Improving Mortality for the Septic Patient with a Resuscitation Bundle in the Emergency Department (ED)

A multidisciplinary committee found that despite an overall sepsis mortality rate similar to expected, there was significant variation in the care these patients received. Efforts to reduce mortality focused on sepsis recognition and treatment by using an ED protocol on appropriate fluid and antibiotic administration.

A sepsis alert process was created to promptly bring clinical resources to the patient bedside. A simple one page order set was created to facilitate care. A focus study within the hospital's MIDAS software system tracked process and outcome metrics. PDSA techniques were utilized to foster timely protocol and implementation of process improvements.

Overall sepsis mortality decreased by 20 percent with an absolute reduction in mortality from 25 percent to 20 percent with a p-value of 0.001. LOS decreased by 1.4 days. Overall sepsis diagnosis increased from an average of 34 cases/month to 44 cases/month. Usage of the sepsis alert protocol increased from 50 percent.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)