Severe Sepsis and Septic Shock

Sepsis is an inflammatory response to a severe infection which triggers a rapid series of events, such as leaking blood vessels and impaired blood flow. Septic shock occurs when adequate blood pressure cannot be restored. Septic shock may lead to multiple organ failure and death. Early detection and treatment of septic patients is key to improving the health of the patient and reducing the risk of death.

The severe sepsis and septic shock project first was implemented during The Hospital and Healthsystem Association of Pennsylvania (HAP) Hospital Engagement Network (HEN) 2.0. It resulted in a 36 percent reduction in sepsis mortality, and a 69 percent reduction in post-op sepsis. To sustain the gains made in the HAP HEN 2.0, there is continued focus on:

  • 3 and 6 hour bundle compliance
  • Data analytics
  • Coaching hospital sepsis teams
  • Onsite hospital visits focusing on physician peer-to-peer advisory, sepsis treatment compliance and sharing of best practices

Goal:  Achieve a 20 percent reduction in severe sepsis and septic shock mortality and post-operative sepsis from baseline

  • Mortality case: The number of patients admitted to an acute care setting with a diagnosis of severe sepsis (R6520) or septic shock (R6521) that die
  • Post-op sepsis case: The number of patients discharged with an ICD-10 surgical procedure code and a diagnosis code for severe sepsis (R6520) or septic shock (R6521)

Sepsis physician advisor: Thomas Stoner, DO, FACOI

Pediatric Sepsis

Pediatric Sepsis Emergency Department Screening Pilot Study, HAP and CHOP Collaborative Work

Early recognition of sepsis in pediatric patients is a gap in current sepsis care. Sepsis is a leading cause of death in children in the United States—with a higher mortality rate than pediatric cancer—and the costs of care are steep for this population.

In June 2018, HAP convened a one-day training to kick off its joint pilot program with The Children’s Hospital of Philadelphia (CHOP) to recognize sepsis in pediatric patients in emergency rooms. Two Pennsylvania community-based hospitals joined HAP and CHOP at the event.

The pilot program aims to show that CHOP’s two-phase protocol for recognizing sepsis will improve sepsis outcomes beyond its facility. The EPIC electronic medical record Best Practice Alert is utilized to recognize sepsis and place pediatric patients on the sepsis pathway of care in an emergency room. The goal is to spread the use of these screening tools and treatment protocols to Pennsylvania hospitals to further improve sepsis outcomes in children.

  • More than 18 children die each day in the U.S. from sepsis
  • More than 200 children are diagnosed with severe sepsis every day, and of those that survive, 40 percent will suffer ongoing injuries including amputation and cognitive challenges

This pilot is part of HAP’s continuous efforts to improve patient safety in Pennsylvania’s hospitals. HAP is proud to partner with CHOP and participating hospitals as we collectively work to improve sepsis recognition and care in Pennsylvania.

Goal:  To screen and recognize sepsis sooner in pediatric patients in community hospital emergency rooms

Project advisors: Scott Weiss, MD, MSCE, FCCM Fran Balamuth, MD, PhD, MSCE, Julie Fitzgerald, MD, PhD, and Theresa Walls, MD, MPH

HAP Contacts

For more information, contact Robert Shipp, vice president, population health and clinical affairs. For media inquiries, contact Rachel Moore, director, media relations.

HAP News