A comprehensive study of sepsis treatment conducted by UF Health researchers has concluded that a new educational program to identify and treat the condition, combined with rapid care, can significantly reduce the number of sepsis-related deaths.
The study was conducted by a multidisciplinary team of 15 sepsis committee members from UF Health Jacksonville, the University of Florida College of Medicine – Jacksonville, and UF Health Shands in Gainesville. The study’s results appeared in the Journal of Critical Care in April.
Sepsis is a life-threatening condition caused by infection that, without treatment, can lead to organ failure and death. More than 750,000 cases of sepsis occur annually in the United States, leading to upwards of 258,000 deaths. The rate of hospitalizations has also tripled over the last two decades, causing sepsis to be a hugely expensive medical condition to treat. In 2011, sepsis was the most expensive condition billed to Medicare, costing more than $20 billion that year.
The UF Health study reviewed data collected for all patients treated at UF Health Jacksonville for sepsis between Oct. 1, 2013, and Nov. 10, 2015. Researchers separated the data into two groups: before and after a sepsis alert program was initiated at the facility on Nov. 19, 2014. The study compared data collected in the 13 months before the program began to the 12 months after.
More than 3,200 patients were admitted for sepsis to UF Health Jacksonville during the study period — 1,637 before and 1,568 after the alert program was implemented. Following the implementation of the alert program, the number of sepsis-related deaths decreased by more than 10 percent, from 226 to 202.
A sepsis alert is used to mobilize resources for efficient delivery of care to the septic patient, using nursing for support, pharmacists for rapid antibiotics and respiratory therapy for point-of-care testing and treatment.
The UF Health team believes four components led to the positive change: interactive education, electronic recognition, the sepsis alert protocol and a designated response team for each area of the hospital for care delivery. The approach was also innovative, as it used the hospital rapid-response team to drive sepsis recognition and care delivery on the wards — an approach that was previously successful in reducing inpatient cardiac arrest rates.
“The research team concluded that a comprehensive program for sepsis recognition and management is associated with improved outcomes,” said Faheem Guirgis, MD, a UF assistant professor of emergency medicine and the study’s lead author. “Though it might seem obvious, it’s critical that hospitals throughout the country build a team approach to sepsis care, beginning with education. It takes a team to recognize and treat this potentially deadly issue.”
In addition to Guirgis, members of the sepsis committee at the UF College of Medicine – Jacksonville participating in the project were Lisa Jones, M.D.; Rhemar Esma, MD; Kaitlin McCurdy, MD; Jason Ferreira, PharmD; Christina Cannon, MD; Laura McLauchlin, DNP; Carmen Smotherman; Dale Kraemer, PhD; Cynthia Gerdick, DNP, PhD; Kendall Webb, MD; Jin Ra, MD; Kelly Gray-Eurom, MD; and Alice Weiss. Frederick Moore, MD, a professor of surgery at the UF College of Medicine in Gainesville, also participated.
Kelly R. Gray-Eurom, MD, MMM, FACEP
Chief Quality Officer, UF Health Jacksonville; Assistant Dean for Quality and Safety; Associate Chair and Director, Clinical and Business Operations, Department of Emergency Medicine
Faheem W. Guirgis, MD, FACEP
Program Director, Emergency Medicine and Acute Care Research Fellowship; Director, Center for Research Training
Chief, Division of Pulmonary, Critical Care and Sleep Medicine; Medical Director, Medical Intensive Care Unit; Associate Program Director, Pulmonary Critical Care Fellowship
L. Kendall Webb, MD, FACEP; FAMIA
Assistant Dean, Clinical Informatics; Chief Medical Information Officer, UF Health Jacksonville