Using quality improvement principles to improve the care of patients with severe sepsis and septic shock

Seoane, Leonardo, Winterbottom, Fiona, Nash, Teresa, Behrhorst, Jessica, Chacko, Elen, Shum, Lucas, Pavlov, Andrey, Briski, David, Thibeau, Shelley, Bergeron, Dominique, Rafael, Tiffany and Sundell, Erik (2013) Using quality improvement principles to improve the care of patients with severe sepsis and septic shock. Ochsner Journal, 13 3: 359-366.

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Name Description MIMEType Size Downloads
Author Seoane, Leonardo
Winterbottom, Fiona
Nash, Teresa
Behrhorst, Jessica
Chacko, Elen
Shum, Lucas
Pavlov, Andrey
Briski, David
Thibeau, Shelley
Bergeron, Dominique
Rafael, Tiffany
Sundell, Erik
Title Using quality improvement principles to improve the care of patients with severe sepsis and septic shock
Journal name Ochsner Journal   Check publisher's open access policy
ISSN 1524-5012
Publication date 2013-01-01
Sub-type Article (original research)
Open Access Status Not Open Access
Volume 13
Issue 3
Start page 359
End page 366
Total pages 8
Place of publication New Orleans, LA, U.S.A.
Publisher Ochsner Clinic
Language eng
Subject 2700 Medicine
Abstract Background: Sepsis, an inflammatory response to an infection that may lead to severe organ dysfunction and death, is the leading cause of death in medical intensive care units. The Society of Critical Care Medicine has issued guidelines and promoted protocols to improve the management of patients with severe sepsis and septic shock. Generally, the medical community has been slow to adopt these guidelines because of the system challenges associated with protocol implementation. We describe an interdisciplinary team approach to the development and implementation of management protocols for treating patients with severe sepsis and septic shock. Methods: To determine the effectiveness of the bundled emergency department and critical care order sets developed by the Sepsis Steering Committee, we performed a case review of 1,105 sequential patients admitted to a large academic tertiary referral hospital with a diagnosis of severe sepsis or septic shock between July 2008 and January 2012. Results: Implementation of the protocol led to improved order set use over time, a significant decrease in the median time to antibiotics of 140 (range 1-820) minutes in 2008 to 72 (range 1-1,020) minutes in 2011 (P≤0.001), and a decrease in median length of stay from 8 days (range 1-54) in 2008 to 7 days (range 1-33) in 2011 (P1/40.036). Conclusion: A multidisciplinary team approach to sepsis management using protocols and early goal-directed therapy is feasible in a large academic medical center to improve the process of care and outcomes.
Keyword Quality improvement
Sepsis
Shock-septic
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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Created: Tue, 21 Jan 2014, 23:34:44 EST by Matthew Lamb on behalf of School of Medicine