Serious Concerns Raised

The HSSIB warns that the tardy diagnosis of sepsis continues to be a significant and urgent patient safety concern for NHS patients. The report, examining three specific cases, reveals instances where patients suffered severe harm or even death due to delayed or incorrect sepsis diagnoses. These findings highlight clinicians’ persistent challenges in promptly identifying sepsis.

Issues in Patient Care

The HSSIB’s report pinpointed ten areas needing improvement. These recommendations, based on the reviewed cases, have broader implications for the NHS. The issues include inconsistent referral paths, communication gaps, and failure to spot early warning signs such as new-onset confusion or suspected infection.

“These reports show a consistent pattern of issues around the early recognition and treatment of sepsis,”

—Melanie Ottewill, Senior Safety Investigator at the HSSIB

One critical aspect is the recognition of sepsis symptoms, which vary greatly. The report also indicates that timely treatment hinges on swift diagnosis. The UK Sepsis Trust states that around 48,000 deaths are linked to sepsis each year in the UK. The report emphasizes that listening to families who express concerns about their loved ones is vital.

Challenges in Diagnosis

The cases investigated involved patients with various infections, including urinary tract infections, abdominal pain, and diabetic foot infections. Two of the patients tragically died. The third faced amputation and a lengthy recovery period. The report stresses that there isn’t a single reliable diagnostic tool for sepsis.

For example, in one case, a lack of consistent referral processes and limited information exchange between hospitals caused delayed diagnosis. Another revealed that a direct escalation route for deteriorating patients was missing, and nurses hesitated to start a sepsis screen without confirmed infection signs.

The Sepsis Alliance has reported that early recognition and treatment of sepsis can significantly improve patient outcomes, reducing mortality rates by as much as 50%. (Sepsis Alliance Stats)

Need for Standardized Treatment

Dr. Ron Daniels, founder and chief medical officer of the UK Sepsis Trust, underscored the urgency of prompt diagnosis and treatment. He also called for a standardized treatment plan, a “sepsis pathway,” to ensure that patients receive optimal care from initial symptoms to diagnosis.

Annie Lennon is a medical journalist.

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primary care Weight Management Programs Show Promise in Preventing Population-Wide Weight Gain

Table of Contents

primary care Weight Management Programs Show Promise in Preventing Population-Wide Weight Gain
- PATHWEIGH Protocol: A 4-Year Study
  - Key Findings of the PATHWEIGH Study
- How PATHWEIGH Works

CHICAGO – A new study reveals that encouraging patients to discuss weight management with their primary care physicians can lead to significant benefits, including increased clinic visits for obesity, prevention of population-wide weight gain, and increased revenue for healthcare systems.

PATHWEIGH Protocol: A 4-Year Study

Researchers at the University of Colorado Anschutz School of Medicine (CU Anschutz) presented data from a 4-year study of the PATHWEIGH protocol at the American Diabetes association (ADA) 85th Scientific sessions. The study, which involved 274,182 patients across 56 primary care clinics in Colorado, demonstrated the potential of integrating weight management into primary care settings.

Did You Know? The CDC reports that obesity affects over 40% of adults in the United States, increasing the risk of heart disease, stroke, type 2 diabetes, and certain types of cancer.

Key Findings of the PATHWEIGH Study

While the intervention group experienced a modest weight loss of 0.1 kg at 18 months, the most significant outcome was the prevention of the typical expected weight gain across the entire population. In contrast, those who did not receive the intervention experienced a weight gain of approximately 0.1 kg.

According to Dr. Leigh Perreault, associate professor of medicine at CU anschutz, “Our data is the first to scale an intervention to more than a quarter of a million people and prevent population weight gain.”

How PATHWEIGH Works

The study employed a stepped-wedge cluster randomized trial design, were clinics were randomized to offer either usual care or the PATHWEIGH intervention. Eventually, all clinics transitioned to using the intervention. Patients receiving usual care had visits where weight could be discussed, but clinicians lacked access to PATHWEIGH tools. In contrast, those in the intervention group had weight-specific visits, and their doctors had access to the protocol.

The PATHWEIGH protocol includes:

A weight-management questionnaire for patients to complete before their visit.
Specialized support tools and education for clinicians.
A weight-specific template embedded in the electronic medical record for diagnosis, documentation, and ordering referrals.

Physicians were encouraged to follow up with patients every 4 to 6 weeks. Though, the use of these tools was optional, meaning patients in the intervention group could still receive usual care.

referral

Sepsis Diagnosis Delays Pose Urgent Safety Risk: HSSIB

Sepsis Diagnosis Delays Still Endanger UK Patients