Discover how New Zealand’s tertiary hospitals are revolutionizing sepsis treatment with the groundbreaking ‘Raise the Flag I’ quality improvement program, enhancing the delivery of life-saving resuscitation bundles.
– by James
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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.
Walland et al., N Z Med J 2023
PMID: 38096437
Study Summary:
A study was conducted to evaluate the impact of the “Raise the Flag” quality improvement programme, which includes the Sepsis Six, on sepsis resuscitation practices at a tertiary hospital. The study compared practices before the programme’s introduction in 2018 and during two subsequent periods.
Key Findings:
- The likelihood of clinicians delivering the resuscitation bundle increased significantly after the programme was implemented, with an adjusted odds ratio (aOR) of 2.20 (95% CI: 1.27-3.79, p=0.005).
- This improvement was not maintained at 18-30 months post-implementation, with an aOR of 1.22 (95% CI: 0.89-1.66, p=0.21).
- Older patients had reduced odds of receiving the bundle, with each additional decade of age decreasing the odds by 17% (aOR 0.83, 95% CI: 0.73-0.95, p=0.005).
- Admissions to intensive care increased in the post-implementation periods, with an aOR of 2.81 (95% CI: 1.13-6.97, p=0.03).
Importance:
The study highlights the initial success of the “Raise the Flag” programme in improving sepsis resuscitation practices. However, it also points out the challenge of sustaining these improvements over time and the influence of patient age on the delivery of care. The increased odds of intensive care admission post-implementation suggest a potential shift in the severity of cases being treated or changes in clinical decision-making.
Contribution to Literature:
This research contributes to the understanding of how quality improvement programmes can affect clinical practice in the short term and the factors that may influence the sustainability of such changes. It also adds to the discussion on age-related disparities in healthcare delivery.