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Impact of a Coordinated Sepsis Response on Time to Treatment in a Pediatric Emergency Department
Jaqueline Corboy1,2, Kimberly Denicolo1, Roderick C Jones1
1Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Insights
A sepsis response team improved fluid administration timeliness in pediatric patients. This initiative addressed critical delays in emergency care, aiming to reduce sepsis-related morbidity and mortality. Further improvements are needed for antibiotic delivery.
Area of Science:
- Pediatric Emergency Medicine
- Sepsis Management
- Healthcare Quality Improvement
Background:
- Sepsis causes significant pediatric hospitalizations and mortality.
- Timely fluid resuscitation and antibiotics are crucial for sepsis treatment.
- The emergency department previously failed to meet sepsis treatment timeliness goals.
Purpose of the Study:
- To implement a sepsis response team to improve timely care.
- To meet Surviving Sepsis Campaign goals for fluid and antibiotic administration.
- To reduce delays in pediatric sepsis management within 8 months.
Main Methods:
- Implemented a sepsis response team with a communication tool and supply cart.
- Utilized statistical process control charts to evaluate performance.
- Conducted observational studies to assess adherence to the new protocol.
Main Results:
- Observed sustained reductions in the average time to administer fluids.
- Increased the proportion of patients receiving fluids within the target 20 minutes.
- Did not observe significant improvements in timely antibiotic administration.
Conclusions:
- A dedicated sepsis response team enhances fluid administration timeliness in pediatric patients.
- Clear roles, communication, and accessible supplies are key to improving sepsis care.
- Further strategies are needed to optimize antibiotic delivery times.
Background:
Sepsis is responsible for 75 000 pediatric hospitalizations annually, with an associated mortality rate estimated between 11% and 19%. Evidence supports the use of timely fluid resuscitation and antibiotics to decrease morbidity and mortality. Our emergency department did not meet the timeliness goals for fluid and antibiotic administration suggested by the 2012 Surviving Sepsis Campaign.
Methods:
In November 2018, we implemented a sepsis response team utilizing a scripted communication tool and a dedicated sepsis supply cart to address timeliness barriers. Performance was evaluated using statistical process control charts. We conducted observations to evaluate adherence to the new process. Our aim was to meet the Surviving Sepsis Campaign's timeliness goals for first fluid and antibiotic administration (20 and 60 minutes, respectively) within 8 months of our intervention.
Results:
We observed sustained decreases in mean time to fluids. We also observed a shift in the proportion of patients receiving fluids within 20 minutes. No shifts were observed for timely antibiotic administration.
Conclusions:
The implementation of a dedicated emergency department sepsis response team with designated roles and responsibilities, directed communication, and easily accessible supplies can lead to improvements in the timeliness of fluid administration in the pediatric population.
