What is the background of your project?
In 2017, I had a life changing experience with Sepsis. The sepsis was entirely preventable. It should have never happened. Over the years, I have explored the reasons why this was allowed to happen. Once the grief and anger subsided, I began to imagine myself on the other side, as the clinician, and human factors kept highlighting themselves as possible triggers to the event. More apparent, was the positive influence the simple act of listening may have had. And so, the idea of using my experience to influence positive change was born, and this very QI Project.
The NICE guideline - Sepsis: recognition, diagnosis, and early management, includes some suggestions for further research. Many of the focuses coincided with the needs identified in my own care. They state: “Delay in detecting and treating sepsis increases mortality. Early detection and appropriate management will reduce morbidity and mortality and will reduce NHS costs by reducing critical care admissions, inappropriate antimicrobial use and length of hospital stay”.
Sepsis recognition remains poor across the board. Factors such as having the right grade of clinician to grade the severity of the sepsis, continuing care across wards, listening, preparing the patient and family, sharing knowledge, and impactful training, are key. Without implementing these, we will continue failing to meet NICE guideline requirements, and more importantly, the patients’ needs.
What was your project aim?
'To raise awareness of the importance of listening in sepsis care and the positive impact it can have on the patient and their loved ones, both in the present, and the future.'
What methodology did you use?
To make sense of the task in hand, and to break down the elements involved with achieving the aim, I completed a driver diagram. This took some serious adjusting as it turned out the project was much bigger than envisaged, and that I’d need to focus on one area. As much as I found it a challenge to complete initially, it had such an impact on my ability to focus on what could be addressed in this project: Using patient stories in training days to aid retention of learning around patient safety and Human Factors.
Now I had my focus, it was time to test my patient story.
What results did you receive?
Though PDSA Cycles and Troika Consulting, I was able to make amendments to my message to ensure what I shared in the training was appropriate for the audience and had the impact desired. I did this by approaching a range of individuals to gain a rounded view.
I got a HUGE amount of qualitative data from this process, and they were incredibly beneficial in creating the right story contents, for the right people.
These are a few of the responses I received:
“Incredibly powerful and moving”
“Words from family would increase the impact for wider implications”
“Definitely consider photos”
“It gives professionals an insight into the impacts of sepsis they may not have considered”
“We need to make sure this NEVER happens”
“Simple actions can make a huge difference, and prevent a lifetime of harm and pain”
“Listen to the patient”
“Remove any messages of negligence as may cause loss of the true message”
“Invaluable”
“I just had to share it”
What’s next?
This QI project doesn’t stop here! Where is my data? What are the results? These are parts of the journey that are still in progress. The skills are there - thanks to the training - but more time is required.
These are my aims ongoing:
- I will get quantitative data by making use of Likert scales prior to, and following, the Patient Story training sessions, and qualitative data in the form of open-ended questions in evaluations. I was reminded that this is an emotive learning experience, and I should offer the opportunities for reflection.
- To truly assess the success of the project, I will need to gather approximately six months of data. The quantitative data will be evaluated using diagnostic tools, such as Pareto charts, and the qualitative data will be reviewed using thematic data analysis.
I’m hoping using my patient story will help highlight the importance of listening to our patients and their carers.
How would you reflect on your QI journey so far?
I’ve always thought: “If there’s a problem, how would I make an improvement?” - this journey has taught me about exploring ideas, pinpointing aims (mine changed SO many times), measuring the impact of the change, and not to be afraid of adjustments if it means having the desired impact.
To future QI Practitioners: If you’re anything like me, there may be times that you might roll your eyes at some of the theory and methodology. All I can say is to trust the process – it works! Here’s to our Quality Improvement futures! Let’s go and change the world, one focused aim at a time!
