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IN-DEPTH: SEPSIS


American Medical Informatics Association in November 2019, the study is the first of a digital sepsis alert in a NHS trust and the largest undertaken anywhere to date. “Our study shows for the first time that robust analysis of a digital alert system was associated with improvements in outcomes for patients and the system presents an opportunity to improve care for patients who may have sepsis,” says Dr Kate Honeyford of the Global Digital Health Unit at Imperial College London and lead author of the study. The alert system and care plan were piloted in selected areas within the hospital: emergency departments and acute and haematology wards at Charing Cross, Hammersmith and St Mary’s hospitals. Between October 2016 and May 2018, there were 21,000 alerts and patients who triggered the alert had 24 per cent lower odds of dying in hospital and a 35 per cent increased chance of


receiving timely antibiotics than patients who did not benefit from the system.


STAYING PATIENT-FOCUSED Sepsis became the central focus of one of the Trust’s first ‘big rooms’ in 2017. (Big rooms are multidisciplinary weekly meetings focused on improving specific care pathways; they are a key element of ‘flow coaching’.) The sepsis big room worked to improve the sepsis care pathway across the Trust – in part through the implementation and improvement of the digital alert and care plan. The big room approach helped achieve steady improvement.


“Each week we would begin with a story about a patient told by a staff member after interviewing them,” Kate adds. “These stories were the foundation of the quality improvement work we did and contributed largely to the development of the system.”


LOOKING AHEAD


Changes to the pathway have largely been behind the scenes, with patients unaware of the alert unless it leads to a diagnosis, but it has prompted more conversations about sepsis. “More patients are surviving sepsis at our hospitals and it is testament to the alert and treatment plans,” says Dr Anne Kinderlerer, consultant rheumatologist at the Trust and co- author of the study. “Our plan is to roll this alert out across the Trust in different health specialties so that we can further reduce the toll and impact that sepsis has on our patients.”


FOR MORE INFORMATION


To learn more about how you can get involved with the sepsis big room please contact imperial.flowcoaching@nhs.net


“ Patient stories were the foundation of the quality improvement work we did and contributed largely to the development of the system.”


Dr Kate Honeyford of the Global Digital Health Unit at Imperial College London


Spring 2020


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