TY - JOUR T1 - Using Quality Improvement Principles to Improve the Care of Patients With Severe Sepsis and Septic Shock JF - Ochsner Journal JO - Ochsner J SP - 359 LP - 366 VL - 13 IS - 3 AU - Leonardo Seoane AU - Fiona Winterbottom AU - Teresa Nash AU - Jessica Behrhorst AU - Elen Chacko AU - Lucas Shum AU - Andrey Pavlov AU - David Briski AU - Shelley Thibeau AU - Dominique Bergeron AU - Tiffany Rafael AU - Erik Sundell Y1 - 2013/09/21 UR - http://www.ochsnerjournal.org/content/13/3/359.abstract N2 - Background Sepsis, an inflammatory response to an infection that may lead to severe organ dysfunction and death, is the leading cause of death in medical intensive care units. The Society of Critical Care Medicine has issued guidelines and promoted protocols to improve the management of patients with severe sepsis and septic shock. Generally, the medical community has been slow to adopt these guidelines because of the system challenges associated with protocol implementation. We describe an interdisciplinary team approach to the development and implementation of management protocols for treating patients with severe sepsis and septic shock.Methods To determine the effectiveness of the bundled emergency department and critical care order sets developed by the Sepsis Steering Committee, we performed a case review of 1,105 sequential patients admitted to a large academic tertiary referral hospital with a diagnosis of severe sepsis or septic shock between July 2008 and January 2012.Results Implementation of the protocol led to improved order set use over time, a significant decrease in the median time to antibiotics of 140 (range 1-820) minutes in 2008 to 72 (range 1-1,020) minutes in 2011 (P≤0.001), and a decrease in median length of stay from 8 days (range 1-54) in 2008 to 7 days (range 1-33) in 2011 (P=0.036).Conclusion A multidisciplinary team approach to sepsis management using protocols and early goal-directed therapy is feasible in a large academic medical center to improve the process of care and outcomes. ER -