Sepsis Performance Programs
Can Optimize Patient Outcomes
Can Optimize Patient Outcomes
SUMMARY
- Sepsis performance improvement programs can optimize compliance with sepsis protocols and are associated with improved patient outcomes.
- Having a Sepsis Performance Improvement program is more important than the specific content of the program.
- Engaging a large multidisciplinary group of clinical leaders is essential for success.
REVIEW
- Despite variances in Sepsis Performance Improvement Programs, they are consistently associated with increased bundle compliance.
- Although there are multiple components to a Sepsis Performance Improvement Program, the factors independently associated with improved bundle compliance and decreased mortality are:
- Use of Screening tools
- Workflow Process Changes
- Educational Programs
USE OF SCREENING TOOLS:
- The goal of sepsis screening tools is NOT to diagnose sepsis, but rather for early identification of possible sepsis cases requiring further evaluation.
- Sepsis screening alone will not result in improved performance measures or patient outcomes.
- A large number of risk scores and screening tools are available (SIRS, MEWS, NEWS, qSOFA)
- None are superior to any other
- Accuracy of the tools are highly variable
- All are susceptible to false positive findings
- Artificial intelligence may help improve the value of these tools.
WORKFLOW PROCESS CHANGES:
- Once a suspected sepsis patient has been identified, implementation of the response is the most critical step.
- Dedicated teams to respond to sepsis alerts, prevents placing the full burden of responsibility on a single extremely busy individual.
- The use of a dedicated team has proven improved clinical outcomes.
- Other process changes contributing to better bundle adherence include:
- Printed/easily accessible protocols
- Standardized order sets
- Frequent auditing
- Nurse driven protocols
EDUCATIONAL PROGRAMS:
- Increased awareness of the sepsis approach via an educational program is essential.
- Education materials could consists of:
- Lectures
- Bedside teaching
- Simulation training
ADDITIONAL CONSIDERATIONS:
- It remains to be seen if improved patient outcomes are due to:
- Care bundle adherence
- If 1 bundle element is of greater value than any other
- If increased awareness irrespective of bundle adherence is important.
- Should we be considering other endpoints than mortality, such as:
- Resource use
- Duration of invasive treatments
- Development of organ dysfunction requiring high levels of care
CONCLUSIONS:
- Implementing a Sepsis Performance Improvement Program is associated with a number of improvements in care processes and patient outcomes.
- Dedicated sepsis teams increase collaborative and timely discussions.
- Workflow changes allow incorporation of clinical judgement while applying the recommended elements of sepsis care.
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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.