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 Click Here to view my calendar! <https://www.google.com/calendar/embed?height=600&wkst=1&bgcolor=%23FFFFFF&src=imranazeb%40gmail.com&color=%232F6309&src=nekttaiicudsjluqlfuv519lslsc6fc5%40import.calendar.google.com&color=%23182C57&ctz=America%2FLos_Angeles> My facebook <https://www.facebook.com/imran.aurangzeb> My LinkedIn <http://www.linkedin.com/pub/imran-aurangzeb/39/b1a/223> My Resume <http://prezi.com/tru2ozkp9cq8/resume/> _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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