Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units

"In 2011, North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period (2008-2013; sustained through 2014) "

Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units
ME Doerfler  et al.
Joint Commission Journal on Quality and Patient Safety. 2015 May;41(5):205-211.

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Reducing blood culture contamination rates in an Emergency Department

"Current guidelines advocate a contamination rate of 2–3%. From January 2013 to November 2014 inclusive, the contamination rate was 4.74% in our Emergency Department, responsible for initial management and investigation of over 40 cases of sepsis per month. A Quality Improvement team was created to try to reduce contamination rates to the recommended target."

A change of culture: reducing blood culture contamination rates in an Emergency Department
J Bentley, S Thakore, L Muir, A Baird, J Lee
BMJ Quality Improvement Report 2016;5: doi:10.1136/bmjquality.u206760.w2754

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Improving the management of sepsis by implementing the 'Sepsis Six'

"Overall, we found there to a be a steady improvement in the delivery of the Sepsis Six bundle in septic patients with 63% of patients receiving appropriate care within one hour, compared to 29% prior to our interventions. However this did not translate to an improvement in patient mortality."

Improving the management of sepsis in a district general hospital by implementing the 'Sepsis Six' recommendations
P Kumar, M Jordan, J Caesar, S Miller
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207871.w4032

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Using a simple handover to improve the timing of gentamicin levels

"Prior to our intervention, the timing of gentamicin levels was poorly performed, with 42.2% of levels taken late and two episodes of missed doses were reported."

Using a simple handover to improve the timing of gentamicin levels
A Williamson, A Bradley, K Khan
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207727.w3081

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Variations and inter-relationship in outcome from emergency admissions in England

"Hospital-level risk-standardised outcomes for emergency admissions across a range of specialties vary considerably and cross traditional speciality boundaries. This suggests that global institutional infra-structure and processes of care influence outcomes."

Variations and inter-relationship in outcome from emergency admissions in England: a retrospective analysis of Hospital Episode Statistics from 2005-2010
PJ Holt, S Sinha, BA Ozdemir, A Karthikesalingam, JD Poloniecki, MM Thompson
BMC Health Services Research, 2014, 14: 270

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Time to act: severe sepsis: rapid diagnosis and treatment saves lives

"Better care could lead to savings in 8 Time to act - Severe sepsis: rapid diagnosis and treatment saves lives terms of reduced length of hospital stay and less intensive care and renal dialysis."

Time to act: severe sepsis: rapid diagnosis and treatment saves lives
Parliamentary and Health Service Ombudsman
September 2013

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