Healthcare News & Insights

Fighting sepsis: Keeping deadly condition under control

While illnesses like ebola and enterovirus D68 have received a lot of press lately, there’s been less attention given to a condition that’s causing harm to many more hospital patients: sepsis.

78752511A condition where a patient’s body has an extreme immune response to fighting a severe infection, once a patient contracts sepsis, it’s a race against the clock to keep the person from getting sicker.

Although the illness is only present in one-tenth of hospital patients, it causes up to half of all hospital deaths in the U.S., according to a research study published this past summer in the Journal for the American Medical Association (JAMA).

In fact, sepsis kills more people each year than breast cancer, AIDS and prostate cancer combined, as stated in a press release from the University of Michigan Health System.

Data from the Centers for Disease Control and Prevention (CDC) suggest that close to 750,000 patients a year contract sepsis, and according to the Agency for Healthcare Research and Quality (AHRQ), it’s the most expensive reason for patients to be hospitalized, currently costing $24 billion annually.

So the illness needs to be controlled to mitigate its negative (and expensive) effects on the population.

Hospitals’ role

What needs to happen to reduce sepsis rates?

For starters, the condition needs to become more of a household name, and hospitals need to take a more active role in preventing it.

A separate JAMA article compares raising awareness about sepsis to efforts undertaken to raise awareness about other illnesses such as heart attack, pneumonia and heart failure.

Several years ago, the healthcare industry set a goal to reduce heart attacks in patients. Clinicians used research to design treatment plans to improve patient outcomes. And federal agencies like the Centers for Medicare & Medicaid Services (CMS) set high standards for hospitals to meet for preventing heart attacks, holding facilities accountable for keeping rates low.

The JAMA article spells out the importance of a similar quality improvement initiative focused on reducing sepsis rates in hospitals. CMS, the CDC and other agencies should create a list of benchmarks hospitals need to meet when diagnosing and treating patients with sepsis, and hospitals should have clear targets they must meet for sepsis prevention.

Any government effort to reduce the likelihood of sepsis should have three components, as listed in the article:

  1. Give incentives to providers for better detection of sepsis
  2. Start with regional collaborations so various approaches can be tested and evaluated, and
  3. Take new evidence from sepsis research into account.

One system’s success

Researchers stress that one of the biggest factors holding back efforts toward sepsis prevention is the lack of a universal tool to diagnose the condition. Without a standard diagnostic test, it’s often difficult for doctors to know whether a patient has sepsis. So they may put off treatment until the condition has progressed, which may be too late for many patients.

Studies where hospitals implemented standard sepsis protocols from the Surviving Sepsis campaign, which was created by the Society of Critical Care Medicine to reduce sepsis rates, have resulted in positive outcomes.

And one early response and warning system used by researchers from the University of Pennsylvania Health System could be a key breakthrough in developing a standard tool all hospitals can use.

The automated alert system, or the “sepsis sniffer,” uses lab and vital sign data that’s been entered into the hospital’s electronic health records (EHR) system to warn providers that a patient may be in danger of developing sepsis.

If a patient has several of the telltale signs, the sepsis sniffer sends an automatic alert to clinical staff on a “sepsis rapid response team.” Providers quickly move to evaluate the patient and take further treatment steps as needed.

Other organizations have tried using EHR alerts to let healthcare staff know about the warning signs of sepsis in the past, but their experiments were more limited in scope. The alerts were only used for patients in certain wards or departments of the hospital. Penn Medicine’s sepsis sniffer was used for all patients admitted to every facility in the hospital system.

Using the EHR tool, doctors were more likely to order tests to determine whether a patient had sepsis, administer antibiotics and IV fluids to patients in a timely manner, and quickly transfer patients with the warning signs of sepsis to the ICU.

These factors led to improved diagnosis rates for sepsis. There was a 50% increase in the documentation of sepsis in patients’ electronic health records using the sepsis sniffer tool. And data suggested there were fewer deaths from sepsis in the Penn Medicine system after the EHR tools were implemented.

Bottom line

No matter what strategy a hospital chooses to prevent sepsis, whether it’s putting warning signs in its EHR or educating providers on accepted sepsis diagnosis protocol, steps must be taken to keep this condition from causing patients more harm down the line.

And given its broad effect on the population, it’s only a matter of time before the feds start turning their focus toward fighting sepsis, so it would benefit hospitals to be ahead of the game.

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