate referral of patients, timely care delivery, and timely evaluation of the effectiveness and appropriateness of interventions.

Improvements within the collaborative include changes to patient pathways, implementation of innovations, sharing of information, updating of systems and review of medication processes.

What have we done so far?

From September 2015 until June 2017 the collaborative has come together for a series of regular sepsis learning sessions to share improvements as well as develop quality improvement and measurement skills. During this time the 12 sepsis teams totalling 165 people regularly report their sepsis process and outcome measures. All reports are currently being collated and findings will be analysed and released later this year.

The aims for improving sepsis set-out at the beginning of the collaborative were:

  • Improve 30-day survival by 20%
  • Reduce length of hospital stay
  • Reduce the number of patients transferred to critical care

The learning sessions were a great platform for showcasing improvements and learning from others. We are pleased to see how much the sepsis collaboratives improved. Examples of sustained outcomes and improvements are:

  • Sepsis screening in emergency departments at 91-95%%
  • Delivery of antibiotics within 1h following presentation at 76% (up from 46%)
  • Acute in-patient screening at 88% (up from 66%)
  • Acute in-patient anti-biotics within 90 minutes at 91% (up from 46%)

Successful changes to improve the care of patients with sepsis include:

  • Introduction of sepsis grab bags and trolleys
  • New and improved sepsis pathways
  • Development of interdisciplinary deteriorating patient pathways
  • Thorough sepsis training and education for nurses and doctors, including e-learning, simulations and sepsis days
  • New roles for dedicated sepsis and deterioration specialist nurses
  • Training and supporting of sepsis champions
  • In-file sound alerts playing “do the fluid balance chart” every time sepsis folder is opened

Best Patient Safety Storyboard Awards

We would also like to congratulate the following patient safety teams for winning the Best Patient Safety Storyboard Awards:

  • Winner: Luton and Dunstable University Hospital NHS Foundation Trust
  • Runners-up: Barking, Havering and Redbridge University Hospitals NHS Trust, Royal Free London Hospital NHS Foundation Trust, University College London Hospitals NHS Foundation Trust

Read more here.

Collaborative members:

  • Barking, Havering and Redbridge University Hospitals NHS Trust
  • Barts Health NHS Trust
  • Basildon and Thurrock University Hospitals NHS Foundation Trust
  • Homerton University Hospital NHS Foundation Trust
  • Luton and Dunstable University Hospital NHS Foundation Trust
  • Mid Essex Hospital Services NHS Trust
  • North Middlesex Hospital NHS Trust
  • Princess Alexandra Hospital NHS Trust
  • Royal Free London NHS Foundation Trust
  • Southend University Hospital NHS Foundation Trust
  • University College London Hospitals NHS Foundation Trust
  • West Hertfordshire Hospitals NHS Trust
  • Whittington Health NHS Trust

Contact us

Thomas Weijburg – Improvement Manager – Patient Safety Programme

@UCLPartnersPSP