Reduce Sepsis Mortality Rates with Five Data-Informed Strategies

TheCenters for Disease Control and Prevention(CDC) report that at least one in threeinpatient deathsis related to sepsis. The condition is a leading cause of hospital deaths andreadmissionsin the U.S., with a total 2019 health system economic impact of$1.5 billion. Many health systems experience high sepsis mortality rates and their costly ramifications, but the good news is that most sepsis-related deaths are preventable.

This sepsis prevention opportunity means that health systems can cut high costs associated with sepsis deaths, and most importantly, improve outcomes for patients with sepsis. With a sophisticated data platform that can aggregate sepsis data and immediately surface relevant insights, improvement teams understand their sepsis populations and which interventions best support sepsis detection, treatment, and surveillance.

A Data-Informed Picture of Sepsis Mortality Rates Steers Improvement Efforts

卫生系统已经非常希望与败血症作斗争，许多卫生系统已经有大量的败血症预防和治疗干预措施，但这不足以克服一种有时难以发现的疾病。Data infrastructure, such as the Health CatalystSepsis Analytics Accelerator结合承诺和教育，对卫生系统预防和治疗败血症至关重要。获取颗粒级脓毒症数据是卫生系统了解脓毒症病因(通常可以在住院环境中预防)以及如何及时补救的最佳方式。

For example, comprehensive analytic insight might reveal a delay in clinicians administering antibiotics for patients with sepsis. The sepsis data tools’ drill-down capabilities would unearth a reason—such as a cumbersome standard procedure of ordering two blood cultures before administering antibiotics—that delays medication for patients in desperate need of treatment. Based on this insight, clinical improvement teams might change the blood culture order process or educate providers to administer antibiotics after one culture instead of two, allowing clinicians to give potentially life-saving antibiotics sooner. These small changes can lead to drastic improvements in early sepsis treatment and reduced sepsis rates.

Five Data-Informed Strategies to Reduce Sepsis Mortality Rates

By regularly turning to data, organizations can tackle sepsis prevention and treatment. Specifically, health systems can apply five data-informed strategies to reduce sepsis mortality rates:

#1: Create Alerts for Early Detection

Health systems can use their data infrastructure (e.g., theHealth Catalyst Data Operating System (DOS™)) to aggregate their population’s sepsis data. Improvement teams can use this comprehensive sepsis data to define pre-sepsis thresholds and then create custom EHR alerts that notify the provider of early sepsis warning signs and the recommended course of action.

For example, the EHR could alert a provider about a patient’s potential for infection, low blood pressure and rapid heart rate, and prompt the facility’s best practice, such as administering antibiotics immediately. Using past sepsis data to surface insights and recommended next steps at the point of decision making helps clinicians detect sepsis earlier in the process when patients have the best chance of recovery.

#2: Improve Three-Hour Bundle Compliance

Survival for patients with sepsis depends on the care team’s interventions. To ensure effective interventions, health systems should follow sepsis guidelines, such as thethree-hour sepsis bundle, that prompts immediate action. The three-hour bundle includes four specific actions care teams should take within three hours of suspecting a patient has sepsis:

1. Obtain a blood culture before antibiotics.
2. Measure lactate levels.
3. Administer broad-spectrum antibiotics.
4. 给予晶体液体降压或乳酸0 4mmol /L。

It is important that health systems have access to accurate sepsis recognition and treatment data, such as in the Sepsis Analytics Accelerator dashboard (Figure 1) to understand performance and identify areas to improve their three-hour bundle compliance. For example, sepsis data might reveal a delay in measuring a patient’s lactate levels within the three-hour timeframe. This insight would signal a need for a change in lactate collection processes or an opportunity to educate clinicians about measuring lactate levels emergently for optimal patient outcomes.

#3: Optimize Emergency Department Processes

Sometimes delays in care for other conditions (e.g., AMI, stroke, traumatic injury) can lead to delays in sepsis care. Using data to understand the causes of a delay in the care process can reveal opportunities to improve triage practices in the emergency department (ED). For example, if a health system’s ED averages a 90-minute wait and a 40-minute wait for lactate collection, patients who enter the ED with sepsis wait over two hours for care. This time frame leaves less than one hour for care teams to complete the four recommended actions in the three-hour bundle, whichproves deadlyfor some patients. With this insight from the ED data, the improvement team can investigate ED triage processes and possibly obtain blood cultures or lactate testing during triage instead of after admission.

#4: Leverage the Centers for Disease Control and Prevention Sepsis Surveillance Toolkit

To diagnose sepsis more accurately, organizations can leverage the CDC’sSepsis Surveillance Toolkit. The toolkit includes instructions for creating a patient cohort based on physiological data (e.g., vital signs) that the CDC considers true indicators of sepsis. Using physiological data helps care teams accuratelyprevent and diagnose sepsis这已经不是第一次了。这种方法不同于传统的基于临床医生记录(例如，书面医嘱、进度记录、体检等)的管理编码识别方法，这给错误留下了更大的空间。

为了有效地使用生理脓毒症识别方法，组织需要策略#1 (DOS)中提到的可靠数据基础设施，以快速收集和组织来自多个来源的数据。有了全面的患者生理数据，各组织现在可以准确地检测和治疗败血症。

#5: Implement Care Transition Processes to Prevent Sepsis Readmissions

Although health systems should prioritize sepsis prevention, they cannot ignore the reported40 percentreadmission rate among patients who have recovered from sepsis. To reduce readmission rates, care teams can implement smoother post-acute care transitions with patients, their families, or long-term care facilities and discuss possible prevention tactics.

作为过渡过程的一部分，护理团队可以确定出院后的随访预约，以确保患者在充分的支持下出院。护理团队还可以向患者及其家人提供关于复发感染的教育，以及如果患者复发的最佳行动方案。对于再次入院风险较高的患者(例如，有共病的患者)，临床医生可以安排定期随访电话，定期监测患者的进展，或与家庭健康机构合作，尽早发现挫折。

Data Enables Optimal Decision Making to Overcome High Sepsis Mortality Rates

Along with high sepsis mortality rates, readmissions related to sepsis are alsomore costlythan readmissions related to heart disease, including heart failure and chronic obstructive pulmonary disease. As organizations continue to face diminishing profit margins, they cannot afford to face sepsis without analytic insight from sepsis data and supporting data infrastructure. Using the five strategies above allows clinicians to decrease sepsis mortality rates by detecting the condition early, immediately applying the best intervention based on the patient’s individual status and reducing readmissions for patients who have recovered from sepsis.

Additional Reading

你想了解更多关于这个话题吗?Here are some articles we suggest:

1. A More Accurate Sepsis Identification Method: Leveraging Physiological Data
2. Drive Better Outcomes with Four Data-Informed Patient Engagement Tactics
3. Six Steps Towards Meaningful, Ongoing Healthcare Performance Improvement
4. How Data Can Reduce Length of Stay and Keep the Revenue Stream Flowing
5. Using Improvement Science in Healthcare to Create True Change

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