Sepsis Too Often Neglected in Hospitals

More than 1400 hospitals in the United States do not have a sepsis program to lead the intervention for a medical emergency that affects at least 1.7 million people, according to a recent survey by the Centers for Disease Control and Prevention (CDC).

For the hospitals that do have sepsis teams, only 55% of them report that their team leaders get dedicated time to manage their sepsis programs.

Sepsis is the body’s extreme response to an infection and it requires urgent medical care to prevent tissue damage, organ damage, and death.

“One in three people who dies in a hospital has sepsis during that hospitalization,” CDC Director Mandy Cohen, MD, MPH, noted in a statement. “That’s why CDC is calling on all US hospitals to have a sepsis program and raise the bar on sepsis care by incorporating seven core elements.”

The Sepsis Seven

• Leadership: Dedicating the necessary human, financial, and information technology resources.

• Accountability: Appointing a leader responsible for program outcomes and setting concrete goals.

• Multiprofessional: Engaging key partners throughout the organization.

• Action: Implementing structures and processes to improve the identification, management, and recovery from sepsis.

• Tracking: Measuring sepsis epidemiology, outcomes and progress toward program goals and the impact of sepsis initiatives.

• Reporting: Providing usable information on sepsis treatment and outcomes to relevant partners.

• Education: Providing sepsis education to healthcare professionals during onboarding and annually.

Craig Weinert, MD, MPH, a pulmonologist and critical care physician and professor of medicine at the University of Minnesota, Minneapolis, says the point the CDC is making with the announcement is that when these sepsis programs have been implemented at hospitals, they have been successful at reducing mortality. And now, the agency is urging all hospitals to implement them and support them properly.

“It’s not asking hospitals to develop new, innovative kinds of sepsis programs. This is not about new drugs or new antibiotics or new devices,” Weinert says. “This is about having hospitals dedicate organizational resources to implementing sepsis programs.”

The CDC’s announcement is aimed toward hospital administrators, Weinert adds. The agency is making the case that sepsis needs more funding in hospitals that either don’t have the programs or aren’t supporting them with dedicated resources.

There’s another message as well, Weinert says.

“COVID basically obliterated sepsis programs for two-and-a-half years,” he says. Now the CDC is saying it’s time to divert staff back to sepsis care.

Stepping Up Sepsis Care

Raymund Dantes, MD, assistant professor of Medicine at Emory University, Atlanta, Georgia, one of the developers of the core elements, says this is like a recipe for sepsis care.

Dantes compares the instructions for hospitals with getting a good restaurant up and running. And in the restaurant business, “you need more than the recipes. You need a leader or manager to ensure you have the right people working together, with the right supplies, getting the right feedback on their work to continuously improve,” he explains.

Dantes, who is also the physician lead for the Emory Healthcare Sepsis Program, says the approach is meant to be flexible to the size of the hospital, population served, and available resources.

He points out that a well-run sepsis program at a 25-bed rural hospital will look very different from the program at a 1000-bed tertiary care hospital.

Some hospitals, Dantes says, will be starting from scratch when getting a sepsis program, and for those hospitals, the developers included a “Getting Started” section as part of the detailed, 29-page full report.

In September, Sepsis Awareness Month, the CDC will provide educational information to healthcare professionals, patients, families, and caregivers about preventing infections that can lead to sepsis through its ongoing Get Ahead of Sepsis campaign.

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