Sepsis is a life-threatening complication of an infection and the leading cause of death
in non-coronary intensive care unit (ICU) patients in the U.S. Quick identification
and early delivery of evidence-based treatment are critical to best care and
improved patient outcomes. Mortality rates range widely, from 10 percent to over
50 percent, across the spectrum of sepsis—from early stages to its more severe
forms, including severe sepsis and septic shock. Timing of appropriate therapy is
critical to achieving desired clinical outcomes.
Intermountain has significantly reduced mortality by consistently applying its
sepsis bundle and providing education on early identification of sepsis through
the focused efforts of the Intensive Medicine Clinical Program.
The Intensive Medicine Clinical Program’s work
has resulted in raised national standards
of caring for patients with sepsis
In 2005, the Intensive Medicine Clinical Program conducted a multiyear,
longitudinal quality-improvement initiative focused on patients
with severe sepsis or septic shock. The goal was to significantly increase
compliance with 11 elements identified in a sepsis bundle and to reduce
in-hospital mortality rates in patients with severe sepsis or septic shock
who were admitted to the ICU from the emergency department (ED). The
complete bundle compliance (all 11 elements) increased from 4.4 percent,
the 2004 baseline, to 74.7 percent at the end of 2010. The mortality rate
for the same period decreased from 20.8 percent to 8.7 percent.
In 2014, the Intensive Medicine Clinical Program broadened the patient
population to include patients who develop severe sepsis or septic shock
and who are initially admitted to an acute inpatient setting. Broadening
the goal to include inpatient sepsis from an acute care setting provides
new opportunities for improvement of the care Intermountain provides
patients with severe sepsis and septic shock. The Clinical Program’s
clinical experts believe the greatest impact on hospital mortality for
this population can be achieved by 1) providing education for early
identification of sepsis, and 2) implementing the sepsis bundle on acute
care floors, while improving the compliance of the sepsis bundle for
patients admitted from the ED to the ICU. Intermountain has seen
earlier initiation of appropriate therapies as a result of its focused efforts.
As a result of educating care providers and implementing the sepsis bundle
over the last several years, Intermountain has significantly decreased
mortality across the enterprise.
“Intermountain Healthcare has become recognized nationally and
internationally as a leader in the care of septic patients and is helping set
new benchmarks for sepsis outcomes,” said Terry Clemmer, MD, and
Medical Director of the Intensive Medicine Clinical Program.