A few years ago at Southlake Regional Health Centre, early results from CIHI’s hospital standardized mortality ratio (HSMR) cued staff to look more closely at septicemia. Although sepsis mortality rates were lower than the national average, medical staff at the Newmarket, Ontario, facility questioned whether deaths due to other diagnoses that were above average might also be attributable to sepsis.
“The HSMR was instrumental in providing us with a key starting point to assess our mortality rates,” says Barbara Kendrick, Southlake’s director of quality and planning.
A review of all septicemia cases confirmed that there might have been a delay in identifying sepsis, as protocols for early identification and treatment were not consistent across the hospital. A task force was created to adopt known best practices and to draft standardized orders for early recognition and treatment on the wards and in the emergency room.
“The key was to shorten the time to treatment,” Kendrick says.
The hospital also turned to its rapid response team, an outreach of the intensive care unit, composed of a critical care nurse and a respiratory therapist. Nurses were trained to recognize sepsis early and instructed to call in the team if they sensed a patient wasn’t doing well. As a result, cases on the ward are being picked up more quickly and treatment is being started sooner, which has reduced ICU admissions.
Kendrick says that this has been a key patient safety initiative at Southlake, where the sepsis philosophy is now to treat as early as possible.