Many thanks Heather for sharing very valuable and useful information.
It looks like that the whole team is very well motivated. How did you do it? Do
you have some kind of education for staff. I am amazed that you have done
without any team. It is an achievement given that there are lots of things
going on in our set up.
What is your sepsis 6 bundle compliance? Ours is about 60% for all put together
though for some of the components we have more than 90%.
BW
Mohan Ranganathan, MD, DA, FCARCSI, PGA
Consultant Anaesthetist & lead for sepsis
George Eliot Hospital NHS Trust
Nuneaton
UK
________________________________
From: Heather McClelland <[email protected]>
To: Dr.Mohan Ranganathan <[email protected]>; Imran Aurangzeb
<[email protected]>; sepsis list serve <[email protected]>
Sent: Thursday, 8 August 2013 7:13 AM
Subject: RE: [Sepsis Groups] 80%+ bundle compliance
Mohan,
Here in Yorkshire we have been implementing the sepsis screening
and Sepsis 6 bundle now for about 2 years. We have much enthusiasm, as they
give clear simple protocols that any member of staff can use and we think we
are now seeing better compliance and a reducing mortality.
Our biggest wins have been to implement and monitor closely the
front end first – ED’s, Medical Assessment Units and Surgical assessment unit,
to improve identification and initiation of Sepsis 6. Introduction of
standardised
forms – colourful stickers that are easily identifiable in patient notes.
Continuous monitoring. Clinician involvement – we have had consultant level
involvement across medicine, ED, anaesthetics throughout. Making things easy
for staff – sepsis boxes on each of the ward areas, standardised antibiotic
regimes for sepsis.
We still have some way to go. We have many challenges with
giving large volumes of fluid, and timeliness of treatment, esp. outside the
ED. Not all our clinical teams are enthusiastic, but we aim to do some targeted
implementation with them. We treat anyone who triggers for sepsis, not just
those with severe sepsis, so the workload is high, but with the aim that we do
not ‘fail to rescue’ those who could end up in severe sepsis. And this is all
without
a dedicated sepsis team! Though we would love one.
Heather McClelland
Nurse Consultant - Emergency Care
Calderdale & Huddersfield NHS Foundation Trust
Tel: 07766905556
From:[email protected]
[mailto:[email protected]] On Behalf Of Dr.Mohan
Ranganathan
Sent: 07 August 2013 13:50
To: Imran Aurangzeb; sepsis list serve
Subject: Re: [Sepsis Groups] 80%+ bundle compliance
Dear Imran,
I am impressed with the sepsis bundle compliance of more than 80%
that you were able to achieve within 3 years. I would be very eager to know how
this was achieved since it would be a useful to many of us who were not able to
achieve such a high compliance rate.
You have said in an earlier e-mail about involving team. But any
thing else. Our sepsis bundle compliance was very patchy without any
coordination in the past. Nor there was any formal audit or feedback. We
started formal sepsis bundle implementation a bit late, little more than a year
ago in our hospital. Now we have a team which overseas the implementation. This
involves a hospital lead for sepsis, a lead nurse for sepsis, educationists,
representative from ER and other departments. There are regular educational
programme about sepsis comprising mostly of formal lecture but also bed side
teaching as and when the opportunity arises.
For the last month or so, we started feedback to different teams
about how they have done and how it could be done differently next time. Very
many thanks for your feedback form that you have sent to the group which was
excellent. Please forgive me for using this form without your prior permission
(with modifications to suit us) and I assumed that it was ok with you since you
distributed to the group.
Many thanks to Dr R Daniels, UK who was kind enough to let us use
sepsis 6 and the pathway from his hospital, we have implemented sepsis 6 to
start with. This happened more than a year ago. We do have six hour bundle in
the ICU for sometime even before the formal sepsis bundle implementation as
described above.
May I ask you and others in this group, if anyone is using sepsis
6 as a measure of sepsis bundle or using 3 hr & 6 hr bundle as
recommended by surviving sepsis campaign.
And also I would like to ask you, what is exactly meant by
clinician driven quality?
Many thanks in advance,
Mohan Ranganathan, MD, DA, FCARCSI, PGA
Consultant Anaesthetist & lead for sepsis
George Eliot Hospital NHS Trust
Nuneaton
UK
________________________________
From:Imran
Aurangzeb <[email protected]>
To: sepsis list serve <[email protected]>
Sent: Sunday, 4 August 2013 12:38 AM
Subject: [Sepsis Groups] 80%+ bundle compliance
Intermountain Healthcare has achieved remarkable results
with sepsis bundle compliance (please click on link)
http://imran-aurangzeb.tumblr.com/image/57282638554
Brent James has done this by involving physicians to
lead quality.
Has anyone implemented a model of clinician driven quality?
Has anyone experimented with gainsharing models?
Thank you.
Imran Aurangzeb, MD, FCCP
For individuals, character is
destiny. For organizations, culture is destiny. — Tony Hsieh
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