Inside Houston Methodist's 15-year journey to cut sepsis deaths

Over the course of 15 years, Houston Methodist Hospital has reduced the sepsis death rate from 35 percent to 6 percent — progress driven by unwavering commitment and constant education.

"We've saved almost 2,500 lives and around $50-plus million dollars in cost avoidance," Faisal Masud, MD, medical director of the center for critical care at Houston Methodist, told Becker's in early September, which is Sepsis Awareness Month. 

The CDC recently unveiled a new hospital program focused on enhancing sepsis care and shared seven elements that should be a part of hospital sepsis programs — all of which Houston Methodist has been doing for years. Houston Methodist is also the only hospital to have been recognized by the Global Sepsis Alliance for its progress on the condition. 

Data and staff engagement 

Reducing sepsis, the body's extreme response to infection, has been an evolving journey at the hospital since 2008. A sepsis committee was formed that year, after a data analysis showed the No. 1 cause of death within the system was sepsis. Ever since, monthly data collection and having a multidisciplinary team focused on sepsis have been key priorities. 

"We've worked on every step of sepsis," Dr. Masud said. "We created a scoring system. We created sepsis teams, which start acting in the emergency room, on the regular floor and in the intensive care unit." 

They've also started a critical care recovery clinic to follow patients who recover from sepsis and prevent readmissions. 

Having 15 years' worth of monthly sepsis data on hand has been central to Houston Methodist's progress in two key ways: It helps drive continued improvements in terms of patient outcomes and maintains staff engagement. 

"We're able to engage everybody because we [can] show our whole hospital staff, everybody, that, 'Hey, your work is making a difference,'" on patients' survival, he said. 

A recent CDC survey of 5,221 hospitals suggests this level of commitment to sepsis is far from standard, with more than 20 percent indicating they did not have a committee that monitors and reviews sepsis care on a regular basis.


Because there is no single symptom or test to detect sepsis, constant education is also critical to ensure new generations of clinicians understand how to connect the puzzle pieces, Dr. Masud said. 

"Sepsis is a combination of things, and that's why people don't always pick up on it," he said. People may show up to the hospital saying they've had an infection and generally report feeling off or as if they're getting worse, not better, which alone should be enough to get healthcare teams thinking about sepsis, he said. 

Patient education is just as critical, given the lack of attention sepsis receives in the mainstream media. On top of that, hospitals don't always explicitly communicate a sepsis diagnosis to patients, so those who recover may leave unaware of the readmission risks

"We tell people they have heart attacks, we tell people their kidneys aren't working, but we don't tell people they have sepsis," he said. "So we have to educate constantly. One thing I tell people is get vaccinated and wash your hands, but if you don't get better [after an infection], seek your healthcare teams and ask one simple question: Do I have sepsis? That question alone can get a whole bunch of people thinking, because it is preventable and treatable, but if it progresses, that's how so many people die." 

Sepsis remains a massive challenge for the nation's healthcare system, with at least 1.7 million cases and 350,000 deaths every year. About one-third of hospital deaths are sepsis-related, and it remains the No. 1 cause of readmission.

But, "everybody can do it," Dr. Masud said of Houston Methodist's progress. "It is possible and it is manageable, but we have to commit to it. That's the only way." 

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