Sutter Health speeds up response times and lowers mortality
Sutter Health in Northern California knew sepsis was a concern. Of the patients who died in its hospitals, 48% had some kind of sepsis, the No. 1 killer of hospital inpatients in this country (Sutter Health Sepsis Initiative). Starting in 2014, the system developed a standardized program to more rapidly identify and treat sepsis.”I’m part of a multidisciplinary team of Sutter Health network nurses, doctors, lab, pharmacy experts, electronic health record specialists, and leaders in our eICU and data analytics,” said Ann Brekke Yungert, RN, Sutter Health Sepsis Initiative nursing lead. Brekke Yungert works at Eden Medical Center, in Castro Valley, Calf., which, along with Mills-Peninsula Medical Center in Burlingame, and Novato Community Hospital in Novato, was a pilot site for the program.
The initiative’s goals include standardizing care delivery, providing care based on the latest evidence-based practice, improving EHR documentation, decreasing mortality, and improving education for clinical teams. “What we tried to do was create protocols that can be standardized across the Sutter facilities,” said Karin Molander, MD, sepsis initiative lead, Mills-Peninsula Medical Center (Sutter Health Sepsis Initiative).
When it comes to sepsis patients, the first six hours really matter. Sutter Health’s sepsis team developed standardized workflows for clinicians in the ED, ICU, and the med/surg units. Sutter’s program focuses on rapid application of the sepsis bundle for patients with signs of severe sepsis and sepsis shock. “Nurses, doctors and clinicians can provide the same level of care for a patient with sepsis, regardless of where the patient entered the hospital,” Brekke Youngert added. Code Sepsis was designated for patients at the highest risk of death. The transfer and admissions processes were streamlined, so patients can be admitted to the ICU faster.
EHRs allowed the team to re-evaluate and improve sepsis screenings. “We worked closely with the bedside staff to create a standard evidence-based sepsis screening tool and EHR clinical decision support,” said Brekke Yungert about the sepsis initiative team.
They are also improving the documentation and coding for sepsis, making it more reliable.
“The nurses now have tools within the electronic health record that prompt them to screen the patient for sepsis. And if they do screen they might have severe sepsis, they trigger action,” explained Kavita Pantakar, MD, hospitalist team member, Eden Medical Center (Sutter Health Sepsis Initiative).
Nancy Dupree, RN, a perioperative nurse at Eden Medical Center, recalled that just a few hours after her staff training on signs of sepsis, she had a patient whose temperature increased rapidly in a short window of time – a potential warning sign for sepsis. Dupree screened the patient, who tested positive for sepsis and was then given lifesaving medication.
That patient was not the only one who has benefited from such quick action. Rapid response teams respond to patients at risk for severe sepsis on inpatient floors. During their hospital stay, such patients continue to be monitored very closely
Mortality from sepsis and septic shock is down by 26% systemwide from January 2014 through July 2015. That translated into 500 lives saved. At Eden Medical Center, there’s been a 48% drop in sepsis-related mortality from July 2014 to July 2015.
“We set high standards for our patients’ experience,” said Brekke Yungert.
Their work has improved both medical outcomes and the quality of life for large portions of the patient population.