A new study recently published in Critical Care Medicine has shown that the BC Patient Safety & Quality Council (BCPSQC)’s investment in the BC Sepsis Network (BCSN) has led to savings of $50.6 million, representing a return of over $112 for every dollar invested.
In 2017, sepsis led to 1 in every 5 deaths globally. Communities that face inequities in access to and quality of care bear a disproportionate burden of sepsis mortality and morbidity, and Canada is no exception. Sepsis is challenging to diagnosis, yet early identification and rapid administration of key supportive measures are needed to ensure the best outcomes with sepsis. Sepsis screening tools and sepsis protocols can support health workers with identifying and treating sepsis, and are most effective when implemented as part of quality improvement (QI) initiatives. In 2012, the BCPQSC launched to BCSN to support province-wide implementation of such an initiative. From 2014-2018, the study’s authors estimate that:
- A total of 981 in-hospital sepsis cases were prevented in BC.
- 172 people were prevented from dying from sepsis.
- A reduction of cases and deaths contributed to societal savigns of approximately $51 million.
- Every $1 invested by the Ministry of Health into the BCPSQC to lead this work resulted in $112.50 in savings to the health care system.
As of 2020, the BCSN has grown to over 36 hospitals, including 300 members, and has diverse representation, including patient partners, allied healthcare staff, physicians, QI experts, and hospital administrators - constituting the largest and most active interconnected sepsis community within Canada. The BSCN focuses on improving the diagnosis and management of early severe infections which lead to sepsis, as well as treating sepsis and septic shock, through the use of protocols that ensure rapid diagnostic tests are performed and timely therapies are delivered.
“These results show what can happen when clinicians who are passionate about improving the quality of care they provide are brought together and supported to lead that work within their organizations,” said Dr. David Sweet, the BCPQSC’s Provincial Clinical Lead for Sepsis and a critical care physician. “I’m so proud of our sepsis network members whose hard work has made such an impact for British Columbians and transformed our province into a national and global leader in caring for sepsis.”
This unique study highlighted the efficacy of a province-wide QI initiative aiming to educate a large number of health workers in early identification and management of sepsis in BC. The results show the degree to which sepsis care has improved in BC as well as how the province compares to the rest of Canada, with BC outperforming the rest of the country in every metric examined in the study. The success of the BCSN demonstrates the critical role of organizations with a provincial mandate in driving change at scale, and the need for further action and investment in QI and sepsis educational programs across Canada and internationally.
“We hope our work can serve as a model of care for other provinces in Canada and elsewhere,” said Dr. Niranjan "Tex" Kissoon, co-author on the publication as well as Executive Medical Director of Children’s & Women’s Global Health at BC Children's Hospital and professor the department of pediatrics at UBC.
Full publication: Khowaja AR, Willms AJ, Krause C, Carriere S, Ridout B, Kennedy C, Young E, Mitton C, Kissoon N, Sweet DD. The Return on Investment of a Province-Wide Quality Improvement Initiative for Reducing In-Hospital Sepsis Rates and Mortality in British Columbia, Canada. Crit Care Med. 2021 Sep 29. doi: 10.1097/CCM.0000000000005353