Royal Liverpool and Broadgreen University Hospitals NHS Trust a Global Digital Exemplar (GDE) Trust, e-sepsis programme has recently been included as part of NHS England’s long term plan.
The programme is one of a series that is being rolled out across the country through the adoption of toolkits, known as blueprints, which allow any NHS hospital to implement improvements quicker and more easily to transform care and improve services for patients and staff.
E-sepsis is a tool designed to increase screening for sepsis and the antibiotics that follow. The programme sees the merging of a number of clinical procedures, including patient observations and laboratory results.
It automatically alerts clinicians when it detects a patient with sepsis – removing the need for manual intervention and prompts clinical action. E-sepsis ensures that screening for sepsis happens automatically, regardless of ward, time of the day or clinician looking after the patient.
Sepsis is monitored at individual, ward and Trust level – so at any point in time, the Trust has a complete view of the care of sepsis patients, and importantly are able to identify them as having sepsis much earlier. Up to 200 lives a year have been saved through e-sepsis at the Trust.
Dr Paul Fitzsimmons, deputy medical director said: “With e-sepsis, we have seen a major impact on sepsis care with lives saved. These are patients with confirmed sepsis where the clinician may not have considered sepsis as a diagnosis. In some cases, it would have been impossible to make a diagnosis of sepsis without the help of e-sepsis. By producing automated sepsis alerts from clinical information from multiple sources we are treating septic patients both faster and more effectively – helping our clinicians prioritise doing the right things first and reducing death rates in severe sepsis.”
The e-sepsis tool has been developed internally by the Trust’s digital team and works seamlessly with other systems in use by the Trust. As a result of implementing the e-sepsis tool, combined with electronic observations and lab results, there are some remarkable improvements in managing sepsis:
- Screening for sepsis is consistently now at 100% for the Emergency Department (ED) and wards.
- The giving of antibiotics to patients with sepsis within 1 hour has increased to 90% in ED and 60% on wards.
- The death rate for sepsis has reduced from 23.17% to 22.92%, severe septic shock from 55.3% to 43.62%, and severe sepsis from 46.47% to 38.21%.
- The death rate for septic shock in under 45s has reduced from 60% to 7.69%.
E-sepsis has also created other operational benefits, including:
- Reduction in unnecessary types of care: identification of sepsis is no longer dependent on where the patient is within the Trust and who they see.
- Reduction in length of stay: an estimated 750 bed days will be saved per year, delivering quality and cost efficiencies for the Trust.
- Improved bed occupancy rates.
- Optimised roles: e-sepsis has dramatically lightened the burden of reporting, freeing up nurses to focus on care rather than on data collection. E-sepsis has also brought forward how the Trust manages sick patients and discussions are in progress as to how ward manages rota sepsis specialists.
- Improved patient satisfaction: the improved patient outcomes resulting from the e-sepsis initiative boost the satisfaction of our patients and their families.
- Increased opportunities for patient engagement in clinical trials: the retrieval of patient records electronically enables suitable patients to be identified as potential candidates to receive ground-breaking treatment.
Aidan Kehoe, chief executive, said: “Combining an approach to quality and safety with digital transformation, e-sepsis has transformed our approach to sepsis care. Through staff continually ‘thinking sepsis’ with innovative digital tools, we are improving the lives, treatment and outcomes of our patients. Through the GDE programme, we have developed a blueprint to enable other Trusts to use and benefit from this e-Sepsis decision support tool and approach. I am incredibly proud of this fantastic work that has been delivered by our talented clinical and digital teams.”