Quality assurance in severe sepsis: an individualised audit/feedback system results in substantial improvements in sepsis care at a large UK teaching hospital
© Simmonds et al.; licensee BioMed Central Ltd. 2013
Published: 5 November 2013
Severe sepsis has a high mortality and high healthcare costs. Rapid recognition and treatment can save lives but requires a coordinated response . Hospital-wide audits in 2005 and 2010 showed significant deficiencies when compared with international guidelines, with 35% of cases receiving antibiotics in <1 hour and only 25% receiving basic pre-ICU interventions in a timely manner. By time-lining our response to severe sepsis, we identified system and process failures . Some system improvements (for example, providing first-line antibiotics in acute areas) were straightforward to tackle, but sepsis care remained reliant on individual clinician response. Equally, whilst dissemination of organisation-level audit data raised the profile of sepsis, it appeared that individual clinicians did not view it as 'their problem'. It is recognised that individualised feedback can improve care, as pride and the competitive nature of healthcare workers drives improvement. This is especially true when adherence to recommended practice is low . We tried to change behaviour by creating a rapid response audit/feedback mechanism that informed clinicians of their own response to the severely septic patient, from which they could learn and improve.
Materials and methods
Individualised feedback on sepsis care has led to substantial improvements in guideline compliance.
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