Utilizing Data to Improve Sepsis Identification in Targeted Populations

Abstract

Background: Abstract: Children’s Memorial Hermann Hospital (CMHH) joined the Improving Pediatric Sepsis Outcomes (IPSO) collaborative in July 2016 with successful data importation beginning Summer 2017. At the beginning of the collaborative, generalized triage screening provided a 30% positive screening rate, and the baseline mortality at 30 days per 1,000 admissions for patients admitted from the Emergency Center (EC) to the pediatric intensive care unit was 0.67. Extensive data analysis revealed that 37% of the patients seen in the emergency department with intent to treat and 100% of attributable deaths related to sepsis at CMHH were identified as complex chronic children who were technology dependent. Methods: Based on the collected data and variable regression analysis utilizing Six Sigma methodology, the problem was defined as the risk for sepsis in the chronic complex patient population who are technology dependent indicated the need for accurate screening. As part of the IPSO collaborative goals of increasing early identification, the CMHH IPSO team worked with the EC nurses to create a triage algorithm to improve the identification of sepsis in this population (Fig. 1). Education was done, and Plan– Do–Study–Act cycle implementation began in January 2018 with the final rollout of the algorithm in the EC of March 2018. Results: Accurate screening of this population increased from a mean of 30%–75% after intervention, resulting in a decrease in mortality for inpatients admitted from the EC to the pediatric intensive care unit to zero/1,000 through the last reported data cycle of December 2018 (Fig. 2). Conclusion: Utilization of data analysis resulted in a defined problem and a targeted intervention resulting in the elimination of sepsis attributed mortality in the targeted population.