Institutional Structures and Processes to Support Sepsis Care: A Multihospital Study Article Swipe
Meghan K. Lóser
,
Jennifer Horowitz
,
Peter England
,
Rania Esteitie
,
Scott Kaatz
,
Elizabeth McLaughlin
,
Elizabeth Munroe
,
Megan Heath
,
Pat Posa
,
Scott A. Flanders
,
Hallie C. Prescott
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/cce.0000000000001004
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/cce.0000000000001004
OBJECTIVES: To identify opportunities for improving hospital-based sepsis care and to inform an ongoing statewide quality improvement initiative in Michigan. DESIGN: Surveys on hospital sepsis processes, including a self-assessment of practices using a 3-point Likert scale, were administered to 51 hospitals participating in the Michigan Hospital Medicine Safety Consortium, a Collaborative Quality Initiative sponsored by Blue Cross Blue Shield of Michigan, at two time points (2020, 2022). Forty-eight hospitals also submitted sepsis protocols for structured review. SETTING: Multicenter quality improvement consortium. SUBJECTS: Fifty-one hospitals in Michigan. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the included hospitals, 92.2% ( n = 47/51) were nonprofit, 88.2% ( n = 45/51) urban, 11.8% ( n = 6/51) rural, and 80.4% ( n = 41/51) teaching hospitals. One hundred percent ( n = 51/51) responded to the survey, and 94.1% ( n = 48/51) provided a sepsis policy/protocol. All surveyed hospitals used at least one quality improvement approach, including audit/feedback (98.0%, n = 50/51) and/or clinician education (68.6%, n = 35/51). Protocols included the Sepsis-1 (18.8%, n = 9/48) or Sepsis-2 (31.3%, n = 15/48) definitions; none ( n = 0/48) used Sepsis-3. All hospitals ( n = 51/51) used at least one process to facilitate rapid sepsis treatment, including order sets (96.1%, n = 49/51) and/or stocking of commonly used antibiotics in at least one clinical setting (92.2%, n = 47/51). Treatment protocols included guidance on antimicrobial therapy (68.8%, n = 33/48), fluid resuscitation (70.8%, n = 34/48), and vasopressor administration (62.5%, n = 30/48). On self-assessment, hospitals reported the lowest scores for peridischarge practices, including screening for cognitive impairment (2.0%, n = 1/51 responded “we are good at this”) and providing anticipatory guidance (3.9%, n = 2/51). There were no meaningful associations of the Centers for Medicare and Medicaid Services’ Severe Sepsis and Septic Shock: Management Bundle performance with differences in hospital characteristics or sepsis policy document characteristics. CONCLUSIONS: Most hospitals used audit/feedback, order sets, and clinician education to facilitate sepsis care. Hospitals did not consistently incorporate organ dysfunction criteria into sepsis definitions. Existing processes focused on early recognition and treatment rather than recovery-based practices.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/cce.0000000000001004
- https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Doing-Business-with-MDHHS/Health-Care-Providers/Certificate-of-Need/CON-Eval/Survey-Reports/2020/Beds/Report-010-Hospital-Beds-by-HSA.pdf?rev=16e5fcc69b6d4a03b17813f6028a34c3&hash=249DA44852A4FC41F010A3EA9D196034
- OA Status
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- Cited By
- 1
- References
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- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388522918Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1097/cce.0000000000001004Digital Object Identifier
- Title
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Institutional Structures and Processes to Support Sepsis Care: A Multihospital StudyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-11-01Full publication date if available
- Authors
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Meghan K. Lóser, Jennifer Horowitz, Peter England, Rania Esteitie, Scott Kaatz, Elizabeth McLaughlin, Elizabeth Munroe, Megan Heath, Pat Posa, Scott A. Flanders, Hallie C. PrescottList of authors in order
- Landing page
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https://doi.org/10.1097/cce.0000000000001004Publisher landing page
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https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Doing-Business-with-MDHHS/Health-Care-Providers/Certificate-of-Need/CON-Eval/Survey-Reports/2020/Beds/Report-010-Hospital-Beds-by-HSA.pdf?rev=16e5fcc69b6d4a03b17813f6028a34c3&hash=249DA44852A4FC41F010A3EA9D196034Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Doing-Business-with-MDHHS/Health-Care-Providers/Certificate-of-Need/CON-Eval/Survey-Reports/2020/Beds/Report-010-Hospital-Beds-by-HSA.pdf?rev=16e5fcc69b6d4a03b17813f6028a34c3&hash=249DA44852A4FC41F010A3EA9D196034Direct OA link when available
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Process management, Business, PsychologyTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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