RT Journal Article
SR Electronic
T1 113 Improvements in sepsis care
JF BMJ Leader
JO BMJ Leader
FD BMJ Publishing Group Ltd
SP A43
OP A43
DO 10.1136/leader-2019-FMLM.113
VO 3
IS Suppl 1
A1 Penrose, Nicola
A1 Knightly, Sally
YR 2019
UL http://bmjleader.bmj.com/content/3/Suppl_1/A43.1.abstract
AB 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 championsSepsis intranet page, e–learning and face to face education packagesChanges to IT system to ask about sepsis at triage and if patients score on NEWS2Fortnightly sepsis microsystem meetingsSepsis lead visible and accessible for direct feedbackKey ED staff identified to encourage use of sepsis screening tool at triageTests of change introducing new ways of working when successful such as escalation stampsSepsis 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.