System wide Healthcare Collaborative for Sepsis Quality Initiative
AHA’s Piedmont Hospital Sepsis program summary: When the critical care team at Piedmont Hospital started using the Surviving Sepsis Campaign/ IHI sepsis bundles, they discovered that the sepsis knowledge deficit coupled with the implementation of bundle requirements was an overwhelming barrier to change. They stepped back and asked, “? What can we do to get the most improvement?” With the guidance of the Process improvement team and Barbara McLean, MN, CRNP, CCRN, FCCM, an external expert consultant, a newly developed and focused approach geared towards Sepsis Prevention was initiated in the ED. A point based, simple algorithm was designed based on the SIRS criteria and infection-exposure risk, enabling staff a method of identification of those patients at high risk for severe sepsis. If a patient is identified as a possible sepsis case, a nurse immediately starts the modified sepsis protocol. Now the protocol is embedded in practice.
Education was applied to all providers, with intensive education and testing for a certification mode. The algorithm was linked to simple protocols for fluid and antibiotic management in the first 60 minutes after identification. A very intensive, all provider education program was initiated at the same time, complete with certification process. The increased identification and the rapidly following interventions promoted a significant and sustainable decrease in mortality across the entire system.