Design of a national patient-centred clinical pathway for sepsis in SwedenDepartment of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
Funäsdalen Primary Healthcare Centre, Funäsdalen, Sweden.
Expert and Consultant in Surgery, Jönköping County, Jönköping, Sweden.
Sepsisföreningen (Patient Organization), Sweden.
Department of Infectious Diseases, Skåne University Hospital, Malmö, Sweden.
Division of Inflammation and ageing, Karolinska University Hospital, Stockholm, Sweden.
Health and Medical Care Administration, Stockholm, Sweden.
Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
Department of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden; Department of Surgical and Perioperative Sciences, Anaesthesiology and Critical Care Medicine, Umeå University, Umeå, Sweden.
Fisksätra Primary Healthcare Centre, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Ambulance Medical Service in Stockholm, Stockholm, Sweden.
Department of Anesthesiology and Intensive Care, Uppsala University Hospital, Uppsala, Sweden; Department of Surgical Sciences, Anesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Show others and affiliations
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
2023-08-092023-08-092024-01-16Bibliographically approved