Sepsis is responsible for half of all hospital deaths and contributes to preventable readmissions at a rate comparable to heart failure and pneumonia. So why doesn't it get as much attention as these conditions? Part of the problem is that the blood infection doesn't have a clear-cut jurisdiction, according to one hospital leader who also sits on the board of a sepsis awareness foundation.
"No one really owns [sepsis]," Martin Doerfler, M.D., pictured, senior vice president of clinical strategy and development at North Shore-LIJ Health System and a board member of the Rory Staunton Foundation, the leading non-profit organization for sepsis prevention, told FierceHealthcare in an exclusive interview.
While a heart failure case would be the cardiology department's responsibility, for example, there are multiple places a sepsis case could fall, he said, from the surgeon who operated on a patient to a hospitalist who oversees the patient's care while he or she is an inpatient. These issues get to the heart of the sepsis threat, Doerfler said. The condition poses unique dangers, he said, because "it is somewhat insidious… it can change rapidly and it is underrecognized."
Moreover, he added, since every sepsis case depends on the individual, "we don't actually know what the specifics are that are going to correlate with people needing to be readmitted."
Early detection is vital
At North Shore-LIJ, Doerfler said, staff have taken steps to recognize sepsis early enough to slow its progression. "We've also spent a fair amount of time working on shortening the time it takes to get antibiotics started for individuals, to get their blood tests done and off to the lab," he said. "We're currently working on reducing the amount of time it takes to get fluids started on individuals who have evidence of organ injury to make sure they have the right amount of fluids to support their physiology."
The system is also prioritizing transitions of care, Doerfler said, as patients with undetected sepsis often come in through the emergency department before heading to the floor or the intensive care unit. "Care occurs across that continuum, making sure that the details of what's been done [and] what's not been done, what's outstanding all have to be worked on… we've worked on all those things," he said.
Interhospital cooperation has been vital to sepsis prevention efforts at North Shore-LIJ, which is currently working with more than 15 hospitals and health systems in various settings, from large urban systems to community providers, he said. "Our work has been applicable across all of those venues," he said. "In that work we've partnered with a variety of hospitals and health systems… I see no reason why this work is not something that can be done and is important to be done in any hospital."
Nor are Doerfler and the Foundation alone in recognizing the threat; the Ohio Hospital Association's Institute for Health Innovation and the Sepsis Alliance recently announced a joint initiative to develop statewide intervention and detection protocols for the condition, which kills 13,000 people in Ohio each year. Eighty of Ohio's 220 hospitals have joined the initiative thus far, FierceHealthcare previously reported.
And this week the Rory Staunton Foundation plans to meet with government and healthcare leaders in the District of Columbia to launch new nationwide initiatives to help raise awareness about sepsis.