Reducing Clinical Variation When Treating Sepsis

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Sepsis, a potentially-life threatening complication of an infection, affects roughly 750,000 Americans each year and costs more than $22,000 per patient to treat, according to Verras.

Verras analyzed more than 500 cases of sepsis at one hospital. It found that on a per-patient, severity adjusted basis, there was significant variation in both length of stay and charges, indicating a variation in practice patterns. The majority of variation was due to not identifying the patient early in hospitalization, moving them to the ICU and beginning an early and aggressive treatment. As a result, patients were hospitalized longer than expected, utilized more resources and had poorer outcomes.

Verras worked with the hospital's medical staff to implement the following physician-led best practices in the first quarter of 2012. It is still waiting to measure results.

1. Establish monitors and criteria to track bundle compliance, mortality and charges per sepsis discharge.
2. Implement emergency department protocols to complement inpatient order sets.
3. Share data on treatment bundle usage, order sets and outcomes with hospitalists and appropriate physicians.
4. Add physician champions and ED leadership to sepsis teams.
5. Establish a work group to improve timeliness and the availability of central line placement.
6. Initiate ongoing education.

More Articles on Reducing Clinical Variation:

Reducing Variation in the Use of MRIs
Clinical Data Crucial for Hospital-Physician Discussions About Cost Reduction
Verras Watson Tool Digs Deeper to Identify Clinical Variation

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