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Fight Sepsis, a Top Killer in Hospitals, with a Simple Hospital Checklist

Sepsis is a common, serious, and extremely expensive complication for many staying in hospitals, that too frequently kills patients. The good news is that a simple checklist of proven best practices to ensure early diagnosis and treatment of sepsis can save lives, by helping prevent it and catch it early, during the “golden hour,” when treatment is most effective. The Stop Sepsis Now Act enacts a statewide anti-sepsis protocol that’s been shown to save thousands of lives.

The National Landscape

Passed in:

Illinois, New Jersey, New York

In The News

“The state just released a study showing that more people with sepsis were being identified and treated earlier, and that fewer of them were dying…. For adults who got faster treatment, the odds of dying declined by 21 percent.”
“Sepsis is the most expensive condition treated in U.S. hospitals, with many patients requiring prolonged care for multisystem organ failure in intensive care units. Researchers with the federal Healthcare Cost and Utilization Project found that sepsis, also called septicemia, cost $23.7 billion to treat in 2013.”

Partners

  • Patient advocacy groups
  • Hospital and medical professional associations working to improve standards of care

Opposition

None noted
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FAQ

Who does this help?
Sepsis can strike anyone, so early diagnosis and optimal treatment of sepsis helps protect all hospital patients.
Is this high cost to the state?
No. It creates a sepsis protocol—a simple checklist for health care providers to follow so that they quickly catch cases of sepsis.
Print

Model Policy

SECTION 1 (TITLE):
This act shall be known as the Stop Sepsis Now Act.

SECTION 2 (PURPOSE):
To reduce unnecessary deaths by ensuring that STATE’s hospitals follow best practices in sepsis diagnosis and treatment

SECTION 3 (PROVISIONS):

(a) Within 100 days of enactment of this section DEPARTMENT [with responsibility for public health in state] shall commence regulatory proceedings, using emergency regulations initially if necessary, to require:
  • (i) All hospitals in STATE to adopt, implement, and periodically update evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis, or septic shock (“sepsis protocols”) that are based on generally accepted standards of care.
  • (ii) Sepsis protocols must include components specific to the identification, care, and treatment of adults and of children, and must clearly identify where and when components will differ for adults and for children seeking treatment in the emergency department or as an inpatient.
  • (iii) These protocols must also include the following components:
  • (1) a process for the screening and early recognition of patients with sepsis, severe sepsis, or septic shock;
  • (2) a process to identify and document individuals appropriate for treatment through sepsis protocols, including explicit criteria defining those patients who should be excluded from the protocols, such as patients with certain clinical conditions or who have elected palliative care;
  • (3) guidelines for hemodynamic support with explicit physiologic and treatment goals, methodology for invasive or non-invasive hemodynamic monitoring, and timeframe goals;
  • (4) for infants and children, guidelines for fluid resuscitation consistent with current, evidence-based guidelines for severe sepsis and septic shock with defined therapeutic goals for children;
  • (5) identification of the infectious source and delivery of early broad spectrum antibiotics with timely re-evaluation to adjust to narrow spectrum antibiotics targeted to identified infectious sources;
  • (6) criteria for use, based on accepted evidence of vasoactive agents; and
  • (7) that hospitals shall be responsible for the collection and utilization of quality measures related to the recognition and treatment of severe sepsis for purposes of internal quality improvement.
  • (iv) The regulations shall be designed to ensure that hospital professional staff with direct patient care responsibilities and, as appropriate, staff with indirect patient care responsibilities, including, but not limited to, laboratory and pharmacy staff, are periodically trained to implement the sepsis protocols required under this law. The hospital shall ensure updated training of staff if the hospital initiates substantive changes to the sepsis protocols.
  • (v) The evidence-based protocols adopted under this Section shall be provided to the Department upon the Department's request.
  • (vi) Hospitals submitting sepsis data as required by the Centers for Medicare and Medicaid Services Hospital Inpatient Quality Reporting program as of fiscal year 2016 are presumed to meet the sepsis protocol requirements outlined in this law for the first two reporting periods after enactment of this section.

(b) The DEPARTMENT shall also:
  • (i) issue recommendations for evidence-based sepsis definitions, protocols and metrics that incorporate evidence-based findings, including appropriate antibiotic stewardship, and that align with appropriate national, hospital and expert stakeholders such as the National Quality Forum, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and the Joint Commission;
  • (ii) issue a methodology for collecting, analyzing, and disclosing the information collected under this law, including collection methods, formatting, and methods and means for aggregate data release and dissemination;
  • (iii) consider appropriate sepsis education programs to complement and advance the early diagnosis, treatment and prevention of sepsis, including in schools and other non-hospital settings;
  • (iv) issue the recommendations in sections (i) and (iii) and methodology of section (ii) no later than 12 months after the effective date of this act; the recommendations shall be provided to the governor and state legislature and shall be publicly available on the Department's website; and
  • (v) consult and seek input and feedback prior to the proposal, publication, or issuance of any guidance, methodologies, metrics, rulemaking, or any other information authorized under this Section from statewide organizations representing hospitals, physicians, advanced practice nurses, pharmacists, and long-term care facilities. Public and private hospitals, epidemiologists, infection prevention professionals, health care informatics and health care data professionals, and academic researchers may also be consulted.