Multimodal Quality Initiatives in Sepsis Care: Assessing Impact on Core Measures and Outcomes

Area of Science:

• Critical Care Medicine
• Quality Improvement Science
• Hospital Administration

Background:

• Sepsis care is challenged by delayed recognition and intervention, impacting patient outcomes.
• The Surviving Sepsis Campaign bundles aim to reduce mortality, but consistent hospital adherence remains a challenge.
• Suboptimal outcomes necessitate innovative approaches to sepsis management.

Purpose of the Study:

• To implement and evaluate a multimodal quality improvement program for severe sepsis and septic shock.
• To enhance compliance with the Severe Sepsis and Septic Shock Management Bundle.
• To reduce sepsis-related mortality in a large urban tertiary hospital.

Main Methods:

• A hospital-wide, multimodal quality improvement program was implemented from 2017 to 2022.
• Interventions included a multidisciplinary committee, sepsis champions, alerts, order sets, a Code Sepsis team, audits, and education.
• Key metrics tracked were Severe Sepsis and Septic Shock Management Bundle compliance and observed/expected mortality ratio.

Main Results:

• Baseline bundle compliance was 25%, with an observed/expected mortality ratio of 1.14.
• By 2022, bundle compliance increased to 62%.
• The observed/expected mortality ratio decreased significantly to 0.73, indicating improved survival.

Conclusions:

• A multimodal, hospital-wide sepsis performance program is feasible and effective in improving patient outcomes.
• Interdisciplinary collaboration is crucial for successful sepsis care initiatives.
• Further research is needed to isolate the impact of individual intervention strategies on sepsis outcomes.