Sepsis is the severe end of infection or ‘infection with badness’ and is a massive healthcare problem with high estimated mortality and burden, but one without a gold standard diagnostic test or a stable definition. This has stifled ambitions to understand the scale, improve sepsis care, antimicrobial stewardship/resistance initiatives, to operationally define it and test for the impact of biomarkers. Sources claim there are from 36,000-260,000 cases and 9,000-120,000 deaths in the UK per year.
There has been a pressing need for a credible, reproducible and easily obtainable intelligence tool relevant to those admitted with infection. Such data could be utilised through the application of quality improvement methodologies in organisations and regions seeking to improve their outcomes.
Commissioned by NHS Improvement and NHS England, and working in partnership with The Imperial College Health Partners (ICHP) through the Patient Safety Collaborative, and building on the methodology for measuring sepsis previously published by Oxford Academic Health Science Network (AHSN), the ambition was to create a dashboard that could be accessed by patients, clinicians, managers, data analysts and researchers to identify the infection population and be meaningful in the context of all of these audiences. At the same time, the team wished to showcase the power and importance of the use of data in the right context.
A dashboard tool was developed which enables NHS staff – for the first time ever – to use reliable data to monitor and assess the impact of interventions on deteriorating patients with suspicion of sepsis. It focuses on measurement of interventions, which helps local teams determine which methods work best, and which may need to be spread more widely across their organisation.
- This work has been shortlisted for an HSJ award (September 2018).
- Creation of a national dashboard that anyone could use. It was launched on the NHS’s 70th birthday and has demonstrated substantial numbers of lives saved since the start of national initiatives.
- The dashboard has had strong support from the National Cross System Sepsis board, Public Health England, the Department of Health and front-line clinicians across the country.
- Oxford AHSN has created resources to assist others utilise ‘Suspicion of Sepsis’ (SOS) to measure outcomes.
- 20 acute organisations have used SOS to measure for improvement with support from the project lead, but a gap was identified between the concept and application, which ICHP have overcome by creating an easily accessible online dashboard.
- It has been used by NHS England to assess if the Sepsis Commission for Quality and Innovation (CQUIN), which was focused on improving processes in the early identification and treatment of sepsis, has improved national SOS outcomes.