A collaborative improvement project by an NHS Emergency Department and Scottish Ambulance Paramedics to improve the identification and delivery of sepsis 6.

Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38). Mean Time to triage improved by 82% from 17 minutes to 3 minutes (p=0.01), time to first antibiotic improved by 39% from 49 minutes to 30 minutes. Overall 78% of patients received antibiotics within an hour of leaving their home; no significant increase in workload was reported by staff. In conclusion alerting by paramedics of potential sepsis patients reduced the time taken to deliver the Sepsis 6 Bundle. Process reliability has been sustained over several months. This process has been spread to seven regional ambulance stations in Lanarkshire Scotland.