By Mike Abrams
One summer day in Thornville, Ohio, Denise Bauer was talking with her husband, Rick Cochran, on the phone and could tell he was in pain and confused. A few hours later he seemed fine as he relaxed in a recliner, but his wife, a nurse, called paramedics because she knew the symptoms were problematic. Before long he couldn’t stand up.
He was rushed by ambulance to Fairfield Medical Center in Lancaster, Ohio where emergency physicians noticed a wound on his leg and initiated a sepsis protocol. After running multiple tests they determined he was suffering from sepsis. He was quickly moved to the ICU because his lungs, kidneys and heart began to shut down. While Rick remained in the hospital for a month to address his response to the infection, he’s alive and well today, sharing his story with the community, a story that is unfortunately not uncommon.
Sepsis is a medical emergency that quietly kills as many Americans each year as stroke and heart attack. The condition is the single most expensive condition to treat in all of health care, accounting for $24 billion in annual U.S. healthcare costs, including more than $6 million in Ohio.
But there is a solution. Knowing the signs of sepsis can be the difference between life and death. Most sepsis cases originate outside of hospital care. It can lead to tissue damage, organ failure, and death if not recognized early and treated appropriately. It is your body's overwhelming and toxic response to an infection. Yet, less than 1 percent of U.S. adults know the signs of sepsis.
The Ohio Hospital Association recently released a report highlighting that Ohio hospitals have achieved a 13.4 percent statewide reduction in sepsis mortality. This represents an estimated 1,486 lives saved over the first 18 months of a statewide community initiative to confront a condition that affected 38,000 Ohioans in 2016.
OHA launched the initiative in June 2015 with a goal of reducing sepsis mortality in Ohio by 30 percent by the end of 2018. The state's sepsis mortality rate sits at 18.4 percent as of December 2016.
The effort has two key strategies: 1) to improve early recognition, and 2) early, appropriate intervention with incorporation of the Surviving Sepsis Campaign’s three-hour sepsis bundle. Hospitals that joined the initiative receive quarterly reports of their progress, access to monthly evidence-based educational and coaching calls, as well as additional resources and support at no cost.
The steps taken by Ohio hospitals can be applied in other states to reduce the nationwide sepsis crisis.
Impact of community partners
OHA’s quality team collaborates with participating member hospitals, emergency medical service providers, home caregivers, and community partners to promote the importance of knowing the signs of sepsis to ensure timely and appropriate clinical intervention to save lives.
In 2016, OHA launched a community partner campaign, which is focused on promoting the signs of sepsis to increase early recognition and early appropriate intervention. The OHA SOS campaign includes OHA member hospitals and providers throughout the continuum of care – from EMTs and home health providers, to hospital ERs, to long-term care facilities. The Sepsis Alliance and LeadingAge Ohio were the first to join OHA for this effort. The campaign directs hospitals and community partner organizations to ohiohospitals.org/SOS where they will submit their interest and support of sharing and promoting the signs of sepsis to their constituencies.
The OHA and Sepsis Alliance partnership has included activities such as conducting a community campaign, promoting sepsis awareness month observance with Ohio’s Governor’s proclamation, participating in annual Spike Out Sepsis (volleyball) event held in Columbus, participating in Sepsis Heroes event in New York City and providing statewide professional continuing medical education.
The OHA quality team also provided member participants with programming that features a wide range of sepsis topics featuring clinical experts and speakers from across the nation including the University of Michigan, Sepsis Alliance, and Jefferson Health System (located in Philadelphia and New Jersey), and many Ohio-based hospitals and health systems.
Power of committed leaders
Systematic changes must start at the top. The OHA Board of Trustees called for a measure of leadership commitment to achieve a reduction in sepsis mortality. Hospital leaders, mostly CEOs, were provided with a list of actions and were asked to identify which actions were being undertaken, thereby demonstrating their commitment of leadership and operational resources.
It is very encouraging to see the level of involvement by members and their leadership, as well as those in the field, like EMTs and home health workers, to prioritize this initiative. Everyone understands that health care professionals must fight sepsis together.
The report also details the educational and clinical activities of 124 Ohio hospitals collaborating on strategies across the state and provides resources for clinicians and community partners to join the cause. A full list of the participating hospitals is included in the report.
Next steps for Ohio
OHA encourages all Ohio hospitals and health systems to join its SOS campaign and promote the signs of sepsis. By getting on board with the SOS program, members have access to the campaign toolkit and OHA sepsis and quality experts.
OHA will continue to collaborate with other health care providers and strategic partners to launch two pilot programs to look at hospital responses to EMS-generated sepsis alerts from the field.
Hospitals around the nation are challenged to look at data to identify which infections pose a higher risk of sepsis, and find biomarkers that indicate the incidence and progression of sepsis. By working together to improve early recognition and appropriate intervention, healthcare professionals can save the lives of people nationwide.
Mike Abrams joined the Ohio Hospital Association (OHA) in February 2012 as president and CEO. He leads a team of 65 associates, supports a 20-member Board of Trustees, serves on a variety of healthcare and hospital task forces and committees, and works with more than 2,000 members of seven OHA professional societies. Learn more at www.ohiohospitals.org