From the outset, we knew that getting the Sepsis Six delivered reliably had to be about winning hearts and minds. Performance measures and improvement methodology, while great in encouraging competition and delivering Board-level goals, would only be a part of the answer as any new drive would be competing for space with existing metrics. We had to make the Sepsis Six a coffee-room word, and make folks want to do their bit..

Early versions of Survive Sepsis were fine in content but dull in delivery. The complexity of the care bundles still existed, and this came through in the teaching. We looked at the ALERT course as a comparator: commercial, not overly cheap, and support by aging white-on-blue Powerpoints and a monochrome spiral bound manual. We had to do better for sepsis. The next step: to make Survive Sepsis sexy…

We’d had interest in Survive Sepsis from other hospitals, so set about creating an exportable product. I’m not ashamed to say that for the first year we had industry funding from 4 companies manufacturing medical equipment and drugs (equal modest sums from Vygon, Edwards, Lilly and Baxter). If we hadn’t, we wouldn’t be where we are today. We built a fancy and enticing website (which disappeared 2 years later when the web builder was taken over by venture capitalists- learning point!) around our new ‘brand’, created corporate presentations and group work toolkits, and designed and printed a glossy, full colour course manual. The latter wasn’t hi-tech; it was a Poweproint presentation, put together over a couple of late nights at Tim’s house. Katy made it look pretty, and Survive Sepsis proper was born as the ‘official training programme of the Surviving Sepsis Campaign’.

Things weren’t all rosy during these early years. My marriage was breaking down, my wife was in hospital for long periods, and I was juggling long hours with distant hospital visits, trying to spend quality time my kids and my emerging mission on sepsis. It was tough, but looking back I think it resolved me even more to try to do the very best I could with the limited skills I had. I think- I hope- I still live by that today. Thankfully my (now ex-) wife survived, is a wonderful Mum, and we work together to do our best for the kids.

Early adopters of Survive Sepsis included hospitals in Wolverhampton, Coventry, Bolton, Wythenshawe and Manchester. Soon, Survive Sepsis had spread such that over 60 hospitals across England and Wales were providing the non-profit training. Wales were amazing, and through Dave Hope, Chris Hancock and the Saving 1000 Lives team soon all Welsh hospitals knew sepsis. I know that, because I’d visited most of them. That’s the thing about trying to effect large-scale change; it doesn’t happen by accident or just by design. It takes hard slog, sacrifices and lots and lots of driving.

We were starting to get somewhere, but recognized that to really embed improved sepsis care the next step was to get some evidence behind the Sepsis Six.

Now I’m no researcher, so the 3 months painstakingly filling in a National Institute for Healthcare Research grant application didn’t fill me with excitement. Nonetheless, it had to be done, and in 2007 we were awarded a modest £58k to set out to prove the Sepsis Six worked. Two years later (published online in 2010 and in print in 2011), and the countries’ first Sepsis Nurses (Clare and Georgina), sharing one full time post, had done it: and how! A robust prospective observational study, with comparable groups, showed that the Sepsis Six was not only associated with a more than 50% improvement in survival, but also that it facilitated the whole process through to Critical Care. Through this work, the national campaign- the campaign beyond education- began to flourish. More about that in my next post..

by RDaniels

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