Concerned about the nation's high mortality rate for sepsis, a team at Dartmouth-Hitchcock in Lebanon, N.H., focused on early detection and rapid delivery of care for sepsis patients and was able to double their chance of survival.
The multidisciplinary team, led by Andreas Taenzer, MD, an anesthesiologist, took data from the High Value Healthcare Collaborative and visited other hospitals to see how they targeted sepsis. The team found that when the sepsis three-hour bundle was implemented consistently and quickly it can save the majority of the sickest patients.
To better identify who the sickest patients are, the sepsis team developed an update to the systemic inflammatory response syndrome triage criteria and hung the update on fliers in the hospital's emergency department. Additionally, the team developed a sepsis scorecard and tweaked the timing of fluids and antibiotic delivery of the sepsis bundle.
As a result of these changes, Dartmouth-Hitchcock clinicians have consistently delivered the three-hour sepsis bundle to more than 80 percent of patients. This improved intervention reduced sepsis patient mortality by more than 50 percent.
Since the program was so successful in the ED, the team is now working to improve sepsis detection and treatment across all general care units.
"The final component will be to roll the effort out to all of the hospitals and care centers in the region," said Dr. Taenzer. "To improve the outcomes of all patients across the state, we need to work with other providers to intervene earlier. We're not there yet, and it's going to take a lot of work to sustain this effort, but we've come an astonishingly long way in a very brief period of time."