Healthcare News & Insights

State requires hospitals to adopt new sepsis protocols

As the leading cause of death in U.S. hospitals and a major driver of medical costs, accounting for an estimated $17 billion annually, it’s surprising hospitals aren’t required to implement specific sepsis protocols. But that’s all about to change.

In May, New York will become the first state to require that all hospitals adopt a new set of protocols for the early identification and treatment of sepsis.

In New York, alone, the number of severe sepsis cases increased 68% — 6,001 in 2005 to 43,608 in 2011, according to the Health Department. And the number of sepsis cases increased 41% — 71,049 in 2005 to 100,073 in 2011. As for mortality rates from severe sepsis: They’re on a similar scale to lung, breast and colon cancer.

Without the new regulations, the Health Department expects that New York will see dramatic increases in cases of sepsis and sepsis mortality as the numbers of persons who are at risk continue to increase.

Rory’s story

The new protocols called “Rory’s Regulations” were named after Rory Staunton, a 12-year old boy from Queens who die last year from sepsis, four days after he cut his arm playing basketball. Suffering with a high fever, mottled skin and a sore leg, Rory was misdiagnosed in the emergency room (ER) as having a stomach flu, reported the Wall Street Journal.

Rory was seen by his pediatrician and at the ER, and was released without key blood test for the infection that could have possibly saved his life. That’s why Rory’s parents are advocating for other states and the federal government to follow in New York’s footsteps so no other parent has to suffer such a gut-wrenching loss.

The rapid diagnosis and management of sepsis is critical to successful treatment, as this story shows. Typically, when tests are done, the sepsis patient is already critically ill and requires immediate attention to avoid rapid deterioration. That’s why it’s extremely vital to treat the patient at the same time as confirming the diagnosis.

Sepsis is treatable with heavy-duty antibiotics, but early detection is the key to successful treatment.

New protocols

The new regulations were released last month by NY Health Commissioner Dr. Nirav Shah. The current best practices are:

  • to administer antibiotics and fluid resuscitation within one hour of a diagnosis of sepsis, and
  • full implementation of spesis protocols within three hours for severe sepsis, and six hours for septic shock.

To provide flexibility for the different types of hospitals that exist, facilities can select protocols that work for them. However, the protocols must be approved by the Department of Health prior to implementation and must be updated periodically and provided by trained staff.

The regulations also require hospitals to collect data for their own improvement purposes, and to report to the Department of Health to ensure compliance with the new regulations.

Covers pediatric care

There are also pediatric care regulations that require doctors to communicate critical test results in “plain language” to parents before their child is discharged from the hospital. They also have to forward all tests results to the primary care provider.

Hospitals also must allow at least one parent or guardian to stay with the pediatric patient at all time and post a “Parents’ Bill of Rights” informing parents of the protection provided by the regulations.

Both sets of regulations will be submitted to the New York State Public Health and Health Planning Council, published in the state register and given a 45-day public comment period. After the review and approval, it’s estimated that the new regulations will take affect in May.

Hospitals will then have to submit their protocols to the State Health Department before July 1 for review, and must implement the protocols within 45 days of approval.

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