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Design of a national patient-centred clinical pathway for sepsis in Sweden
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; National Program Group for Infectious Diseases, National System for Knowledge-Driven Management within Swedish Healthcare, Sweden's Regions in Collaboration, Sweden.
Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden.
National Program Group for Infectious Diseases, National System for Knowledge-Driven Management within Swedish Healthcare, Sweden's Regions in Collaboration, Sweden; Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Emergency Medicine, Linköping University Hospital, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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2023 (English)In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 55, no 10, p. 716-724Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The World Health Organization has adopted a resolution on sepsis and urged member states to develop national processes to improve sepsis care. In Sweden, sepsis was selected as one of the ten first diagnoses to be addressed, when the Swedish government in 2019 allocated funds for patient-centred clinical pathways in healthcare. A national multidisciplinary working group, including a patient representative, was appointed to develop the patient-centred clinical pathway for sepsis.

METHODS: The working group mapped challenges and needs surrounding sepsis care and included a survey sent to all emergency departments (ED) in Sweden, and then designed a patient-centred clinical pathway for sepsis.

RESULTS: The working group decided to focus on the following four areas: (1) sepsis alert for early detection and management optimisation for the most severely ill sepsis patients in the ED; (2) accurate sepsis diagnosis coding; (3) structured information to patients at discharge after sepsis care and (4) structured telephone follow-up after sepsis care. A health-economic analysis indicated that the implementation of the clinical pathway for sepsis will most likely not drive costs. An important aspect of the clinical pathway is implementing continuous monitoring of performance and process indicators. A national working group is currently building up such a system for monitoring, focusing on extraction of this information from the electronic health records systems.

CONCLUSION: A national patient-centred clinical pathway for sepsis has been developed and is currently being implemented in Swedish healthcare. We believe that the clinical pathway and the accompanying monitoring will provide a more efficient and equal sepsis care and improved possibilities to monitor and further develop sepsis care in Sweden.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 55, no 10, p. 716-724
Keywords [en]
SOFA score, Sepsis, clinical pathway, discharge coding, sepsis alert, sepsis recovery
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:oru:diva-107467DOI: 10.1080/23744235.2023.2234033ISI: 001035690300001PubMedID: 37477232Scopus ID: 2-s2.0-85163827076OAI: oai:DiVA.org:oru-107467DiVA, id: diva2:1786599
Available from: 2023-08-09 Created: 2023-08-09 Last updated: 2024-01-16Bibliographically approved

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Cajander, SaraKurland, Lisa

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