Dr Emmanuel Nsutebu introduces us to this Sepsis project and the role of leadership in Quality Improvement.

1. Sepsis-Time is life Project and role of clinical
leadership in QI
Dr Emmanuel Nsutebu – Consultant Infectious Diseases Physician
Clinical lead for Sepsis
AQ Clinical Lead – Sepsis
AQUA Patient Safety Fellow
Emmanuel.Nsutebu@rlbuht.nhs.uk

2. Objectives of the session
• How to improve recognition and management
of sepsis
• Importance of clinical leadership -10 tips

3. What is clinical leadership?
• It is about creating conditions that make it
easier for others to bring about change or do
their job
• A leader is a facilitator!!!
• A sponsor for change whilst working with
clinicians
• Persist in your vision but listen and adapt!

4. Heart & Minds
• ‘If you want to build a
ship do not gather men
together and assign
tasks. Instead teach them
the longing for the wide
endless sea.’
(Saint Exupery, Little Prince)
Spend time describing the vision

5. Tip 1: Set a clear vision!
• Recognition and initial management was our
main focus
• Adapt your organisation vision/mission
• Clinicians need to recognise the value and
develop the vision
• Clinicians care about saving lives and reducing
suffering – not targets!
• Adaptive change requires a case for urgency!

7. • SepSAS – Sepsis -Screen, Act, Save lives
• SepSIS – Sepsis -Screen, Intervene, Save lives
• Sepsis -Time is life Project!
Tip 2: Branding is important!

8. Tip 3: Run it like a campaign
• Involve executives and align with values/goals
of the organisation
• Involve key players
• Mobilise resources
Chief executive
Senior nursesMedical Director

9. A 73 year old man was admitted with cellulitis
via minors with no signs of sepsis. Within 1
hour, he became hypotensive with a lactate of
6 - septic shock. He was transferred to ED Resus
and sepsis 6 implemented within 30 minutes.
He recovered and left hospital after 5 days. Dr
Nsutebu saw him in clinic in April and he was
immensely grateful to the ED staff for having
saved his life– he has volunteered to join our
sepsis steering group as a patient rep!
Tip 4: Use patient stories………

10. Tip 5: Listen to staff and make the
most of enthusiasm
• Sepsis cards Sepsis badges

11. Consider why staff may resist change?
• Listen and validate their concerns – involve
them to find a solution
New ABG machines
measure lactate
New sepsis 6 bundle/pathway

12. Tip 6: Train others to lead and organise
• You cannot do it on your own!
• Sepsis Steering Group
• A good team is unstoppable

13. Tip 7: Drive innovation
New simulation training
Pilot of bolus
administration of IV
antibiotics
Blood culture packs

14. Tip 8: Focus on systems

15. Tip 9: Make the most of incidents/crisis
• Case of 54 year old lady who developed septic shock after
admission to hospital
• Was not recognised and treated in a timely manner
• Used on AMU to educate staff and drive change
• Focus on early recognition and FULL implementation of the sepsis
bundle

16. I had a full arsenal of
sepsis signs and
symptoms not only one
but 4 consecutive
doctors failed to spot it…
I did not receive
antibiotics for over 15
hours
Patient’s complaint letter
17% of patients with
severe sepsis received
sepsis 6 within 6 hours
Audit in 2012
Where we were and what made us
want to make a difference…

17. Most importantly -Celebrate success!
• Sepsis Newsletter

20. Tip 10. Use data
• Highlight the benefits: Over 12 months,
– 15% reduction in septic shock mortality
– 2830 bed days saved
– £608,450 saving

21. • In 2012 we completed sepsis 6 bundle in 17% of
patients within 6 hours
• Advancing Quality (AQuA) data suggests that an
average of 60% of patients are receiving standard
care within 4 hours.

22. Summary
• Clinical leadership is important in QI
• Think about how you will lead QI as well as
the technical aspects
• “A true leader releases passion, ingenuity and
talent in people!!

23. Any questions?
Emmanuel.Nsutebu@rlbuht.nhs.uk