Saving Lives With Enhanced Sepsis Treatment Protocol

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Improving sepsis treatment is key to improving global health and wellness. There are an estimated 20 to 30 million cases of sepsis a year worldwide. Sepsis is a leading cause of death in U.S. hospitals—accounting for one in every five hospital deaths. Timely and effective care of sepsis, including adherence to evidence-based guidelines, continues to be a major priority.

Upon reviewing their sepsis data, UCHealth observed a significant variation in their EMR workflows and outcomes. Best practice alerts would fire frequently with the intent to aid in sepsis identification, taking valuable time away from health professionals. To increase and standardize sepsis care systemwide, UCHealth created a telemedicine-based sepsis detection and response system, using AI to implement a nurse-driven and physician-supported CMS care bundle.

Stage 7 Success Story: Enhancing Sepsis Treatment

In an effort to reduce burden on health professionals and enhance sepsis outcomes, UCHealth implemented a virtual sepsis response in a phased approach through their Virtual Health Center (VHC). The VHC provides coordinated for care health professionals, allowing remote teams to investigate warnings generated by alerts.

Acknowledging the ever-increasing demands on nurses—including increased prevalence of best practice alerts, clinical alert systems and alarm fatigue—the VHC provides remote surveillance for both deterioration and sepsis care in real time. The remote center utilizes AI, as well as two simple physiologic scoring tools, based on data from an acute care wearable device. The wearable allows for the continuous monitoring of vital signs and has the ability to ingest pre-validated data. Experienced critical care clinicians are able to use this multimodal alert system to provide earlier care locally.

UCHealth designed and implemented a nursing-driven workflow focused on sepsis treatment, utilizing both the local primary nurse and remote critical care nurse. Per CMS bundle guidelines, if initial workup results show signs of abnormalities, the remote center physician works in collaboration with the local physician to deliver care accordingly. If needed, the remote center physician is authorized to initiate the sepsis bundle in lieu of the bedside care team.

Using a phased approach, all UCHealth acute and progressive care units implemented the virtual sepsis program by May 2019. The rollout continued across the system, with hospitals in southern Colorado going live in October 2019 and hospitals in northern Colorado going live in January 2020. By March 2020, all UCHealth hospitals were enrolled—with 1,250 acute care inpatient beds available for sepsis monitoring.

Since implementing new nursing-driven workflows with increased standardization to evidence-based best practices, UCHealth has observed remarkable results:

  • 59-minute reduction in time obtaining blood cultures
  • 33-minute reduction in time administering antibiotics
  • 63-minute reduction in time administering fluids
  • 215,000+ best practice alerts avoided
  • ~30% decrease in sepsis mortality

Achieving EMRAM and O-EMRAM Stage 7 Revalidation

HIMSS is pleased to recognize UCHealth for both their Electronic Medical Record Adoption Model (EMRAM) Stage 7 revalidation and their Outpatient Electronic Medical Record Adoption Model (O-EMRAM) Stage 7 revalidation.

“It was a pleasure to visit UCHealth and witness their commitment to improve the health and lives of their patients,” said Philip Bradley, regional director, analytics, HIMSS. “Congratulations again, UCHealth—very well deserved.”

“In the continual surveillance of admitted patients for signs of sepsis, the Virtual Health Center provides another layer of protection for our patients in detecting and treating this deadly disease,” said Diana Breyer, MD, chief quality officer of UCHealth’s northern region. “The Virtual Health Center is able to detect potential sepsis earlier than our conventional methods, and it provides support to the bedside team in considering the diagnosis and making sure time-sensitive treatments are ordered.”

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