Lakeland Regional Medical Center has recently been recognized as one of the nation’s leaders in identifying and treating sepsis, a bloodstream infection that accounts for 20% of all admissions to intensive care units and is responsible for more deaths each year than breast and colon cancer combined. Under the leadership of Dr. Dean Sandifer, medical director of the intensive care units, LRMC’s critical care and emergency department teams embraced the national Surviving Sepsis Campaign in 2005 and have achieved amazing outcomes.
The Surviving Sepsis Campaign (SSC), an initiative of the European Society of Intensive Care Medicine (ESICM), the International Sepsis Forum (ISF), and the Society of Critical Care Medicine, was developed to improve the management, diagnosis, and treatment of sepsis. LRMC’s Critical Care team determined that by adopting the standards put in place by SSC, LRMC could achieve change and save lives.
Sepsis can be a complicated diagnosis, sometimes hard to recognize, frequently called different things, or diagnosed by different criteria. It’s a serious illness that progresses rapidly, and in a hospital with the state’s largest emergency department and four intensive care units, many care providers are involved with many patients.
The process to introduce a change in treating sepsis began by pinpointing four key elements the team hoped to accomplish. They were: changing the mental picture of sepsis to identify patients sooner in the process, establishing more uniformity for diagnosis and treatment, developing more urgency to make diagnoses and start treatment, and incorporating the Surviving Sepsis Campaign’s guidelines into day to day practice. The team would know that changes equaled improvement by instituting the Surviving Sepsis Campaign guidelines and by keeping monthly data to monitor key elements of change.
While Dr. Sandifer served as the physician champion, his leadership team included Carrie Ogilvie, trauma and critical care nursing director; the ICU managers and nurse educators, as well as representatives from pharmacy and respiratory therapy. They delivered the message at ICU monthly meetings and through an ICU email, and have also worked to improve communication through the ED and ICUs. They published and posted results, reviewed opportunities for improvement, and celebrated successes. Education, communication, and relentless determination to a data-driven process were vital.
With 24 months of data collected and submitted, LRMC’s results for achieving the target goals for initiating Early Goal Directed Therapy (EGDT) were the best among 165 hospitals participating in the Surviving Sepsis Campaign. In January 2010, Dr. Sandifer was invited to speak at the Society of Critical Care Medicine to share these results with his peers, and he has been lauded nationally for achieving such success at a large, non-academic hospital.
Congratulations to Dr. Sandifer, Carrie Ogilvie, and LRMC’s intensive care and emergency department teams for their outstanding commitment to delivering exceptional care.