Grant: Operating Grant

Early and intensive clinical intervention of patients in emergency departments has been demonstrated by the literature to significantly improve the morbidity and mortality outcomes of patients with sepsis. Emergency medicine departments within several organizations are now advocating the adoption of early intervention guidelines for patients with the signs and symptoms of sepsis. This proposed research will lead to a comprehensive understanding of how diverse emergency department (ED) sites across British Columbia (BC) engage in a Quality Improvement Collaborative to lead to improvements in time-based process measures (e.g. time to antibiotics) and clinical outcomes (e.g. reduced morbidity and mortality rates) for septic (including severe sepsis and septic shock) patients in EDs. Funding from the BC Ministry of Health (MoH) has led to the creation of a community (i.e. ED) driven and grassroots initiative, Evidence to Excellence (E2E), to address the challenge of translating the best evidence of sepsis management across BC emergency departments. Improving sepsis management is one of the central foci chosen by the E2E initiative. CIHR funding for this proposed research will support the evaluation component of a sepsis management collaborative, which is currently not funded within the scope of in-kind funding provided by the MoH. This research study will employ the IHI Collaborative model, incorporate the principles of participatory action research; and utilize an electronic CoP to engage emergency department practitioners (e.g. physicians, nurses, administrators, etc) from across B.C. to (i) share the evidence of early intervention in sepsis (e.g. exchanging ideas, engaging in discussions, sharing resources, amalgamating knowledge); (ii) adapt the evidence to their patterns of practice; (iii) develop a common set of orders for implementation of the sepsis pathway; and (iv) agree on common indicators to evaluate time-based process measures and clinical outcomes.