Recommended Features of Hospital Sepsis Programs Are Associated With Improved Sepsis Management and Outcomes
Recommended Citation
Prescott HC, Heath M, McLaughlin E, Horowitz J, Blamoun J, Bozyk P, Cahill M, Hsaiky L, Jayaprakash N, Tamae Kakazu M, Malani A, Taylor SP, Flanders S, Posa P. Recommended Features of Hospital Sepsis Programs Are Associated With Improved Sepsis Management and Outcomes. Am J Respir Crit Care Med 2025; 211:2.
Document Type
Conference Proceeding
Publication Date
5-20-2025
Publication Title
Am J Respir Crit Care Med
Abstract
RATIONALE: The 2023 CDC Hospital Sepsis Program Core Elements provides high-level guidance for developing effective hospital programs to monitor and improve outcomes from sepsis. The guidance includes 28 'priority examples' of hospital sepsis program features that map to the 7 core elements of hospital leadership commitment, accountability, multiprofessional expertise, action, tracking, reporting, and education. We sought to assess whether recommended hospital sepsis program features are associated with improved sepsis management and outcomes.METHODS: We surveyed 66 hospitals in Michigan that participate in a statewide sepsis collaborative quality initiative (HMS-Sepsis) funded by Blue Cross Blue Shield of Michigan. The survey was administered in spring 2024 and asked about hospital sepsis program features. Survey responses were mapped to 28 priority examples in the CDC Hospital Sepsis Program Core Elements. We then tested associations of hospital sepsis program features with sepsis management and risk-adjusted 30-day mortality using HMS-Sepsis registry data from January 2022 to August 2024. HMS-Sepsis registry data are entered by professional abstractors at each hospital and audited for accuracy. Risk-adjustment was done using the HMS-Sepsis mortality model, a validated risk-adjustment model that uses physiologic data from the first 6 hours of emergency department presentation.RESULTS: Hospitals reported a median 21 (IQR 16-24) priority examples. The number of priority examples was associated with hospitals' performance on the HMS-Sepsis early sepsis management bundle (correlation 0.422, p<0.001) and risk-adjusted 30-day mortality (correlation 0.261, p=0.03). Three individual priority examples were significantly associated with both management and outcomes: (1) setting ambitious—but achievable—goals for improving sepsis care and patient outcomes; (2) assessing progress towards hospital sepsis goals at regular intervals and updating goals periodically to promote continual improvement; and (3) monitoring progress towards achieving hospital goals for sepsis management and/or outcomes. For example, assessing progress toward hospital sepsis goals and updating goals periodically occurred in 100%, 67.2%, and 46.5% of hospitals in quintiles 1 (best), quintiles 2-4, and quintile 5 of standardized mortality, p=0.01. An additional six priority examples were associated with either management (n=4) or outcomes (n=2).CONCLUSIONS: The strength of hospital sepsis programs, as measured by 2023 CDC Hospital Sepsis Program Core Elements, is correlated with both sepsis management and sepsis outcomes. Setting and monitoring of hospital sepsis goals was most strongly associated with management and outcomes. Robust hospital sepsis programs have the potential to improve sepsis management and outcomes.
Volume
211
First Page
2
