Sunday, November 20, 2011

Sepsis Kills - What Kaiser Is Doing about It

Sepsis is a leading cause of death in American hospitals, but ask most people what sepsis is, and they’ll give you a blank stare. About 750,000 Americans get sepsis every year at a cost of $17 billion to the U.S. health-care system, and about 200,000 die from it, according to the Global Sepsis Alliance, a coalition of 250,000 intensive- and critical-care physicians.

“Sepsis: A Deadly Disorder You’ve Never Heard of, “ Marketwatch, October 10, 2010

November 20, 2011- I received the e-mail below from an old friend George Halvorson, CEO of Kaiser. I told George I would pass it along in my medinnovation blog with the expectation the email contents might save a few lives. This could happen. My blog is now receiving 1000 hits on some days, and many of my readers are physicians and hospital executives who can doing something about sepsis.

George Halvorson E-Mail

Sepsis kills.Sepsis is actually the number one cause of death in hospitals in California. According to the official state death rate statistics, more people die in hospitals from sepsis than die from cancer, stroke, or heart disease. State statistics tell us that twenty-four percent of seniors who die in California hospitals -- nearly one in four seniors -- die from sepsis.

Very few people know that to be true. Very few people are doing anything about it.

Our goal is to have the safest hospitals in America, so we are an exception to that rule. We are doing something about sepsis -- and what we are doing is working.

When we started measuring the percentage of our sepsis patients who did not survive, our first mortality numbers were significantly more than twenty percent. One in four sepsis patients did not survive.

Now we have made consistent improvements in every hospital and our death rate has dropped to eleven percent .That is half as many people passing on. That’s he average for all KP hospitals. Some are now less than eight percent.

How did we do that? How did we save all of those lives?

We had very smart people focus on the problem to figure out what we needed to do to make care better for sepsis patients. It turns out that speed is essential. There is a time called the “Golden Hour” at the beginning of treatment for each patient where rapid intervention with the right treatment really is golden.

Delayed care can be fatal. Fast care can work miracles .So we figured out how to diagnose quickly, pre-plan every response, predefine the right medications, and train people in our care sites to respond in a hurry with the right stuff in the right way.

Most hospitals -- outside of KP -- usually do not have sepsis response teams or even organized sepsis treatment plans .In too many other hospitals, just getting the blood test results back to the floor where the patient is waiting can take hours. Ordering medications in those other hospitals can take a long time, and the medication can take hours to get to the patient.

Inventing a sepsis response from scratch for each patient is the wrong way to deliver care for sepsis patients .In our hospitals, we have teams of nurses, pharmacists, lab techs, and physicians all knowing that getting sepsis care right for each patient may be the most important thing that ever happens in the life of that sepsis patient.

It is literally a life and death situation. We save lives because we work in teams of caregivers focused on saving each of those lives.

It is incredibly important work. For the person who doesn’t die because we get it right, it’s hard to imagine anything more important.

I had written a letter earlier to share some of our initial successes with sepsis care. The good news is that our successes are continuing. Continuous improvement is a celebration all by itself. We are now sharing our learning and processes with the rest of health care. We are working with a national coalition -- Partnership for Quality Care (PQC) -- to spread our learnings to some of the best hospitals in the U.S.

PQC hospitals are setting a goal of reducing sepsis deaths by at least twenty-five percent. I believe they will all succeed.

Be well.


Tweet: Sepsis annually kills 750,000 American hospital patients. Kaiser’s hospital sepsis rapid response teams have cut deaths from sepsis in half.


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