Development of a Quality Improvement Learning Collaborative to Improve Pediatric Sepsis Outcomes.

Area of Science:

• Pediatrics
• Critical Care Medicine
• Public Health

Background:

• Pediatric sepsis is a significant public health concern with persistent challenges despite existing guidelines.
• Current initiatives have yielded modest improvements, highlighting the need for enhanced strategies.

Purpose of the Study:

• To improve sepsis outcomes in pediatric emergency departments, ICUs, general care, and hematology/oncology units.
• To reduce sepsis-attributable mortality and hospital-onset sepsis incidence by 25% through a collaborative quality improvement initiative.

Main Methods:

• Development of a multicenter quality improvement learning collaborative (Improving Pediatric Sepsis Outcomes - IPSO) involving US children's hospitals.
• Review of treatment guidelines and literature, coupled with expert opinion, to create a key driver diagram (KDD).
• Engagement of 56 hospital-based teams in educational and information-sharing activities.

Main Results:

• Established baseline sepsis-attributable mortality at 3.1% and hospital-onset sepsis incidence at 1.3 cases per 1000 admissions.
• Developed a KDD with primary drivers focused on infection treatment, sepsis recognition/diagnosis, care de-escalation, patient/family engagement, and performance optimization.
• Achieved 100% team engagement in collaborative learning and information sharing.

Conclusions:

• The IPSO collaborative provides a framework for improving pediatric sepsis outcomes.
• Collaborative learning and reliable implementation of evidence-based interventions are key to reducing pediatric sepsis mortality and incidence.
• The KDD serves as a strategic tool to guide quality improvement efforts in pediatric sepsis management.