Freedom of Information Request: FOI 0408
University Hospitals Birmingham NHS Foundation Trust (UHB) completed a merger by acquisition of Heart of England NHS Foundation Trust (HEFT) on 1st April 2018. For the purposes of this request we have answered on behalf of the pre-merger UHB i.e. Queen Elizabeth Hospital.
I would like to request the below information please in relation to QEHB:
1. Your annual quality report notes the timely treatment of sepsis as a priority.
In relation to indicator 2a (timely identification of sepsis in emergency departments and acute inpatient settings). Could you provide me with:
a. What areas this exactly relates to?
Emergency departments include the main Emergency department (ED) at Queen Elizabeth Hospital Birmingham (QEHB). Acute inpatients include all other inpatients wards.
b. The underlying methodology involved for this indicator?
Patients who need screening for sepsis are identified in line with the national CQUIN document. Patients with an observation trigger of 4 and above are selected for auditing. At Queen Elizabeth Hospital Birmingham (QEHB) we use the standard early warning scoring system (SEWS). Observations are recorded onto our electronic patient record system. When certain criterion is met patients with a trigger are alerted for review. All patients with a SEWS of 4 and above are recorded by the Trust informatics department and a sample of 300 patients each quarter are pulled for inclusion in the serious infection audit – Part A (150 for the emergency department and 150 patients for inpatients).
From quarter 3 – 2018/19 the Trust will be moving to using the updated national early warning scoring system (NEWS2).
c. What exclusion criteria are used?
Patients are excluded in line with the national serious infection CQUIN document 2018/19.
2. In relation to the electronic sepsis assessment in use in your trust, please confirm:
a. How this is triggered e.g. SEWS >3?
SEWS 4 and above
b. If the patient persistently has an elevated SEWS does the system generate a sepsis assessment each time or only once in a specific time period
The system will generate a sepsis assessment for each alert.
c. The questions the nurse or doctor is required to completed?
Doctors are required to complete the assessment.
Below is a screen shot of the sepsis assessment doctors need to complete
d. How the trust monitors completion of electronic sepsis assessments including management of poor performance?
Electronic assessment was introduced at the beginning of July 2018. Currently the Trust is awaiting a report to analyse this information and use this to manage poor performance.
e. A breakdown of performance by month for each ward areas for the last 12 months.
We do not hold this information. The national CQUIN information is required to be submitted as an overall Trust score each quarter. Information broken down by ward areas is not currently available (see d, above).
