SOS_plain_image crop“Sepsis is a devastating condition that is notoriously tricky to diagnose, so I’m delighted to support this important new tool. Not only will it let clinicians understand the impact of different interventions for sepsis, but crucially, in the future it could help analyse which infections lead to sepsis more often. It is yet another example of how technology is improving patient care in the NHS.”

Matt Hancock, Secretary of State for Health and Social Care

Overview

The Suspicion of Sepsis (SOS) Insights Dashboard has been created by Imperial College Health Partners (ICHP) through the Patient Safety Collaborative, in collaboration with NHS Improvement and NHS England, and building on the methodology for measuring sepsis previously published by Oxford Academic Health Science Network. It was launched for World Sepsis Day 2018.

The SOS Insights Dashboard means that for the first time the NHS can accurately measure the number of patients admitted to hospital who are at risk of sepsis. Endorsed by Matt Hancock, MP, Secretary of State for Health and Social Care, all hospitals across England are being asked to use the tool which will allow them to identify how many patients are at risk of sepsis. As a result, the NHS will now be able to track improvements such as rates of survival and length of hospital stays and the impact on patients locally, regionally and nationally. By showing the numbers of admissions, rates of survival, and lengths of stay, it will give clinicians the clearest information yet for which types of infections can cause patients to deteriorate quickly, and which treatments are most effective at saving lives.

Challenge / problem identified

Sepsis is the severe, life-threatening end of infection, and arises when the body’s response to infection injures its own tissues and organs. Without early identification and treatment there is a significant risk of long-term disability or death.

Sepsis doesn’t have a gold standard diagnostic test and there is no single, stable sepsis definition meaning its frequency and deaths cannot be measured or compared over time, but only roughly estimated. Not having a reliable accurate measurement meant that clinicians could not reliably monitor the impact of improvement measures.

This has been compounded by coding changes this year that led to an increase in reported sepsis numbers.

This has highlighted the need for a proxy measure, and the only credible, reproducible and easily obtainable proxy measure is those admitted to hospital with infection – the Suspicion of Sepsis (SOS) category.

Actions taken

The SOS Insight Dashboard is an example of what can be achieved through cross-system collaboration. The Dashboard has been created by Imperial College Health Partners (ICHP), through the Patient Safety Collaborative (PSC), with NHS Improvement’s Patient Safety Measurement Unit (PSMU) and NHS England all providing the unique breadth to bring partners together and spark cross-boundary critical conversations.

Dr Matt Inada-Kim, National Clinical Advisor, and colleagues in Oxford AHSN, conceived the SOS category in 2017 in their paper: Defining and measuring suspicion of sepsis: an analysis of routine data”.

ICHP led on the concept, development and building of the Dashboard trialling it with clinicians as well as international figures in sepsis Mervyn Singer (Professor of Intensive Care Medicine at University College London) and John Welch (President, International Society for Rapid Response Systems).

Impacts / outcomes

The SOS Insights Dashboard means that:

  1. For the first time ever there is a national consistent measure for hospital admissions for patients with infections or ‘suspicion of sepsis’, their length of stay and discharge and the associated mortality rate. The SOS Dashboard uses this measure to bring together this data on local, regional and national basis.
  2. Using the SOS Insights Dashboard, clinicians can see who is most at risk of developing sepsis. It also enables them to gain insight retrospectively on the effectiveness of their targeted sepsis interventions, supporting them to better plan future treatments.
  3. The SOS Dashboard is the exciting first step in gaining a clearer understanding of the scale of infection and sepsis, and will underpin the future of conversations about how to plan and prepare, leading to better patient outcomes.

So far:

  • 10 Patient Safety Collaborative regions were involved in the initial pilot
  • 15 Patient Safety Collaboratives have committed to adoption and spread
  • Seven Patient Safety Collaboratives have hosted or scheduled a SOS Insights Dashboard presentation/workshop
  • The team have presented the SOS Insight Dashboard at three national conferences.

It is open and free to access for all through the online platform. It is clear evidence of the how data use can be so powerful in potentially saving thousands of patients lives.

“As a national advisor and regional lead for sepsis, I am very aware that we simply can’t improve quality without accurate data to assess the effectiveness of our interventions. This dashboard has provided me with accurate information to asses trends in outcomes for patients with infection and provides excellent intelligence to develop and assess quality improvement interventions for all infections and sepsis. Being able to have this information for my hospital and other organisations at a click of a button is extra-ordinary and a game changer! The SOS dashboard is brilliant.”

Dr Emmanuel Nsutebu – Consultant Infectious Diseases Physician and Associate Medical Director for Deterioration and Sepsis, AQuA Leadership for Improvement Fellow, AQ Sepsis Clinical Lead, National Clinical Advisor for Sepsis (NHS England) and Deterioration (NHS Improvement)

Plans for the future

In Summer 2018 the Dashboard was proudly shortlisted for a HSJ award 2018 in ‘Enhancing Care by Sharing Data and Information’.

The Dashboard shows the power and importance of the use of data in the right context.

The programme team are spreading the work of the Dashboard through clinicians across the country. It is the exciting first step in gaining a clearer understanding of the scale of sepsis and it is underpinning the future of conversations about how to plan and prepare leading to better patient outcomes.

ICHP will be developing a further support package including guidance, webinars, roadshows/ workshops (contact ICHP if you wish to host one). There is already work on the development of the next version of the dashboard based ongoing conversations.

Start and end dates

2017 (ongoing)

Find out more

Kenny Ajayi, Programme Lead – Patient Safety, Imperial College Health Partners
E: Kenny.Ajayi@imperialcollegehealthpartners.com
T: 07961 040277

Media contact:

Katie Harrison, Communications Manager, Imperial College Health Partners
E: Katie.harrison@imperialcollegehealthpartners.com
T: 07496792559