Raise the Flag I: the impact of a sepsis quality improvement programme on delivery of a sepsis resuscitation bundle at a tertiary hospital in New Zealand

Abstract

aims: To study changes in sepsis resuscitation practice at a tertiary hospital before and after the introduction of a quality improvement programme, and to identify variables associated with its delivery. methods: "Raise the Flag", a quality sepsis programme, including the Sepsis Six, was launched in 2018. Adult patients with sepsis were sampled prior to the intervention and during two subsequent periods. results: Clinicians were more likely to deliver the resuscitation bundle in the post-implementation period (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.27-3.79, p=0.005). This was not sustained at 18-30 months (aOR 1.22, 95% CI 0.89-1.66, p=0.21).After adjusting for potential confounders, each additional decade of patient age was associated with reduced odds of receiving the bundle (aOR 0.83, 95% CI 0.73-0.95, p=0.005). Admission to intensive care increased in the combined post-implementation periods (aOR 2.81, 95% CI 1.13-6.97, p=0.03). conclusion:The odds of receiving a resuscitation bundle improved immediately following the launch of the Raise the Flag programme. Resuscitation practice differed based on patient age. Odds of admission to intensive care were increased.