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Quality improvement programmes in paediatric sepsis from a global perspective
Daniela C de Souza1, Raina Paul2, Rebeca Mozun3
1Latin American Sepsis Institute, São Paulo, Brazil; Pediatric Intensive Care Unit, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil; Pediatric Intensive Care Unit, Hospital Sírio Libanês, São Paulo, Brazil.
Insights
Improving quality of care for pediatric sepsis is crucial. Global efforts require comprehensive programs addressing the entire patient journey, from prevention to survivor support, to reduce child mortality.
Area of Science:
- Pediatric critical care medicine
- Global public health
- Quality improvement science
Background:
- Sepsis significantly impacts child health outcomes globally, characterized by a dysregulated host response leading to organ failure.
- Children possess unique vulnerabilities to sepsis, making it a critical global health priority with high morbidity, mortality, and societal costs.
- Despite a 2017 WHO resolution, few countries have implemented systematic, pediatric-focused quality improvement programs for sepsis.
Purpose of the Study:
- To examine successes and barriers in quality improvement programs for pediatric sepsis.
- To highlight the need for holistic program design encompassing the entire patient journey.
- To outline implementation strategies and benchmarking measures for global quality improvement.
Main Methods:
- Review of existing quality improvement programs for pediatric sepsis.
- Analysis of successes and systematic barriers to implementation.
- Identification of key components for comprehensive program design.
Main Results:
- Existing quality improvement programs often lack a comprehensive approach, failing to address the full patient continuum.
- Systematic barriers hinder the widespread implementation of effective pediatric sepsis quality improvement initiatives.
- Successful programs require integration of prevention, caregiver awareness, early recognition, healthcare workforce education, system development, and long-term survivor support.
Conclusions:
- Quality improvement in pediatric sepsis necessitates a patient-journey-focused approach, integrating all stages from prevention to long-term care.
- A global learning platform is essential to accelerate and standardize quality improvement efforts for pediatric sepsis worldwide.
- Enhanced global collaboration and systematic implementation strategies are vital to reduce the burden of pediatric sepsis.
Abstract:
Sepsis is a major contributor to poor child health outcomes around the world. The high morbidity, mortality, and societal cost associated with paediatric sepsis render it a global health priority, as summarised in Paper 1 of this Series. Sepsis is characterised by a dysregulated host response to infection that manifests as organ failure, and children are uniquely susceptible to sepsis, as discussed in Paper 2. The focus of this third Series paper is quality improvement in paediatric sepsis. The 2017 WHO resolution on sepsis outlined key aims to reduce the burden of sepsis. As of 2024, only a small number of countries have implemented systematic, paediatric-focused quality improvement programmes to raise sepsis awareness, enhance recognition of sepsis, promote timely treatment, and provide long-term support for paediatric sepsis survivors. We examine programme successes and systematic barriers to quality improvement targeting paediatric sepsis. We highlight the need for programme design to consider the entire patient journey, starting with prevention, caregiver awareness, recognition at home, education of the health-care workforce, development of health-care systems, and establishment of long-term family and survivor support extending beyond the intensive care unit. Building on lessons learnt from existing quality improvement programmes, we outline implementation strategies and measures to enable benchmarking. Ultimately, quality improvement on a global scale can only be accelerated through a global learning platform focusing on paediatric sepsis.
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