Sepsis claims 44,000 lives annually in the U.K, and costs the NHS an estimated £2.5 billion.
Early intervention with the Sepsis Six certainly saves lives, but has also been shown to reduce length of hospital stay and need for Critical Care admission. Fixing your organization’s response to sepsis will save an extra 100 lives per year for a typical medium-sized DGH, and £1.25 million annually; just by getting the basics right.
Who do I need to engage in my organisation?
The first thing is to get the right people together. A good change team will include people with influence, will, passion, initiative and determination- ‘doers’ as well as thinkers.
A typical sepsis team might include nursing and medical staff from Patient Safety, Critical Care, Acute and Emergency Medicine, Microbiology and Infectious Diseases, and a key person to make things happen, like a Clinical Director.
The best change teams will throw people together who wouldn’t normally share ideas.
Your team will need to present a case for change – a model business case can be Click Here. Such a document will be essential to get Board members on board, and you’ll need to do this to drive change! It may also help to highlight the recent Parliamentary Health Service Ombudsman’s report www.ombudsman.org.uk/time-to-act.
Outline-business-case-options-HoEFT.docxWhat do I need to measure and improve?
Your change team, supported by your board, will now need to plan what you want to achieve.
We’re working with NHS England to set standards upon which to measure and accredit clinical teams and systems for sepsis management. For now, though, you’ll simply need to decide what to measure and improve: a sensible duet of metrics is:
- How many eligible patients are screened for sepsis? (e.g, denominator: Number of patients triggering on MEWS/NEWS, numerator: number actually screened)
- How many patients with sepsis receive antibiotics within one hour? (denominator: number of patients with sepsis, numerator: number receiving first-hour antibiotics)
How do we implement the change?
Now for the hard part: strategic planning. Small steps of change using a plan-do-study-act cycle work best, and benchmarking high-performing clinical areas can accelerate change.
Your organization might decide to appoint specialist sepsis nurses, to automate sepsis recognition with electronic systems, to invest in human resources for measurement, or might innovate! There’s no right or wrong solution provided improvement results, and we’ll post some examples of successful programmes here soon!
This academic briefing covers incidence, mortality and economic costs of sepsis together with clinical and cost-effectiveness of interventions and improvement strategies. Use it to satisfy your own curiosity or to persuade others! It may even help to inform a business case for service development- an outline example of which you can find here.
On our Toolkits page you will find additional information that will inform your knowledge.