Quality improvement

With rates of sepsis increasing in Queensland, Clinical Excellence Queensland is working with key stakeholders to improve early recognition and treatment of sepsis in an effort to reduce its devastating impact on families and our communities. For information on adult sepsis, paediatric sepsis, pathways and resources, prevalence of sepsis, recognition and treatment, signs and symptoms, pharmacy and primary care program and post sepsis care.

The Peter MacCallum Cancer Centre developed a whole-of-hospital sepsis pathway in February 2013 which was later adapted for cancer services at Melbourne Health in June 2015 with positive patient outcomes. Through its innovation project, Melbourne Health again adapted the Peter MacCallum Cancer Centre’s sepsis pathway, this time implementing it across the Royal Melbourne Hospital to ensure all patients were receiving the highest quality of care every single time. In December 2020, due to its success, the Better Care Victoria Innovation Fund supported the scaling and spreading of this innovation project.

Key Outcomes included:

• Developed an evidence-based sepsis clinical pathway that has been used in more than 700 episodes of care
• Halved the rate of death due to sepsis
• Reduced ICU admissions by 65.4 per cent
• Reduced the time from diagnosis to administration of antibiotic treatment by 51.9 per cent
• Decreased patients’ hospital length of stay by 42.9 per cent

In 2019, following lobbying by The George Institute’s Sepsis Australia Program a one off funding allocation was provided by the Australian Government Department of Health to support implementation of the Stopping Sepsis National Action Plan recommendations under a National Sepsis Program led collaboratively by The George Institute’s Sepsis Australia and the Commission which was completed in June 2022 at the launch of the national Sepsis Clinical Care Standard resulting delivery of the following projects:

• Project 1: Epidemiology of sepsis report
• Project 2: National retrospective medical record review
• Project 3: Sepsis trigger tools systematic review
• Project 4: Materials to support implementation of National Safety and Quality Health Service Standards (NSQHS)
• Project 5: Revision of the Antimicrobial Stewardship Clinical Care Standard
• Project 6: Sepsis Clinical Care Standard
• Project 7: Public awareness campaign
• Project 8: Sepsis Survivorship

In 2022-23, following further lobbying by The George Institute’s Sepsis Australia Program a second one off funding allocation was provided by the Australian Government Department of Health and Aging to support implementation of additional Stopping Sepsis National Action Plan recommendations under a National Sepsis Program Extension led collaboratively by The George Institutes Sepsis Australia and the Commission to deliver projects on:

• Improving recognition of sepsis for First Nations people
• Targeted national public awareness campaign
• Education and training resources for health services
• Coordinated sepsis care and post sepsis support for sepsis survivors, their families, and families bereaved by sepsis
• National plan for sepsis data collection and tools for quality improvement

Initiated in 2002 the campaign has published four editions of evidence-based guidelines, implementation of a performance improvement program, and analysis and publication of data from more than 30,000 patient charts collected from around the world. The three key phases underpinning  guideline development are:

Phase I:  Development of Awareness of Scope of the Problem

Phase II:  Development and Publication of Guidelines

Phase III:  Guideline Implementation, Behaviour Change, and Data Collection

In 2023/24, the SSC Guidelines are undergoing review with publication expected early 2025. See resources to access current sepsis guidelines and bundles for adults, paediatrics and associated tools and education.

WHO is developing guidance using the best evidence to help patients and the healthcare workers looking after them. The guidance will focus on making global recommendations for early recognition, initial resuscitation, and the early treatment of sepsis during which periods patients are most vulnerable. The recommendations support to Member States to develop and implement national programs for the management of sepsis in adults and children. The wide intended audience includes health care workers (health professionals including doctors, nurses, intensivists/critical care staff, ambulance staff), policy-makers, their expert advisers and technical/ program staff at organisations involved in the management of adults or children with sepsis. Recommendations will be published as WHO guidelines, and will include tools to support implementation.