Multidisciplinary Approach to Improve Sepsis Outcomes.

Area of Science:

• Critical Care Medicine
• Quality Improvement
• Healthcare Management

Background:

• Severe sepsis and septic shock are major causes of morbidity and mortality, incurring substantial healthcare costs.
• The Surviving Sepsis Campaign (2012) emphasizes time-sensitive care bundles to improve patient outcomes.
• A prior review at a community teaching hospital revealed suboptimal compliance with sepsis management bundles in the medical intensive care unit (ICU).

Purpose of the Study:

• To design and implement a quality improvement initiative to enhance sepsis detection and timely completion of care bundles for ICU patients.
• To evaluate the impact of a novel sepsis alert protocol on compliance with sepsis management recommendations and patient mortality.

Main Methods:

• A "sepsis alert" protocol was implemented, combining electronic and overhead team alerts to mobilize a multidisciplinary response team (nursing, pharmacy, phlebotomy, senior resident) to the bedside.
• A documentation template for sepsis diagnosis and bundle adherence was created.
• Compliance rates for sepsis bundle elements and patient mortality were assessed before and after implementation.

Main Results:

• Compliance with appropriately timed serum lactate draws significantly improved post-implementation (88.6% vs. 70.8%, p = .008).
• No significant improvements were observed in compliance with blood culture timing, antibiotic administration, or hospital mortality rates.

Conclusions:

• The sepsis alert protocol effectively improved the timeliness of lactate draws in ICU patients.
• Further interventions may be necessary to address compliance gaps in other sepsis bundle elements and to impact overall mortality.