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Economic Impact of Clinical Sepsis: A Case for Improvement Efforts September 2010

Economic Impact of Clinical Sepsis: A Case for Improvement Efforts September 2010. Patient Safety Council 2010 Project: Sepsis Mortality Reduction . This Project … promotes early identification and treatment of sepsis. Our goal is to reduce incidence and mortality by 25%.

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Economic Impact of Clinical Sepsis: A Case for Improvement Efforts September 2010

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  1. Economic Impact of Clinical Sepsis: A Case for Improvement Efforts September 2010

  2. Patient Safety Council 2010 Project:Sepsis Mortality Reduction • This Project … promotes early identification and treatment of sepsis. Our goal is to reduce incidence and mortality by 25%. • It’s important … as sepsis is treatable with early intervention. Yet, it’s is the no. 1 cause of death in ICUs nationally; and 4 to 5 patients die per day of sepsis in our region. • Success will be measured by… increased compliance with evidenced-based best practices, reduced incidence and mortality of sepsis, and a decrease in overall patient hospital stay and costs. • What we need from you… commitment to support a multidisciplinary team approach to sepsis , including collaboration with colleagues, and providing recent data to track our progress.

  3. The Hospital’s Burden of Severe Sepsis Medical Wards Post-Operative Intensive Care Units Emergency Dept. • U.S. Sepsis Statistics • Severe sepsis is reported in 2.26 cases/100 hospital discharges, and 1 in 5 ICU admissions.1 • Severe sepsis is associated with a mortality of 30-50%.2 2Shapiro NI, et al. Critical Care Medicine, 2006; 34: 1025-1032

  4. Sepsis is Costly • Severe sepsis is estimated as 40% of all ICU expenditures1; $16.7B in the US alone.2 • The ALOS is 19.6 days and costs $22,100 per case.2 • The ICU patient with sepsis costs 6 X more than that care of a patient without sepsis.3 1Bone RC et al. Chest. 1992; 101: 1644–55 2Angus, DC et al. Critical Care Medicine. 2001; 29:1303-1310 3Edbrooke, DL et al. Critical Care Medicine. 1999; 27: 1760-1767

  5. Using EGDT in Sepsis is Cost-Effective Median Hospital Charges 39.2% reduction “…cost decreased an average of $9,346 per patient.” Becker, 2007 Trzeciak, 2006

  6. Potential Impact of EGDT – Here at (Your Facility) 1Nguyen, HB et al. Critical Care Medicine. 2007; 35:1105-1112 2Angus, DC et al. Critical Care Medicine. 2001; 29:1303-1310

  7. Please Support Our Next Steps! Support Sepsis Team meetings – including ED, Critical Care and Med-Surg physicians, staff and management to implement EGDT protocols (add other groups as needed) Provide authority to sepsis team for decisions, and timeline to achieve metrics Ensure monthly data availability to promote awareness and track progress Celebrate sepsis patients’ ‘lives saved’ at our hospital

  8. References American Heart Association. 2008 Heart and Stroke Statistical Update. Angus DC, et al., Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Critical Care Medicine, 2001; 29:1303-1310 Barlotta, K, et al. Projected impact of early goal directed therapy on hospital resource utilization for severe sepsis and septic shock patients. Annals of Emergency Medicine, 2005; 46 (3 Supplement 1): 24. Becker ML, et al., LIFE Campaign: implementation of sepsis bundle results in significant cost savings. Annals of Emergency Medicine, 2007; 50:S19-S20. Edbrooke, DL, et al., The patient-related costs of care for sepsis patients in a United Kingdom adult general intensive care unit. Critical Care Medicine, 1999; 27: 1760-1767. Huang DT, et al. Implementation of early goal-directed therapy for severe sepsis and septic shock: A decision analysis. Critical Care Medicine, 2007; Volume 35, Number 9, 2090-2100. National Center for Health Statistics. Available at: www.cdc.gov/nchs/fastats/pneumonia.htm on 6/24/08. Nguyen, HB et al., Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality, Critical Care Medicine. 2007; 35: 1105-1112 Otero, RM et al., Early Goal-Directed Therapy in Severe Sepsis and Septic Shock Revisited: Concepts, Controversies, and Contemporary Findings. CHEST, 2006; 130; 1579-1595 Rivers EP, et al., Early goal-directed therapy in severe sepsis and septic shock: a contemporary review of the literature. Current Opinion in Anesthesiology, 2008; 128-140. Rivers EP et al., Early Goal-directed Therapy in the Treatment of Severe Sepsis and Septic Shock. New England Journal of Medicine, November 8, 2001; Volume 345, No. 19, 1368-1377. Shorr AF, et al., Economic implications of an evidence-based sepsis protocol: can we improve outcomes and lower costs? Critical Care Medicine, 2007; 35: 1257-1262. Treciak, S, et al. Translating research to clinical practice: a one-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest, 2006; 129: 225-232. Zhan C, et al., Excess Length of Stay, Charges & Mortality Attributable to Medical Injuries During Hospitalization, JAMA, 2003, 290: 1868-1874.

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