Post-Sepsis Care: Co-designed models of support (SEPSIS SUPPORT)

Background:

Sepsis is the bodies life-threatening response to an infection, that affects 49 million people globally each year.In 2022–23, there were over 84,000 sepsis-related hospitalisations in Australia, far exceeding previous estimates of 55,000 cases annually, with one in four adults admitted to intensive care unit (ICU) and one in seven cases resulting in death. In 2017, approximately 25% of paediatric ICU deaths in Australia and New Zealand were related to severe infections.

Survivorship after sepsis is a global health care priority. Sepsis survivors face significant long-term morbidity, with between 30% - 50% of adults experiencing new limitations to usual activities or exacerbation of pre-existing chronic conditions resulting in reduced quality of life. For children, up to 40% experience ongoing impacts to physical and psychosocial development, education, family functioning and reduced quality of life. Consequently, post-sepsis hospital readmission rates are high, with as many as 70% of sepsis survivors (45 and over) readmitted within 1 year of discharge. The resulting direct and indirect impact of sepsis is estimated to cost the Australian health system over $4.7 AUS billion per annum.

Post sepsis follow-up services are rare for both adults and paediatric sepsis survivors. The current lack of follow up post-sepsis care demonstrates a significant unmet need and a clinical gap in alignment with the Australian Commission for Safety and Quality in Healthcare (The Commission) National Sepsis Clinical Care Standard survivorship recommendations. Following discharge, sepsis survivors, their families and those bereaved by sepsis require comprehensive, coordinated follow-up support within the community.

Aim:

The SEPSIS SUPPORT program aims to revolutionise post-sepsis support in Australia by co-designing and piloting innovative new follow-up models of care. This study represents a collaboration between two major research programs. SEPSIS SUPPORT is led by The George Institute in partnership with the Australian Commission on Safety and Quality in Health Care, Sepsis Australia, and Clinical Excellence Queensland, with funding from an NHMRC Partnership Grant. Paediatric Post-Sepsis Models of Care (Paediatric MoC) is a two-year NHMRC Collaborations in Health Services Research Grant led by Queensland University of Technology (QUT), in collaboration with Clinical Excellence Queensland (CEQ, Queensland Sepsis Program), Sepsis Australia (SA), Children’s Health Queensland (CHQ), the Queensland Family and Child Commission (QFCC), Health Translation Queensland, and the University of Queensland.

This outcome of this work will be the development of comprehensive, holistic and culturally safe models of care that will improve the quality of life for survivors and provide essential support to families, caregivers and those bereaved by sepsis. The work targets a critical gap in the management of sepsis and plans to provide a national scalable solution directly addressing Quality Statement 7, Care after hospital and Survivorship of The Commission’s National Sepsis Clinical Care Standard.

SEPSIS SUPPORT has the potential to have a transformative impact on post-sepsis healthcare. Working collaboratively with sepsis survivors, families, caregivers, and those bereaved by sepsis, the program aims to develop successful post-sepsis models of care that will significantly improve the functional outcomes and quality of life for the thousands of Australians impacted by sepsis each year. Sepsis care currently costs the Australian health system billions of dollars annually, the outcomes of this work will inform health policy and funding decisions via a business case focused on sustainable, cost-effective sepsis care that alleviates health system burden and aligns Australian practice with national post-sepsis survivorship recommendations.

Research Methodology:

SEPSIS SUPPORT is a multi-phase program that will co-design and evaluate new post-sepsis follow-up models of care. Phase one will involve a national scoping review and engagement with key sepsis networks to determine what current post sepsis services exist across Australia. Surveys and focus groups with clinicians, sepsis survivors, families, and those bereaved by sepsis will identify post-sepsis support needs and determine the key components required within new follow-up models of care. Stakeholder driven insights will be crucial in the co-design (via Delphi and consensus meeting) and development of the new service models. The final phase will involve pilot testing and evaluating the proposed models at selected vanguard sites and undertaking a business case assessment.

Pilot sites will be selected from our established national sepsis clinical network.

This project is co-chaired by A/Prof Naomi Hammond from the George Institute and Professor Debbie Long from the Queensland University of Technology.