Sorting Sepsis: Collision Avoidance

Right now, there are people all over the country thinking about how to ‘Sort out Sepsis’ within a Patient Safety Collaborative. And there are also people thinking about how they are going to meet the new Sepsis CQUIN performance target. Some people will be thinking about both! And it’s a CHALLENGE!

One group will assess their progress using measures for improvement generated by staff working at the front line of care, the other group will assess their progress using performance measures based on which boxes are ticked on a paper form or computer. Both measures are useful, but in the rush to ‘meet’ the CQUIN the latter has the potential to shift focus from efforts to increase the reliable delivery of evidence based interventions to patients with a life threatening sepsis to the important, but far less critical, ticking of a box. So how can this collision of priorities be avoided?

Here are some thoughts…

First up, we recognise and understand the difference between the two types of measures (see my blog on topic). And whilst the CQUIN is intended to drive positive change, we recognise equally important enablers such as Collaboratives and safety campaigns (Surviving Sepsis, Sign up to Safety). And we act on this because we understand that, if we don’t, the effective recognition and treatment of sepsis as will remain out of reach as a reliable destination for all.

If you want to know more about the size of the challenge check out Mary Dixon Woods Understanding the challenges of improving safety in clinical systems (14.16 – 15.50mins). And so secondly, since my cup is half full, I’m banking on organisations that can embrace learning, take the safety collaborative route, and apply a robust change model to deliver a better outcome all round.

Where would YOU start?

Well, probably… with a very small study of the way you currently capture data, check for repetition, rate of completion, relevance of the data required, and the ease with which it can be captured by busy, sometimes tired, clinicians. When you are reviewing the criteria with your practitioners (rather than a committee), consider from the outset how you design for data capture in a way that reflects the clinical and patient need first, and only then think about how to capture compliance with your target (see my blog on how to do this well).

Now this approach might take more time than the command and control route, and this will be tough for those in charge. But importantly, you will have a better chance of improving and sustaining your performance in all aspects of the Sepsis 6, not just the screening – and only then can all patients be reassured that they have the best chance of surviving sepsis where you work!