Sepsis Outcomes as an Overall Quality Indicator

January 27, 2016


What condition represents the biggest challenge to—and the biggest opportunity for—your organization? Sepsis. Here’s why.

Steth

In a new white paper, Healthgrades explores some surprising commonalities among 2016 recipients of the Distinguished Hospital Award for Clinical Excellence (DHACE) (PDF). First, their performance in treating sepsis (indicated by risk-adjusted mortality rates) improved over the three-year study period, even while performance in other cohorts remained steady. Second, academic and community hospital DHACE recipients both had similarly superior performance in sepsis care.

Third, sepsis mortality rate trends were related to mortality rates for other emergent conditions like respiratory failure, heart failure, and stroke. For example, when hospitals experienced a 50% decrease in sepsis mortality rates, they achieved a 20% drop in mortality from respiratory failure. Similarly, a 50% increase in sepsis mortality was associated with a 20% increase in respiratory failure mortality.

Why are high-performing hospitals doing so well in addressing sepsis care? Why are they experiencing transference to other emergent conditions? There is likely a combination of reasons.

  • Increasing Incidence: Sepsis affects approximately 1.6 million Americans each year, and kills more than 258,000 of them. AHRQ recognizes sepsis as the most expensive hospital condition to treat, costing $20 billion in 2011. Worse, cases of sepsis are increasing due to antibiotic resistance, an aging population, and more invasive care. In its white paper, Healthgrades found it was the only condition studied with year-over-year volume increases, jumping nearly 26.5% over three years. Those patients who survive sepsis may experience complications and ongoing reduction quality of life due to readmissions, amputations, and permanent organ damage.
  • Challenging Diagnosis: Despite its severe consequences, sepsis is difficult to diagnose. Its combination of symptoms—including sore throat, diarrhea, vomiting, pain, shortness of breath, and shivering or fever—is similar to many other less harmful conditions. So it is important for your physicians to recognize the constellation of symptoms and order lab tests quickly to look for signs of infection.
  • Rapid Coordinated Response: Sepsis is deadly. It requires your clinicians to act quickly as a carefully coordinated care team to save a patient’s life. One study estimates that early identification and treatment could save 92,000 lives and 1.25 million hospital days each year. That type of effort requires a sophisticated program of dedicated professional education, interdisciplinary teamwork, extensive care coordination, and specialized tools. Not coincidentally, it also mirrors the rapid, synchronized response necessary for conditions like heart attack, stroke, or a gastrointestinal bleed.
  • Consumer Education: Healthcare professionals aren’t the only ones in need of sepsis education and treatment tools. Despite the increasing incidence of sepsis and its high mortality rate, the general public remains largely unaware of it.  According to the Sepsis Alliance, fewer than half of Americans have even heard of it. So the CDC has declared September as Sepsis Awareness Month. It educates the public on early signs and symptoms and on who is at higher risk (people with weakened immune systems or who have suffered severe physical trauma, infants, children, the elderly, and those with chronic illnesses).

In summary, designing care protocols for a high-impact, prevalent condition that is difficult to diagnose and that requires a rapid and sophisticated team-based response can improve your hospital’s emergent care generally.

How can sepsis care drive your overall clinical outcomes? Recognize it as a key clinical challenge that serves as a model for emergent care programs.

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