Tracking and reporting metrics ensure that hospitals are filling identified gaps and meeting goals of their sepsis-prevention programs.
And the work is vitally necessary, given that about 1.7 million adults in the U.S. develop sepsis each year, according to the Centers for Disease Control and Prevention. At least 350,000 die from sepsis.
One way to enable these metrics is by forming an interdisciplinary sepsis core team.
“Through concurrent chart review, the team provides real-time feedback to providers and nurses based on a risk score,” nurse manager Carol Ann Gelderman, MS, explained during a webinar on tracking and reporting sepsis measures. “When we report up to our leadership, our unit level and our core team, we talk about the number of lives,” which refers to patient lives touched by the sepsis team.
Gelderman and her team at Northeast Georgia Health System document all recommendations on care or identification gaps, and improvements on patient workup or treatment.
These measures have allowed the health system to touch nearly 6,000 patients over a short period. Real-time concurrent review also reduced door-to-antibiotic time and average length of stay for sepsis patients, resulting in millions of dollars in savings, said Gelderman.
This is the fourth installment in the webinar series on the CDC’s Hospital Sepsis Program Core Elements, which can help health care facilities implement, monitor and optimize their sepsis programs and outcomes. This free continuing education webinar series was developed in collaboration with the AMA and CDC’s Project Firstline.
Tracking and reporting are two of the CDC’s seven core elements that offer a blueprint to hospitals for building a successful sepsis program.
“Sepsis programs have been associated with reductions in hospital mortality, length of stay and health care costs,” said webinar moderator Erica Kaufman West, MD, AMA’s director of infectious diseases.
Here is how to improve sepsis metrics through tracking and reporting.
Monitor sepsis management
Tracking and reporting “really speaks to monitoring sepsis epidemiology, management and outcomes, and reporting that data back to the relevant stakeholders in a way that is able to further drive change,” said Hallie Prescott, MD, associate professor in pulmonary and critical care medicine at the University of Michigan Medical School and a staff physician at the Ann Arbor Veterans Affairs Healthcare System.
Priority examples for sepsis tracking may include monitoring of sepsis epidemiology: How many hospitalizations are there, how many people are coming in with community-onset sepsis, and how many are contracting it during hospitalization?
Monitoring sepsis outcomes is another key step. Relevant data can include hospital mortality, readmissions and patient-centered outcomes after discharge. Outcomes should correlate with the key gaps and key areas of focus in the sepsis program, said Dr. Prescott.
Assessing the usability and impact of hospital sepsis tools to inform ongoing improvement, is also important. There needs to be a method of making sure tools such as electronic order sets are easy to use and helpful for physicians and other health professionals.
Reporting—which goes hand in hand with tracking of data—involves getting data back out to the front-line physicians, health professionals and managers in the hospital.
“The priority example for this core element is to report sepsis management and outcome data to nursing, physician, unit-based and hospital-based leadership at routine intervals, such as monthly or quarterly,” said Dr. Prescott.
Find origins of fallout cases
Several other experts shared how their respective tracking and reporting programs have led to improved patient outcomes.
Michelle Evans, MSN, sepsis program coordinator at Summa Health System in Akron, Ohio, saw mortality rates drop below the state rate and state goal for sepsis patients through improved reporting and data tracking methods.
Evans enters all chart reviews herself into a homegrown database. She also keeps track of fallouts or protocol omissions, to identify where problems occur and opportunities to improve patient care.
As an example, “We’re really focusing on septic shock and trying to get those antibiotics in within an hour,” she said, noting sepsis data is reported to multiple teams, using the data to identify areas of focus and to drive improvements.
