Hospital System Reduces Sepsis Mortality by 33 Percent in Three Years

Catholic Healthcare West (CHW), the nation's eighth largest health system, announces that its severe sepsis prevention initiative has saved an additional 991 lives and reduced severe sepsis inpatient mortality rate by 33 percent at the end of three years.

"A core tenant of the healthcare reform plan enacted by Congress is that we can improve quality while also reducing costs," says Lloyd H. Dean, CHW president and CEO. "The results of this program clearly demonstrate those achievements are possible."

CHW launched the three-year initiative in July 2007 with the goal of reducing its inpatient severe sepsis mortality rate by 5 percent across its 41 hospitals in California, Arizona, and Nevada by 2010.

"This is a remarkable expression of CHW's mission to deliver excellent care," says Robert Wiebe, MD, CHW's chief medical officer. "The collaborative effort amongst our outstanding physicians, nurses, and hospital staff has shown tangible improvements in care. We are diagnosing sepsis earlier, treating it more aggressively, and saving lives."

Sepsis is the body's overwhelming response to a serious bacterial infection. It can start in a single area in the body or can be widespread in the bloodstream. If not diagnosed early and treated quickly, sepsis can rapidly lead to organ failure and death. According to the national Surviving Sepsis Campaign, there are more than 750,000 cases of severe sepsis annually in North America with 210,000 fatalities, making it the No. 1 cause of inpatient mortality.

Using the Surviving Sepsis Campaign recommendations, as well as the Institute for Health Care Improvement's collaborative improvement methods, CHW caregivers and staff focused on early recognition of severe sepsis patients, increasing the use of aggressive and appropriate treatment protocols, educating healthcare professionals, monitoring compliance to treatment guidelines, and facilitating data collection for the purposes of improvement and feedback.

"This is innovative and groundbreaking work," says R. Phillip Dellinger, MD, a leader in the Surviving Sepsis Campaign, professor of medicine at University Medicine and Dentistry in New Jersey, and the director of critical care for Cooper University Hospital in Camden, New Jersey. "CHW's caregivers have demonstrated the power of a well-organized quality program that both reduces morbidity and mortality while also achieving significant cost savings."

Each CHW hospital has a multi-disciplinary team comprising physicians, nurses, respiratory therapists, pharmacists, and other clinicians that implement an early resuscitation 'bundle' -- a series of evidence-based measurable treatments that have proven effective when implemented together -- during the first six hours a patient is diagnosed with sepsis. The bundle consists of measuring the patient's blood lactate levels and blood cultures, administering appropriate antibiotics within the first hour of a patient presenting to the emergency department and administering appropriate treatments for low blood pressure.

Because sepsis is such a widespread and serious problem in the inpatient setting, studies have shown that treating it more effectively will result in lower healthcare costs. In three years, CHW estimates its severe sepsis prevention resulted in a savings of more than 36 million in direct variable costs.

"By standardizing this early resuscitation bundle throughout our system, CHW is able to deliver the appropriate care to our patients when they need it, avoiding lengthy and costly hospital stays," says Wiebe.

In its nine Sacramento and San Francisco Bay Area hospitals, CHW has received a two-year grant totaling $1.8 million from the Gordon and Betty Moore Foundation to support the expansion of sepsis prevention nursing education. Utilizing the grant and a portion of matching funds, CHW has hired an analyst, paid for innovative sepsis education services and has developed a comprehensive sepsis education program.

"The Gordon and Betty Moore Foundation is pleased to be supporting this important initiative, which has made a significant and positive impact on the lives of patients and their families," says Marybeth Sharpe, director of the Betty Irene Moore Nursing Initiative Program. "We congratulate the CHW hospitals on implementing evidence-based practices for identification and treatment of sepsis and recognize the critical role of CHW's frontline nurses and other clinicians in this effort."