Spotlight on OU Medical Center Edmond’s Severe Sepsis, Septic Shock Mortality and Treatment Improvement

Posted on: 1/24/20


Each of the Excellence in Quality Award submissions will be featured in this column over the coming weeks to highlight and share successful quality initiatives. For each submission, we will describe how the problem was identified, the improvement goal(s), interventions and outcomes. Please feel free to utilize this information, duplicate interventions, and share with your staff.

OU Medical Center Edmond received an Honorable Mention for their Severe Sepsis, Septic Shock Mortality and Treatment Improvement project submitted by Shaun Horn, chief nursing officer.

Identifying the Problem: Compliance with the sepsis treatment bundle in January 2018 was 70%; sepsis mortality was 15%.

The Goal: Increase bundle treatment compliance to > 83% by June 2019; decrease severe sepsis and septic shock mortality to <19% by June 2019.

Interventions:  
  1. A multidisciplinary team was created and included the CNO, CMO, physician hospitalist director, nursing directors of ED, ICU, med-surg, behavioral health, house supervisor, and quality coordinator.
  2. The CMO partnered with ED physicians to improve communications and handoff of sepsis patients;
  3. A sepsis checklist tool was implemented;
  4. A “Code Sepsis” process was initiated;
  5. A process to acknowledge staff who recognized sepsis not only boosted morale but increased compliance with the sepsis treatment bundle.
The Outcome: Compliance with the sepsis treatment bundle was 94% in July 2019 (sustaining >83% compliance from Sept 2018 through July 2019). Sepsis mortality was 13% in July 2019 (sustaining 0-13% mortality rate from Oct 2018 through July 2019). As compliance with the sepsis treatment bundle increased, sepsis mortality decreased.

Comments: Engagement and accountability of everyone involved in sepsis care has been the key to success. Executive leadership support allowed the nursing staff to feel empowered to act in cases of missing sepsis bundle treatment requirements. Promotion of a team approach between the physicians, nursing, lab, and others involved in sepsis care has resulted in collaboration celebrations of success.