Sepsis is when the body's response to infection is abnormal
and then damages the body's own tissues and organs.
It can be a very serious disease. Approximately 20-50% of people
who are admitted with suspected sepsis will end up dying within that first admission.
The problem is that it's enigmatic. It can present in a number of different ways
and therefore can be very challenging for busy clinicians to detect.
It can affect patients quickly, so a patient can deteriorate literally in front of your eyes
and so rapid diagnosis and giving the right treatments quickly
definitely improves patient outcomes and it does save lives.
We recognised within Guy's and St Thomas' that we didn't have very robust numbers
on the numbers of patients that we were seeing who had sepsis.
That was a gap in our understanding of the condition.
So we needed a way of measuring what we were doing
and then understanding what we were doing badly in order to improve.
We approached that question by trying to understand how we could
apply some of our electronic data to exactly that problem.
We were asked to provide a clinical decision-making tool
that would aid clinicians in the diagnosis of sepsis and then provide
another tool that would allow clinicians to actually record
the six key tasks that need to be completed in the first hour of diagnosis.
Collaboration and co-creation were key to this project. We work very closely with the sepsis team,
who provided all of the clinical information and requirements for the tools,
but together with our colleagues within DT&I as well, to really get the best product
for our clinicians that would involve using conditional logic and not add towards stress.
It was really refreshing to develop that kind of project with such a team
because we got a whole range of different inputs and different expertise and different insights.
We benefited from working with technologists but also with transformation,
in terms of their ability to think about the quality improvement
and the transformation that would need to support the digital tool.
The screening tool helps by directing clinicians to think about
sepsis as a cause for deterioration, what the source might be,
and therefore what the management is.
So day to day our clinicians enter a lot of data into a lot of different IT systems.
If we can develop ways where they don't have to enter that data yet again,
and run algorithms further, that helps them, because it minimises
their time with the computer and hopefully maximises it with the patient.
So far I'm excited. I think over the July-August period we've captured
a good amount of patients, I think it is showing us that we are making the diagnosis,
I think it is helping us not under-diagnose or over-diagnose, and we get the 'sepsis 6' bundle,
which is a package of care, a pathway of care for a patient,
and we can utilise that package of care as quickly as possible.
It's been received very well by our nursing colleagues on the wards,
it's now embedded in their daily practice, so a lot of the nurses
are doing this as part of their regular thing.
The tool is saving lives, it's stopping patients from deteriorating,
it's triggering treatment quickly, it's stopping our patients from becoming
so unwell that we've missed our opportunity to get treatment into them.
Data is always going to be key to quality improvement. The strength of this approach
is it allows us to capture data on sepsis, it allows us to refine our definition of sepsis,
to understand the cohort and our management, to use standardised definitions
and outcomes in order to benchmark ourselves against other organisations.
What we have also done though is that we went back to those clinicians
who have completed the tool to ask them for their feedback,
to find out what's working, what perhaps needs changing.
We know that collaboration between clinical teams and technical teams
and operational teams is fundamental to success.
These teams enjoy working together and design better pathways.
It's not very often as an IT person you can be involved with
the actual saving of patients' lives. That's a great thing.
Sepsis is a killer, so getting that right, that's why we're here.
And getting it right for staff, this is something that worries staff,
it worries clinicians, being able to treat sepsis promptly and correctly.
So not only does it have a profound impact on both patients and staff
in terms of doing things well, but it also means that as a fundamental
barometer of how we deliver healthcare, outcomes for really important
conditions such as this are absolutely crucial.