Health Service Focus

24.10.19

Saving lives using technology

Source: NHE: Sep/Oct 19

Afzal Chaudhry, consultant nephrologist and chief clinical information officer at Cambridge University Hospitals NHS FT (CUH), describes how new monitoring technology is allowing patients at risk of sepsis to be identified and treated more quickly.

Sepsis is a life-threatening condition that arises when the body responds to an infection by attacking its own tissues and organs. Every year in the UK, 250,000 people are affected by sepsis and it accounts for approximately 44,000 deaths - more than bowel, breast and prostate cancer combined. However, sepsis can be difficult to spot and is often mistaken, in the early stages, for other more localised infections. National guidance recommends that patients with sepsis are given antibiotics within an hour of diagnosis to reduce the risk of serious complications as for every hour of antibiotic delay, the risk of mortality increases by approximately 8%. 

In 2016, we created a Sepsis Action Group at Cambridge University Hospitals FT – comprising of clinicians from our emergency department, infectious diseases, acute medicine and rapid response teams, as well as our eHospital digital team. They collaboratively explored how technology could be used to better alert clinical colleagues to patients with potential sepsis when they present in our emergency department. They subsequently developed and built an innovative ‘alert and action’ set within our EPR used across both of our hospitals - Addenbrooke’s and The Rosie. 

This ‘alert and action’ set - a form of clinical decision support - was launched in our emergency department in August 2016. The alert brings to the attention of both nurses and doctors that sepsis could be a possible diagnosis if a patient's clinical observations (including temperature, blood pressure, pulse and respiratory rate) meet certain criteria. The ‘action’ feature then provides a series of electronic prompts to support clinicians in undertaking the necessary steps and tests, linked to national guidance, to effectively diagnose, care for, and treat the patient. 

As 99% of all clinical care at our hospitals is documented, ordered and available in our EPR, our nurses electronically order blood samples, blood cultures and oxygen for potential sepsis patients; these are typically completed within 30 minutes of receiving the alert. When a doctor arrives to see the patient, the results are available in the system, enabling the appropriate treatment to be immediately determined. Within the EPR, doctors select the most appropriate antibiotics to treat the source of the patient’s infection, with the system providing additional decision support by recommending the correct dose and frequency. 

Since implementing this digital initiative, we have seen a 70% increase in the proportion of patients with sepsis receiving antibiotics within the recommended one-hour national timeframe when presenting in our emergency department. Following this success, we tailored the ‘alert and action’ set to our inpatient areas and rolled it out across all adult inpatient wards in June 2017 – achieving a 50% increase in patients receiving antibiotics within one hour of sepsis diagnosis. 

When compared to our 2015 data, we have successfully reduced sepsis mortality by between 28% and 42% across our two hospitals. In 2018/19, this equated to at least 64 lives being saved. This significant improvement in sepsis care is an excellent example of how we as a trust are combining clinical and technical expertise and using our advanced technology and capability in healthcare to benefit our patients and improve outcomes. 

And as a Global Digital Exemplar, and a leading digital Trust in the UK, we have recently created a national blueprint of our sepsis work with NHS England to help support other NHS trusts in their use of technology to improve patient safety and sepsis treatment on a national scale.

FOR MORE INFORMATION

Tw: @AfzalChaud

W: www.cuh.nhs.uk

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

First NHS trusts introduce NHS SBS’ The Edge4Health

16/01/2020First NHS trusts introduce NHS SBS’ The Edge4Health

A major new procurement platform developed by NHS Shared Business Services (NHS SBS), The Edge4Health, is being adopted by NHS trust staff across... more >
NHS mental health director demands urgent gambling action

16/01/2020NHS mental health director demands urgent gambling action

The director of NHS mental health, Claire Murdoch, has penned a written plea to the heads of top gambling firms, urging them to take action on im... more >
Transforming services: We need a left shift not a left drift

16/01/2020Transforming services: We need a left shift not a left drift

Dean Royles, strategic workforce advisor at Skills for Health and co-author of ‘An Introduction to Human Resource Management,’ discus... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

Transforming services: We need a left shift not a left drift

16/01/2020Transforming services: We need a left shift not a left drift

Dean Royles, strategic workforce advisor at Skills for Health and co-author of ‘An Introduction to Human Resource Management,’ discusses the need to move the treatment of patients from primary to secondary care and how the NHS People Plan can help achieve this. Throughout my (overlong) career in the NHS, the national policy on modernising the way NHS services are delivered has been pretty consistent. All recent governments; ... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >

interviews

Mike Farrar, Swim England - Last Word

07/12/2019Mike Farrar, Swim England - Last Word

Mike Farrar Chairperson of Swim England Would you talk us through your previous roles within the NHS? I’ve held a number of ... more >
Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >