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Multidisciplinary Approach to Improve Sepsis Outcomes

MacMillan, Andrew; Rudinsky, David; Han, Gena; Elliott, John O.; Jordan, Kim

The Journal for Healthcare Quality (JHQ): July/August 2019 - Volume 41 - Issue 4 - p 220–227
doi: 10.1097/JHQ.0000000000000166
Original Article

ABSTRACT Severe sepsis and septic shock cause significant morbidity and mortality with health care costs approximating $17 billion annually. The Surviving Sepsis Campaign 2012 recommended time-sensitive care bundles to improve outcomes for patients with sepsis. At our community teaching hospital, a review of sepsis management for patients admitted to a medical intensive care unit (ICU) between December 2015 and March 2016 found 70.8% compliance with timing of lactate draw, 65.3% compliance for blood cultures, and 51.4% compliance with antibiotic administration recommendations. Thus, a quality improvement initiative to improve detection and time to bundle completion for ICU-level patients was designed. Previous studies suggest that utilization of sepsis alert systems and sepsis response teams in the emergency department setting is associated with improved compliance with recommended sepsis bundles and improved hospital mortality. Therefore, a “sepsis alert” protocol was implemented that used both an electronic alert and an overhead team alert that mobilized nursing, pharmacy, phlebotomy, and a senior internal medicine resident to bedside. In addition, a template to document sepsis diagnosis and bundle adherence was created. After implementation, we noted improvement in appropriately timed serum lactate, 88.6% versus 70.8% (p = .008) with no significant improvements in blood cultures, antibiotic administration, or mortality.

For more information on this article, contact Andrew MacMillan at

The authors declare no conflicts of interest.

All authors participated in the conceptualization and design of the study, interpretation of the results, and drafting and revision of the manuscript. All authors have approved the final draft for submission.

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© 2019 National Association for Healthcare Quality
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