Sepsis prevention: Ohio collaborative develops protocols to attack deadly blood infection

Every day 38 Ohioans die from sepsis, the sixth most common reason for hospitalizations in the state. The blood infection contributes to half of all hospital deaths in the United States, including 13,000 people in Ohio each year.

But a new joint initiative by the Ohio Hospital Association's Institute for Health Innovation and the Sepsis Alliance aims to attack the deadly blood infection and develop protocols that state hospitals can follow for early detection and intervention.

Its goal is to work with Ohio hospitals to reduce mortality from sepsis by 35 percent, Mike Abrams, pictured, president and CEO of the Ohio Hospital Association, told FierceHealthcare in an exclusive interview.

"We decided to focus on things that were really problematic in our state and that lend themselves to interventions. The incidence of sepsis is increasing in the state, so we looked at the costs associated with it," he said. "Every case costs between $22,000 and $57,000."

Indeed, recent research indicates that sepsis accounts for just as many readmissions and deaths as heart attacks and congestive heart failure, but it costs health providers as much to treat as both of those disorders combined. And a Bloomberg analysis in June found Medicare paid hospitals $7.2 billion to treat sepsis in 2013, or about 11.6 percent of the $62 billion it doled out to hospitals overall.

The problem isn't limited to small hospitals that have limited resources. Large hospitals with plenty of resources also struggle with sepsis, he said.

So far 80 of Ohio's 220 hospitals have signed up to join the initiative, which just launched in May, according to Abrams. He said hospitals that take part in the collaboration will receive an individualized gap analysis and action plan to address weaknesses, and partnership leaders will collaborate with clinical leaders for at least two years to address the problems.

"The big emphasis is on early recognition and intervention," said Abrams, noting that natural progression of sepsis from general to severe to septic shock to death is quite rapid. "We feel that if we can have providers quickly identify cases early and start a bundle of interventions to intercept the condition, we will save lives."

Abrams said the collaborative wants to work with clinical leaders at hospitals as part of their rounds and quality programs to provide them with a greater understanding of sepsis "bundles" that must be completed within three or six hours from the time that severe sepsis first presents in a patient. "The clinical literature is very clear of what the interventions need to be," he said. "We are teaching them that timely administration means everything for survival and progression of the states of severity."

In addition, Abrams said that the collaborative hopes its work will inspire other associations and organizations to tackle sepsis and ensure it is treated as a medical emergency.

There are so many issues, like obesity, that the healthcare industry tries to address that are difficult because clinicians don't know the impact of the recommended intervention for years, Abrams said. But with sespis, the impact of the intervention is very clear, he said. "We know what to do and we know we aren't doing it. If we can inspire clinicians to follow these three- and six-hour bundles, we will save lives."