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. 2016 Jan-Feb;31(1):56-63.
doi: 10.1177/1062860614551042. Epub 2014 Sep 12.

Improving Outcomes in Patients With Sepsis

Scott B Armen  1 , Carol V Freer  1 , John W Showalter  1 , Tonya Crook  1 , Cynthia J Whitener  1 , Cheri West  1 , Thomas E Terndrup  1 , Marissa Grifasi  1 , Christopher J DeFlitch  1 , Christopher S Hollenbeak  2
Affiliations

Improving Outcomes in Patients With Sepsis

Scott B Armen et al. Am J Med Qual. 2016 Jan-Feb.

Abstract

Sepsis mortality may be improved by early recognition and appropriate treatment based on evidence-based guidelines. An intervention was developed that focused on earlier identification of sepsis, early antimicrobial administration, and an educational program that was disseminated throughout all hospital units and services. There were 1331 patients with sepsis during the intervention period and 1401 patients with sepsis during the control period. After controlling for expected mortality, patients in the intervention period had 30% lower odds of dying (odds ratio = 0.70, 95% confidence interval [CI] = 0.57 to 0.84). They also had 1.07 fewer days on average in the intensive care unit (95% CI = -1.98 to -0.16), 2.15 fewer hospital days (95% CI = -3.45 to -0.86), and incurred on average $1949 less in hospital costs, although the effect on costs was not statistically significant. Continued incremental improvement and sustainment is anticipated through organizational oversight, continued education, and initiation of an automated electronic sepsis alert function.

Keywords: evidence-based medicine; interdisciplinary health team; outcomes assessment; quality improvement; sepsis; severe sepsis.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Quarterly outcomes after sepsis intervention. (A) Trend in observed mortality rate for patients with sepsis by quarter, 2009 to 2011. (B) Trend in ratio of observed mortality to expected mortality by quarter, 2009 to 2011. (C) Trend in average length of hospital stay for patients with sepsis by quarter, 2009 to 2011. (D) Trend in average hospital costs for patients with sepsis by quarter, 2009 to 2011.
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