Early warning system cuts sepsis cases at Tampa General

In fiscal year 2023, Tampa (Fla.) General Hospital's average length of stay for sepsis patients was 0.8 days shorter than in 2022. Early mortalities — patients who die within 48 hours of coming to the hospital with sepsis — have been reduced from 6 to 4 percent.

More than 1.7 million adults in the United States were diagnosed with sepsis and close to 270,000 died from it in 2021, according to the National Institutes of Health. 

The CDC suggests the number of cases of sepsis that result in severe illness or death is increasing because incidents are being better tracked, people are living longer with chronic diseases, there are more antibiotic-resistant infections known to lead to sepsis, and organ transplants, which require the use of immune system suppressing medications, are more common.

Clinical leaders at TGH are determined to make sure their hospital doesn't follow the predicted trends. "People love technology" in hospitals because "it will show us where the problem is," Peggy Duggan, MD, chief medical officer at TGH, told Becker's. "But building the structure around the technology is often short. Technology is useless if I don't have people who know how to use it, deploy it and then give us feedback as to how to make it better. Our job as hospital administrators is to create the environment for success."

The hospital launched a sepsis early warning system to diagnose and treat the deadly condition, first before the pandemic and then again in 2022 with accompanying technology. This initiative, which makes use of "process, people and technology," is used when patients arrive in the emergency department with sepsis and when admitted patients are showing signs of sepsis, Jaimie Weber, MD, medical director for clinical quality analytics at TGH, told Becker's.

TGH's electronic health records system is connected to a command center that aggregates every patient's data — labs, notes, vital signs, etc. The hospital has a rapid response team that receives sepsis alerts in real time and notifies highly skilled, specially trained nurses who can observe the situation and determine if a call to the physician is warranted.

Once admitted, "if it looks like a patient is developing sepsis, we have a pathway to follow. There are [pre] written orders and a plan so patients get the sepsis care they need over the next three to five days," said Dr. Weber, noting if a patient presents at the emergency department with sepsis, the program is initiated immediately.

"We developed a tool that gives us alerts, but the real difference here is that we have trained individuals who are monitoring these systems," Dr. Duggan said.

One of the goals of the system is to give nurses tools that fit into their current workflows without adding extra things to do. "We're not trying to push a new technology on them and ask them to change the way they do things," Dr. Weber said. "We're trying to give them information that will help them do their work." 

The same rapid response team monitors patients throughout the protocol to make sure they receive appropriate care in line with the hospital's sepsis reduction program.

The initiative has increased awareness around the hospital about the severity and urgency of sepsis. All members of the hospital team who might interact with patients — physicians, nurses, lab technicians, phlebotomists, environmental service workers, nutrition counselors and others — are in the loop when it comes to the hospital's intent on reducing sepsis statistics.

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