Consultant in Emergency Medicine Director, National Emergency Medicine Program Ministry of Health. Abdulrahman S Alqahtani

Transcription

1 Abdulrahman Saad Alqahtani, MD Consultant in Emergency Medicine Director, National Emergency Medicine Program Ministry of Health February 8, 2018 Abdulrahman S Alqahtani 1

2 Objectives Overview of KSA health system. Sepsis problem in MOH Sepsis Care Improvement Project Future plans February 8, 2018 Abdulrahman S Alqahtani 2

3 Overview of KSA health System Total population: 31 million 70% < 30 Life expectancy: 73 Total expenditure on health per capita: 2500 Total expenditure on health as % of GDP: 4.7% February 8, 2018 Abdulrahman S Alqahtani 3

4 Population (m) The population is changing Projected KSA Population Growth Nonnationals Saudi nationals KSA s elderly population is set to grow Over 65s will grow m Over 60s will grow k k k February 8, 2018 Abdulrahman S Alqahtani 4

5 Overview of KSA health System Government funded MOH 60% National Guard, Military 20% Private 20% February 8, 2018 Abdulrahman S Alqahtani 5

6 The Sepsis problem WHO announced that Sepsis to be made into a global health priority Sepsis worldwide put episodes per year at 31.5 million, with approximately 5.3 million deaths annually Episodes of Sepsis are increasing at a rate of 8-13% per year February 8, 2018 Abdulrahman S Alqahtani 6

7 The opportunity For each 100,000 population, episodes of Sepsis will occur per year WHO. KSA should see upwards of 128,000 Sepsis episodes per year A 50% evidenced mortality suggests 64,000 deaths If mortality was reduced to 25% mortality, this would Save 32,000 lives Save the KSA health service SAR 1.67 Billion ( 322 million) per year Improve annual productivity by SAR 8,561 million ( 1,709 million) February 8, 2018 Abdulrahman S Alqahtani 7

8 Sepsis Care Improvement Project (SCIP) National initiative under EDSP ED based (initial phase) Initially 7 hospitals (319 cases) Local and international experts International partner February 8, 2018 Abdulrahman S Alqahtani 8

9 Emergency Departments Assessment YES, 25% Sepsis Protocol NO, 75% February 8, 2018 Abdulrahman S Alqahtani 9

10 Emergency Departments Assessment Lactic acid test availability in ED NO, 50% YES, 50% February 8, 2018 Abdulrahman S Alqahtani 10

11 Emergency Departments Assessment Vasopressors available in ED Antibiotics available as Floor stock NO, 25% YES, 37% YES, 75% NO, 63% February 8, 2018 Abdulrahman S Alqahtani 11

12 Screening & Data Collection Sheet High ED visit rate q-sofa Electronic system Coding Cost February 8, 2018 Abdulrahman S Alqahtani 12

13 Initial results 47.3 % of patients received antibiotics within 3 hours of arrival to Emergency Department February 8, 2018 Abdulrahman S Alqahtani 13

14 Initial results 27 % receive enough IV fluid within 3 hours of arrival to ED February 8, 2018 Abdulrahman S Alqahtani 14

15 Initial results Blood culture was obtained in less than 15% of the patients Lactic acid testing was done only 25% of the time. February 8, 2018 Abdulrahman S Alqahtani 15

16 We don t care enough February 8, 2018 Abdulrahman S Alqahtani 16

17 September 2017 workshop First workshop on the topic of sepsis Local and international experts Presence and support of the Deputy minister of health The UK sepsis trust UK partner Escalla February 8, 2018 Abdulrahman S Alqahtani 17

18 February 8, 2018 Abdulrahman S Alqahtani 18

19 Ownership and Leadership No ownership of Sepsis MOH committee on sepsis Leadership support February 8, 2018 Abdulrahman S Alqahtani 19

20 Changing behavior Team based workshop on sepsis care improvement Change management Understanding barriers to change Reconciling competing health agenda s such as AMR and early Sepsis treatment February 8, 2018 Abdulrahman S Alqahtani 20

21 Standardized methods Standardization of Emergency departments triage form Develop sepsis and septic shock pathway in every hospital. February 8, 2018 Abdulrahman S Alqahtani 21

22 Reinforcement and reliability Clinical audits CBAHI standards Hospital accreditation ADAA health KPI s Performance program February 8, 2018 Abdulrahman S Alqahtani 22

23 Future plans Agree on the screening tool, NEWS National guidelines Children and women's hospitals Scale up to more hospitals Involve other healthcare sectors, private Research February 8, 2018 Abdulrahman S Alqahtani 23

24 February 8, 2018 Abdulrahman S Alqahtani 24