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Downstate Times

The Newsletter for SUNY Downstate
University Hospital of Brooklyn

Downstate Times PDF
Issue 9, June 2013

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ISSUE 9 star JUNE 2013

UHB Develops Best Practices to Stop Sepsis in Its Tracks

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UHB Sepsis Committee Members (l. to r.): Olatokunboh Osineye, PI Manager and Sepsis Committee Coordinator; Ian deSouza, MD, Sepsis Committee Chair; Alix Laguerre, Clinical Labs Administrator; Daniel Pierre, PI Manager; Robert Schulz, MD; Samrat Worah, MD; Genevieve Watson-Grey, RN; Donareen Denny, RN; Jean Powell, RN. Seated: Judy Drummer, RN; and Margaret Jackson, RN, AVP and Chief Nursing Officer.

Studies have shown that fast diagnosis and treatment is the key to fighting sepsis— a severe blood infection that is the leading cause of death in hospitals. In January, Governor Cuomo announced that New York will be the first state to require all hospitals to adopt best practices for the early detection and treatment of sepsis. Through regulations issued by the Department of Health (DOH), hospitals will also be expected to provide special protections for pediatric patients. Known as Rory's Regulations, they are named for a 12-year-old who died of sepsis because his test results were not communicated in time.

Even before the Governor's initiative was announced, Downstate was actively involved in developing evidence-based protocols for faster diagnosis and treatment of sepsis. Since June 2011, UHB has been a member of the STOP Sepsis Collaborative, a Greater New York Hospital Association/United Hospital Fund quality initiative that now includes 57 New York hospitals.

"Although we were not the first hospital on board, we were soon ahead of the curve in reporting positive results," says Michael Lucchesi, MD, UHB's chief medical officer. "Our initial focus was on adults in the ER and critical care units. Now we are including pediatric patients, as well."

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Downstate is helping to set the gold standard for sepsis patient care.

Under the direction of Mathew Foley, MD, director of emergency services, sepsis bundles, or workflow guidelines, have been developed to instruct nurses and other medical staff how to quickly detect and treat sepsis in the ER. But as Dr. Foley points out, diagnosing children is more difficult. "For one thing, children have more rapid heartbeats, which is one criteria for diagnosing adults with severe sepsis. Lactate level is another criteria that may be different for children and adults," he explains.

Since the Governor's initiative was announced, Dr. Lucchesi has been attending regular meetings of the Health Commissioner's Sepsis Advisory Committee. In addition, UHB's own Sepsis Control Initiative holds monthly meetings attended by a multidisciplinary group of infection control physicians and pharmacists, critical care and pediatric intensivists, nurses, and hospital administrators. Their aim is to be ready for the September 3rd deadline, when all hospitals are required to submit their sepsis bundles to the DOH for review; supporting patient data are due in December. Once the protocols are accepted, they are likely to go into effect immediately. Hospitals that are found to be noncompliant by IPRO, the Joint Commission, and other regulatory bodies may face stiff penalties.

"Long before sepsis protocols were state mandated, UHB had already developed its own best practices," says Dr. Lucchesi. "We are confident that we will cross the finish line without breaking a sweat."