Implementing an obstetric sepsis bundle in a large academic hospital system

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Healthcare Quality Improvement

Background:

• Obstetric sepsis, previously maternal sepsis, is a major cause of maternal mortality and morbidity.
• Existing sepsis management protocols often lack obstetric-specific considerations.
• New York-Presbyterian identified critical gaps in sepsis care for pregnant and postpartum individuals.

Purpose of the Study:

• To implement a system-wide, comprehensive sepsis bundle for obstetric patients.
• To develop obstetric-specific sepsis identification criteria and management algorithms.
• To standardize and improve the early recognition and treatment of sepsis in maternal care across multiple hospital campuses.

Main Methods:

• Developed new sepsis criteria tailored for obstetric patients.
• Created electronic medical record (EMR) alerts for obstetric-specific indicators.
• Established a structured sepsis management algorithm and conducted simulation-based training.
• Collaborated across eight hospital campuses for system-wide implementation.

Main Results:

• Achieved a significant reduction in preventable sepsis-related morbidity.
• Identified further areas for improvement in fever and chorioamnionitis management.
• Highlighted challenges in adapting sepsis criteria and integrating trauma-informed care.

Conclusions:

• Tailored quality improvement initiatives are effective in enhancing obstetric patient safety.
• Proactive interventions and standardized protocols are crucial for improving maternal health outcomes.
• Ongoing monitoring and education are essential for sustained improvement in maternal sepsis care.