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Digital alerting to improve sepsis detection and patient outcomes in NHS Trusts: a qualitative study (DiAlS Qual).

The DiAlS study will investigate the impact of digital sepsis alerts on patient outcomes and staff activity in NHS hospital Trusts across England and Wales. As UK hospitals move from paper based to electronic health records, the integration of digital alerts to identify patients at risk of deterioration has also become common.

DiAlS Qual research team is now in the dissemination and communication phase of the study. 


Sepsis is a serious disease, most often caused by a bacterial infection, and can be treated with antibiotics. Identifying patients with sepsis as early as possible means treatment with antibiotics can be started earlier. To identify patients who may have sepsis, measurements such as high or low temperature and fast breathing rate are used to create a score showing the possibility of sepsis.

Electronic Health Records (EHR) in hospitals contain the information needed to create a score and can alert a doctor or nurse that a patient may have sepsis. Research has shown that more patients get antibiotics earlier because of hospitals using this type of digital alert. Different hospitals have used different methods to create a score and use different types of digital alerts.

This research wants to find out what hospital doctors and nurses think about digital alerts for sepsis and how they use them. We also want to find out what patients who have had sepsis think about hospitals using these digital alerts. Understanding how these digital alerts are used and how they affect patient care can help us to see how they could be used better so patients can benefit. 

This study is part of a wider programme of work seeking to determine the effectiveness of the introduction of digital alerts to improve outcomes of patients with sepsis. This component of the work seeks to explore healthcare professionals’ and patients’/family members views and experiences of deteriorating patient/sepsis alert systems in hospitals. This work will be undertaken within at least some of the NHS Trusts involved in the wider programme of work (Royal Berkshire NHS Foundation Trust, Oxford University Hospitals NHS Foundation Trust, University College London Hospitals NHS Foundation Trust, Imperial College Healthcare NHS Trust, Chelsea and Westminster Hospital NHS Foundation Trust and Cardiff & Vale University Health Board) and potentially additional Trusts if required.   

This is a qualitative study which includes three methods of data collection; observation of healthcare professionals working in hospitals, one-on-one interviews with healthcare professionals and interviews/focus groups with patients/family members.  

Healthcare professionals will include doctors, nurses and other professionals who use, or help implement, deteriorating patient/sepsis alerts in NHS hospital trusts. Patients/family members will include patients recruited from NHS trusts and community settings, who have previously had sepsis or are family members of patients who have had sepsis. 


The aim of this study: To explore the views and experiences of healthcare professionals and patients/family members othe use of deteriorating patient/sepsis alert systems in hospitals. 

In order to answer this we have four key objectives:

  1. To understand how healthcare professionals use sepsis alerts and how alerts influence their decision making. 

  1. To observe healthcare professionals use of sepsis alerts during routine hospital shifts. 

  1. To identify barriers and facilitators to the implementation and use of digital sepsis alerts in NHS hospital settings. 

  1. To explore patients’ and family members views of sepsis alert systems and management of sepsis in hospitals. 


The chief investigator for this study is Dr Sarah Tonkin-Crine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG. 

This study is funded by the National Institute for Health Research Health and Social Care Delivery Research (NIHR HS&DR).

This study is part of a wider programme, The Digital Alerting for Sepsis (DiAlS) study at The Institute for Cancer Research


Patient and Family Member Participant Information Sheet

Learn more about the Infections & Acute Care Research Group