Sepsis Programs in Acute Care U.S. Hospitals

SUMMARY:

  • Sepsis programs within a hospital have been found to decrease:

    • Mortality
    • Length of stay
    • Hospital costs

  • The National Healthcare Safety Network conducted a survey in 2022 acute care hospitals on their sepsis programs.

  • Of 5,221 respondents, the majority of hospitals reported the presence of a sepsis committee with responsibility for oversight.
  • Effectiveness of sepsis programs was not evaluated.
  • Presence of programs and their features varied by hospital size.
  • Opportunities exist for future enhancements.

REVIEW:

  • Survey about sepsis programs focused on:

    • Leadership support for sepsis activities
    • Approaches to rapid sepsis identification
    • Sepsis management approaches

  • 5,221 acute care hospitals responded

    • The majority (55%) of respondents were smaller size hospitals.
    • Very few large size hospitals responded.

EPSIS PROGRAMS:

  • Overall 73% of hospitals reported having a sepsis committees.
  • Sepsis committees were less prevalent in smaller hospitals and progressively increased based on hospital size.
  • Providing sepsis program leaders dedicated time as well as allocating resources to support sepsis efforts followed a similar trend.
  • Review of CMS  SEP-1 measures as well as monitoring and reviewing the effectiveness of sepsis strategies was a very common goal regardless of hospital size.
SEPSIS SCREENING:
  • Most hospitals had an EHR-generated sepsis alert based on SIRS criteria
  • A small amount had a similar alerting mechanism based on qSOFA criteria
  • Effectiveness of these programs is suspicious with 38 (large hospital) to 51%  (101-250 beds) of hospitals having a manual screening process in place.
SEPSIS PROTOCOLS:
  • Most hospitals reported having a sepsis protocol in place.
  • However, mostly smaller hospitals do not have an automated system to prompt for the compliance of time sensitive aspects of sepsis care.
    • This progressively increased from small to large hospitals.

CONCLUSIONS:

  • Self-reporting by hospitals indicates the prevalence of sepsis program committees.

  • The purpose of these committees is to monitor and review effectiveness of sepsis care within the hospital, however, definitions of a sepsis program was not required for this survey.

  • However, smaller hospitals appear limited in sepsis leadership, rapid identification and management practices as compared to larger hospitals.

  • This survey identifies opportunities to further improve the structure and care of the hospitalized sepsis patient.

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Erkan Hassan is the Co-Founder & Chief Clinical Officer of Sepsis Program Optimization where he designs & oversees the implementation of solutions to optimize sepsis programs.

To discuss your organization’s Barriers of Effective Sepsis Care, contact Erkan by phone (844) 4SEPSIS (844-473-7747), email (erkan@spo.icu), or video chat.