Surviving sepsis: Making best care routine, at scale Northumbria Healthcare NHS Foundation Trust

Sepsis is a life-threatening condition caused by the body’s immune response to infection. Without quick treatment, it can lead to organ failure, septic shock and, in 35% of cases, death. Sepsis currently claims 44,000 lives annually in the UK and places a significant economic burden on the NHS, with around 70% of patients needing treatment in critical care units.

This project aimed to save lives by improving timely recognition and treatment of sepsis using evidence-based techniques, and build understanding of what contributes to avoidable deaths in an acute health care organisation.

A key goal was to increase use of the ‘Sepsis Six' care bundle, which involves three diagnostic and three therapeutic steps delivered within one hour of diagnosis. Although this proven technique had previously been applied in emergency and critical care units, this project involved extensive implementation across all hospital wards within Northumbria Healthcare NHS Foundation Trust.

Staff at all levels were trained to act quickly if sepsis was suspected, with nominated ‘sepsis champions’ leading and supporting ward teams through the change process. Weekly reporting and ongoing audits measured compliance with Sepsis Six delivery, allowing ward teams to receive rapid feedback on their performance and identify areas for improvement.

Outcome evaluation was carried out by the North East Quality Observatory Service, using data collected on patients with sepsis, length of stay and mortality, and bundle compliance.

Despite the challenges of busy winter months and service reconfigurations, compliance with Sepsis Six rose from 1% in April 2014, to 62% in June 2016. Sepsis trolleys on high-risk wards were highlighted by staff as a particularly valuable improvement, ensuring that necessary care bundle components were readily available when sepsis was identified.

A bespoke infection screening tool was used to help diagnose sepsis and prompt the use of Sepsis Six. This led to a 21% reduction in deaths compared with patients who were not screened. Analysis of results from over 8,000 screened patients revealed that an estimated 158 lives were saved and 1,339 critical care bed days avoided – equivalent to a saving of £1.65m.

A comprehensive communications strategy underpinned the project, capturing the attention and enthusiasm of staff. The use of social media took the project to a wider audience and provided an opportunity to engage patients and their families in improving quality.

It is hoped that the findings from this project will inform future provision of regional and national screening processes, and have an impact on sepsis survival rates globally.

Contact details

For further information about the project, please email Annie Laverty, Director of Patient Experience and Quality.