113 Improvements in sepsis care. (3rd November 2019)

• Record Type: Journal Article
• Authors: Penrose, Nicola; Knightly, Sally
• Is Part Of: BMJ leader. Volume 3(2019)Supplement 1
• Page Start: A43
• Page End: A43
• Publication Date: 2019-11-03
• Subjects: Medical personnel -- Periodicals; Leadership -- Periodicals; Medicine -- Practice -- Management -- Periodicals; Health services administration -- Periodicals; 610.68
• DOI: 10.1136/leader-2019-FMLM.113
• Languages: English
• ISSNs: 2398-631X

Abstract

Abstract : The Royal Oldham Hospital is an acute site with a Cat 1 Emergency Department serving a population of 235, 000. In 2018–19 there were 110, 000 ED attendances with 30, 000 emergency admissions. With over 1500 patients admitted each year with sepsis and around 1 in 5 (20%) dying in hospital sepsis is a high volume, high mortality and high impact condition. A multi-disciplinary sepsis steering group was set up chaired by a sepsis lead clinician with input from key clinical areas along with quality improvement team. Worked with Advancing Quality Alliance using a sepsis measure set to track care. Strong, enthusiastic, leadership backed by senior support and evidence based quality improvement methodology allowed us to embed a number of changes. Involvement of all staff groups and specialities has led to a change in culture where staff now consider sepsis early in a patients journey and know how to escalate and treat sepsis. Sepsis champions Sepsis intranet page, e–learning and face to face education packages Changes to IT system to ask about sepsis at triage and if patients score on NEWS2 Fortnightly sepsis microsystem meetings Sepsis lead visible and accessible for direct feedback Key ED staff identified to encourage use of sepsis screening tool at triage Tests of change introducing new ways of working when successful such as escalation stamps Sepsis data was collected throughout the year for the AQuA measure set and national CQUIN. Target for AQuA was 75% of measures achieved and this was met. 2018/19 CQUIN data showed improvement for patients receiving antibiotics within an hour from 70% in Q1 to 86% in Q4 in ED and from 75% in Q1 to 91% in Q4 for inpatients. Cultural change within TROH backed by specific system changes with senior support means that patients at risk of sepsis are identified, assessed and treated in a timely manner. Empowering staff to identify risk of sepsis and appropriately escalate and treat means both patients and staff benefit.