Sepsis and Shock Response Team: Impact of a Multidisciplinary Approach to Implementing Surviving Sepsis Campaign Guidelines and Surviving the Process

Abstract

The Surviving Sepsis Campaign guidelines are designed to decrease mortality through consistent application of a 7-element bundle. This study evaluated the impact of improvement in bundle adherence using a time-series analysis of compliance with the bundle elements before and after interventions intended to improve the process, while also looking at hospital mortality. This article describes interventions used to improve bundle compliance and hospital mortality in patients admitted through the emergency department with sepsis, severe sepsis, or septic shock. Quality improvement methodology was used to develop high-impact interventions that led to dramatically improved adherence to the Surviving Sepsis Campaign guidelines bundle. Improved performance was associated with a significant decrease in the in-hospital mortality of severe sepsis patients presenting to the emergency department.

Keywords

sepsis quality team

Get full access to this article

View all access options for this article.

References

Angus

Linde-Zwirble

Lidicker

Clermont

Carcillo

Pinsky

MR.

Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303-1310.

Rivers

Nguyen

Havstad

et al . Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377.

Peake

Delaney

Bailey

et al . Goal-directed resuscitation for patients with early septic shock. N Engl J Med. 2014;371:1496-1506.

Lin

Huang

Lin

Liu

Wang

Kuo

HP.

A modified goal-directed protocol improves clinical outcomes in intensive care unit patients with septic shock: a randomized controlled trial. Shock. 2006;26:551-557.

Levy

Rhodes

Phillips

et al . Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study. Intensive Care Med. 2014;40:1623-1633.

Lilly

CM.

The ProCESS trial—a new era of sepsis management. N Engl J Med. 2014;370:1750-1751.

Dellinger

Levy

Rhodes

et al . Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39:165-228.

Barochia

Cui

Eichacker

PQ.

The Surviving Sepsis Campaign’s revised sepsis bundles. Curr Infect Dis Rep. 2013;15:385-393.

Casserly

Baram

Walsh

Sucov

Ward

Levy

MM.

Implementing a collaborative protocol in a sepsis intervention program: lessons learned. Lung. 2011;189:11-19.

10.

Schramm

Kashyap

Mullon

Gajic

Afessa

Septic shock: a multidisciplinary response team and weekly feedback to clinicians improve the process of care and mortality. Crit Care Med. 2011;39:252-258.

11.

Wang

Donnelly

Shapiro

Hohmann

Levitan

EB.

Hospital variations in severe sepsis mortality. Am J Med Qual. 2015;30:328-336.

12.

Mouncey

Osborn

Power

et al . Trial of early, goal-directed resuscitation for septic shock. N Engl J Med. 2015;372:1301-1311.

13.

Sebat

Musthafa

Johnson

et al . Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Crit Care Med. 2007;35:2568-2575.

14.

Funk

Sebat

Kumar

A systems approach to the early recognition and rapid administration of best practice therapy in sepsis and septic shock. Curr Opin Crit Care. 2009;15:301-307.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

1.28 MB