Stop sepsis, save lives

A large number of patients present to the Emergency Department (ED) with sepsis, severe sepsis or septic shock. Septic shock is associated with 40% mortality risk and is the most common cause of death in the ICU. Moreover, survivors of septic shock are at risk of permanent organ dysfunction, prolonged hospital stay and long term institutionalization. Many of these complications can be minimized and may be avoided by prevention via public health improvement and education, early identification of sepsis, and timely effective intervention. Methods: IHI quality improvement methodology applied to guide our work. The Quality Leaders from ED, ICUs and general wards were invited to participate and collaborate to develop and test the Sepsis 6 Pathway. From the data collected so far we noted the following: Sepsis patients ages range from as young as 19 to 89 years. The most common sepsis diagnoses are septic shock, pneumonia and urosepsis. For the initial management of sepsis patients 49% are managed in the ED. In August we started monitoring delays in time between the patient's admission and criteria met for sepsis diagnosis; and the time between criteria met for sepsis and referral to ICU. If the patient is admitted to the ward this can be as long as days. If the patient is admitted to MICU or ED it ranges from 0 minutes – 1 hrs. The time between criteria met for sepsis and treatment initiated is the most important indicator we are monitoring, which based on the data collected so far averages between 0 minutes – 1 day. Conclusion: Sepsis causes avoidable and preventable patient harm. A multi-faceted approach may help reduce morbidity and mortality. Early implementation of the sepsis 6 pathway is underway in HMC across main acute care areas. Outcome measures will be collected and compared against international standards.