Hospitals in pursuit of excellence

Removing Sepsis

Senior leaders at Kaiser Permanente Northern California, Oakland, knew the system's community-acquired sepsis mortality rate must be lowered. In 2007, the system's 21 facilities had 5,500 sepsis admissions with a mortality rate of 25 percent, whereas the system's other 200,000 admissions had a mortality rate of 2 percent. Melinda Skeath, RN, executive director, quality and regulatory services, knew that rate could and should go down. In a $1 million project, the system created and then enacted its own bundle for sepsis treatment, which involved substantial changes in the emergency department. This included physician and nurse training, new monitoring equipment, and new supply sets. The results—the mortality rate for deaths from community-acquired sepsis fell from 32 percent in January 2006 to 13 percent in February 2010. The system staff was better able to initially diagnose sepsis, with the rate of diagnosis doubling. Sepsis admissions climbed from 37 per 1,000 of total admissions in January 2006 to 78 per 1,000 total admissions in February 2010. Length of stay dropped for community-acquired sepsis patients by 1.6 days comparing 2007 data with 2009 data, or 17 percent, generating an estimated $30 million in savings. Contact Melinda.skeath@kp.org