Partnership takes aim at sepsis control

Last week, Health and Human Services Secretary Kathleen Sebelius and Centers for Medicare and Medicaid Services Administrator Don Berwick, MD, joined with leaders of major hospitals, employers, health plans, physicians, nurses, and patient advocates to announce the Partnership for Patients--a new national partnership designed to save lives by stopping millions of preventable injuries and complications in patient care over the next three years.

One of the groups taking on this challenge is the Partnership for Quality Care (PQC), a conglomeration of healthcare systems and health labor unions that have been focusing on the issue of quality care and patient safety nationwide for the past several years.

PQC's newest target: sepsis. Earlier this year, the group commissioned a public survey that found that 74 percent of the public questioned were very concerned that sepsis is the No. 1 cause of death in the U.S.; in addition, 71 percent were very concerned that nearly 2 million people can acquire an infection while hospitalized.

FierceHealthcare recently spoke with PQC board member Dennis Rivera (pictured), healthcare chair of the Service Employees International Union, about new directions the PQC is taking to address sepsis.

FH: What's behind the campaign to stop sepsis? 

Rivera: We together--employers and healthcare workers--basically fought very hard to pass [last year] the Affordable Care Act. What we said was how we needed to go for the second stage of healthcare reform. How can we improve the quality of care? How do we make it better? How do we control the costs? [To do this] we attended a conference at the Center for Better Health at Vanderbilt University. We stayed there for three days [with the] help of the Vanderbilt University staff to identify which are problems we could attack immediately and which were within our control.

We identified, more than 2 million patients who go to the hospital for a particular procedure or illness end up getting infected in the hospital. So, almost 200,000 [individuals] die as a result of that. And, we believe that could be prevented if we the healthcare workers--and by that I mean everybody in the healthcare field from doctors to nurses and everybody else--could [be] educated [about that issue].

The other thing that we wanted to do ... was to find out how aware the American public [felt] about this issue. What became incredibly clear was that [the public was] not clear that this was going on--but they became incredibly concerned [when they learned] that sepsis is the number one cause of death in American hospitals. ... So in that sense, by speaking with you [and] sharing with you the information that we have, we are about to start an advertising campaign [this month] explaining the findings [on sepsis].

FH: The problems associated with sepsis have been around for years. What's the significance with this campaign?

Rivera: I think what's courageous about this effort is that it is from the inside the healthcare community--that we're alerting the public that this is taking place. That has not been the case. The case has been to say that we've got a problem--that you have to wash your hands. But there was never an aggressive campaign at a location to deal with the magnitude of the problem and the severity of it. 

These are people from inside the healthcare systems across the U.S. We are banding together and saying we can do better--we're going to share the protocols and we're going to require that they go and identify how different medical centers are doing in dealing with this issue. And we believe that we can improve the quality of care in the U.S.

FH: How are you encouraging your members to get involved?

Rivera: Certainly at this moment, I would say that our members are no different than the doctors or others who are working in the healthcare field. [Sepsis, right now] is a concern. It's not a burning issue. What we want to do is make it a burning issue through education. We've identified that yes, with little things such as washing your hands, the way we dress and all of that stuff, we could control...these infections.

FH: Are you focusing on initiatives such as "did you wash your hands?"

Rivera: We are in the processes of doing that now. Not only that, but right now we are starting focus groups around the country among healthcare workers--not only in terms of attitudes toward leading with these efforts but of the attitude that if you are a healthcare worker, you are supposed to be leading a healthy life: you have to work in a clean and healthy environment. We believe that is going to be good for America.

FH: With your advertising campaign, who is your main audience going to be?

Rivera: We're going to try to reach out with an external campaign to the American public and the internal campaign--inside of the healthcare institutions. Everybody.

The first campaign will start with a single proposition which is that more people die in American hospitals of sepsis than people die from cancer or any other disease. When I started dealing with this subject, the champion of this subject was Kaiser Permanente's CEO George Halvorson [who chairs PQC]. Then I started going to meetings where there would be 200 to 300 people. Those who have had a relative or friend that they know who went to a hospital and got an infection [identified themselves], and that's when the consciousness of the problem start[ed] to come. Anecdotally, I [had heard] about it, but then I start[ed] to see those hands going up and up. It happens. But it has been almost expected that these things happen when objectively speaking, they don't have to happen. There are hospitals where this doesn't happen today and other hospitals where it is incredibly common to happen. We want to bring the spotlight to that.

FH: Have many of these stats been under the radar--not reported?

Rivera: I think Don Berwick has done a good job in dealing with the subject with the campaign to save 100,000 lives. But I don't think that has ... that kind of momentum among healthcare workers and the American public. And I think in great measure that this campaign for 100,000 lives--we have done it inside the hospitals and not outside the hospitals. I think that by going out to the public, the public has to demand that from us. So we are going to make kind of a synergy that will basically provide the setting in terms of a new culture to deal with the problem.

FH: Are you looking at addressing other infections such as MRSA in the future?

Rivera: What we thought is that we have to start somewhere. That's where we are going to start with this one. And it's going to give us a body of experience--even with one problem. Hopefully, we will have the Department of Health and Human Services and purchasers of healthcare across the country with us--so that we believe that we will have an impact. And then based on that, we will move to other areas ... [such as] dealing with asthma or dealing with diabetes, obesity, hypertension, hospital readmissions. How do we deal with some of these issues? There are plenty of problems to deal with. We want to tackle this [sepsis] one first.

This interview has been edited and condensed for clarity.