CDC calls for hospitals to 'raise the bar on sepsis care' with new program guidance

Sepsis is a factor among roughly 1 in 3 hospital deaths, yet, as of last year, more than a quarter of hospitals didn’t have a formal sepsis committee in place and nearly half said they did not provide dedicated time for sepsis program leaders.

The Centers for Disease Control and Prevention (CDC) is aiming to change that. Last week, the agency kicked off the Hospital Sepsis Program Core Elements, a free resource center for hospitals beginning or refining their efforts to identify and address sepsis in their facilities.

“Rapid diagnosis and immediate appropriate treatment, including antibiotics, are essential to saving lives, yet the challenges of awareness about and recognition of sepsis are enormous,” Mandy Cohen, M.D., director of the CDC, said in a release on the new materials. “That’s why CDC is calling on all U.S. hospitals to have a sepsis program and raise the bar on sepsis care by incorporating these seven core elements … [which] provide an organizational framework and key concepts that guide hospitals as they work to improve early recognition and treatment to save lives.”

The Core Elements, which range from leadership commitment to data reporting, are a complement to sepsis clinical guidelines intended to serve as a “manager’s guide” for organizing staff and preparing necessary resources, the agency said.

They’re applicable to hospitals of all sizes and locations and are modeled after CDC’s Core Elements of Antibiotic Stewardship, which the agency said has so far “proven to be an impactful resource” for organizations.

Each of the seven elements includes a handful of “Priority Examples” that hospitals’ existing sepsis programs can home in on. Within the “Education” element, for instance, CDC recommends programs focus on providing an annual sepsis education to clinical staff, including sepsis-specific training during hiring or onboarding and providing written and verbal education on sepsis to patients or their loved ones prior to discharge.

The agency’s resource also outlines starting points for hospitals or health systems yet to get launch a formal sepsis program, or those with limited resources. These include recommendations to identify program leaders; secure support from organization leadership; conduct a needs analysis spanning regulatory requirements, existing processes, treatment guidelines and order sets; and establish a set of initial goals based on that analysis.

“Many guideline statements [on sepsis] are based on weak evidence, such that guidance may change as more evidence is accrued,” CDC wrote in the Core Elements document. “Given this landscape, hospitals must have processes in place to implement recommended sepsis practices and also evolve practice over time in response to accruing evidence.”

CDC released the guidance materials alongside results from the 2022 annual survey of its National Healthcare Safety Network, a surveillance system for tracking hospitals’ safety measures.

These showed that among 5,221 enrolled acute hospitals, 73% of all hospitals and 53% of those with 25 or fewer beds had sepsis committees in place. Additionally, 10% of hospitals reported having no standardized process in place for assisting with rapid sepsis identification while another 10% said they had no standardized protocol in place to assist in managing sepsis care—both of which were more common among hospitals with fewer beds.

“These data highlight opportunities, particularly in smaller hospitals, to improve the early identification of, care for, and outcomes among patients with sepsis in the United States by ensuring that all hospitals have sepsis programs with protected time for program leaders, engagement of medical specialists, and integration with [antibiotic stewardship programs],” CDC researchers wrote in a report detailing the survey’s findings.