Overview and Opportunity:
Severe Sepsis and Septic Shock are leading causes of mortality in hospitalized patients. In-hospital mortality due to severe sepsis ranges from 25% to 60%. Intermountain has successfully decreased mortality to around 9% for patients with severe sepsis or septic shock that are admitted directly to the ICU from the emergency department (ED). The Intensive Medicine Clinical Program (IMCP) has not formally developed goals or improvement programs focusing on patients who are admitted to a general hospital unit and then develop sepsis during hospitalization. Mortality for patients who develop severe sepsis on acute care inpatient settings and transfer to ICU can be as high as 40%. The IMCP believes the greatest impact on hospital mortality for this population can be made by providing education for early identification of sepsis and implementation of the sepsis bundle on acute care floors while continuing to improve the compliance of the sepsis bundle for patients admitted from the ED to the ICU.
The following measure will be accomplished:
1. Develop and implement computer-based training (CBT) education for all acute care nursing staff to promote early sepsis recognition and appropriate care. Achieve 95% compliance to CBT.
2. For patients who meet the criteria of severe sepsis or septic shock as defined by the Surviving Sepsis Campaign and who are admitted to the ICU from either the ED or an acute care floor the following measures will be accomplished:
a) Increase in Sepsis Bundle Compliance from 24 % to 40% with 98% power to detect a statistically significant improvement
Relative decrease in Hospital Mortality in the board goal population by 10% (from 17% to 15.3%)
Baseline: 24% Bundle Compliance; 17% Mortality
Entry: Education (1) deployed to participating facilities
Target: Education + Compliance 2a) or Mortality (2b)
Stretch: Education (1) + Compliance (2a) + Mortality (2b)
Baseline Period: 1/1/2013 to 6/30/2013
Measurement Period: 6/1/2014 to 9/30/2014