YNHHS clinical redesign project aims to strengthen and streamline sepsis treatment

Sepsis is a life-threatening illness that can affect any patient – inside and outside the hospital.

Nationwide, more than a million people a year get sepsis, which is an extreme immune response to an infection. It occurs when the body releases chemicals into the blood to fight the infection, triggering widespread inflammation. Without timely treatment, sepsis can cause a number of complications, including organ failure and death.

In the past, Yale New Haven Health’s delivery networks have taken different approaches to identifying and treating sepsis. That changed last December, when 80 people from throughout the health system formally launched a sepsis clinical redesign project.

The project focuses on quickly identifying and effectively managing patients who come to the emergency departments with sepsis or develop sepsis in an inpatient area. The project also aims to decrease sepsis-related deaths among inpatients.

“As representatives from each delivery network examined their procedures, they saw an opportunity to reduce unnecessary clinical variation and improve care for patients with sepsis,” said Scott Sussman, MD, senior medical director, Clinical Operations, YNHHS.

One of the first project components to launch are “bundles” – sets of specific protocols and procedures for identifying and treating sepsis patients. These bundles include evidence-based practices research has shown to be effective, including best practices from different YNHHS delivery networks and national guidelines.

The clinical redesign teams have implemented a change in Epic that makes it faster and easier for providers to order the care bundles because “time is critical” for patients with sepsis, said Jennifer Johnson, APRN, a consultant with YNHHS’ Office of Strategy Management (OSM). She and OSM consultant Anesta Williams, RN, lead the sepsis clinical redesign teams, which also include physicians, advanced practice providers and representatives from the Laboratory, Nursing, Pharmacy, Information Technology Services and other departments. The ED and inpatient groups also have Patient and Family Advisory Council (PFAC) members.

PFAC member Pat Caruso, who is on the ED group, brings unique qualifications to the project. Twice she had sepsis related to cancer treatment. She’s also a retired nurse with experience in emergency and critical care and safety and quality.

“This is a great opportunity for me to help physicians and staff identify and treat sepsis patients sooner,” she said. “I know from personal experience that not every patient displays typical sepsis symptoms, so it’s important for staff to really listen to what their patients are telling them. I think that with my experience, I can impact care for the next person.”

The clinical redesign teams are implementing other components of the project and will gather data to assess its effectiveness. Watch for updates.