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.