Three Delays Model Applied to Sepsis Care Seeking and Provision in a Private Hospital in Lagos, Nigeria

Abiola Fasina -Ayoola, Emergency Healthcare Consultants, Lagos, Nigeria.
Adebisi Adeyeye, University College London
Oludoyinmola Ojifinni, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Catherine Staton, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, North Carolina USA
Joao Vissoci, Global Emergency Medicine Innovation and Implementation Research Center, Duke University, North Carolina USA

Background Using the three-delays model, we explored the barriers patients and clinicians face concerning sepsis management which contribute to the poorer sepsis outcomes documented in Nigeria studies. Methods Fifteen clinicians were enrolled in dyad and triad group discussions to identify barriers to providing sepsis care. Patients with sepsis are being enrolled for in-depth interviews in March 2024. Results Interim results reveal delay at three levels. Delay 1 was in the decision to seek care due to difficulty in determining disease severity. Delay 2 occurred at the facility due to poor organization of emergency services. Delay 3 involved difficulty in obtaining approvals from health management organizations for patients who had insurance coverage. Conclusion Patient and physician barriers must be addressed to improve sepsis outcomes in our context. There is a need to develop a clinical practice guideline for sepsis in our context, which considers our resource constraints.