Highlights from January 2010 Quarterly Meeting Presentation

Representatives from Pomona Valley Hospital told their story of  perseverance and working together as a team to successfully reduce severe sepsis mortality. According to Peggy Cusack, RN, BSN, Nursing Director of Critcal Care Service and Nora Catipon, RN, MSN, GNP-BC, Critical Care, the effort was worth it. By reducing the severe sepsis mortality rate from 32.6% in 2007 to 19% in 2009, 173 lives were saved.

Outcomes of Pomona Valley’s Sepsis initiative
•    Average Length of Stay in Hospital ↓7.24 days
•    Average Length of Stay in ICU ↓3.25 days
•    162 minutes from ED to ICU
•    ICU Mortality reduced 18%
•    Total Cost Savings $7.5 million

The goal was to provide standardized care for severe sepsis patients. The effort involved team collaboration, leadership, innovation, and system management. Addressing issues on a daily basis and actively looking for patients who slipped through the cracks proved to be necessary.

Getting started involved:
•    Acquiring current statistics on ALOS, Case Mix Index (CMI), mortality rate, insurance payor mix and cost of care associated with diagnosis
•    Assessing equipment resources and location
•    Acquiring assistance from the lab for rapid turn-around times for lactates
•    Developing communication strategies
•    Establishing communication and agreement between ED and ICU
•    Training the RRT to help with sepsis screening for early recognition
•    Developing clinical resources for sepsis management available 24/7
•    Providing quarterly presentations to medical staff
•    Sharing data and successes frequently

The turning point occurred following implementation of the “Gold Alert” tools in 2009 to streamline ED care, provide early treatment and coordinate responses across departments. An aim was established to transfer patients to ICU in less than 5 hours with the ED RN initiating the screening tool and implementing a 6-hour bundle for early goal directed therapy (EGDT).

The cost of treating sepsis is 162% higher than any other diagnosis. Pomona Valley Hospital has successfully reduced the mortality rates, saved lives, shortened average hospital stays and saved $7.5 million. This proves the importance of identifying opportunities for improvement, the usefulness of the PDSA process when improvements are not immediate, and the necessity of perseverance.

Download Pomona Valley Hospital Presentation

Download Highlights from the January 2010 Quarterly Meeting "Practical and Tactical"