1. Common Barriers to Implementing the Sepsis Care Model
October 2015

2. CONFIDENTIAL - Internal Use Only
HVHC Sepsis Care Model
Beginning 2013, HVHC members have been meeting regularly to review data and best practices for patients with sepsis.
The HVHC sepsis project adopted the Surviving Sepsis Campaign (SSC) 3-hour bundle after review of the available evidence.
The HVHC sepsis bundle has been implemented in 13 health care systems, delivered to over 6,000 patients between spring of 2013 and 2015.
CONFIDENTIAL - Internal Use Only

3. CONFIDENTIAL - Internal Use Only
HVHC Sepsis Care Model
Implementing the HVHC Sepsis Care Model may require change in in care processes, roles, protocols, and EHR support.
Common barriers to implementing the 3-hour bundle have been identified by:
Discussions with members of the HVHC Sepsis Improvement Project Team
Review of reports submitted by HVHC members
Interviews with senior leaders, managers, and frontline care teams at several sites
CONFIDENTIAL - Internal Use Only

4. Common Barriers to Implementing the HVHC Sepsis Model
Difficult to accurately record the volume and timing of IV fluids
Length of time required to make changes in the EHR
Access to meaningful data
Changing roles and responsibilities
Communication
Maintaining momentum and focus
CONFIDENTIAL - Internal Use Only

5. HVHC Members with Solutions
Difficult to accurately record the volume and timing of IV fluids
DHMC: planned wireless smart pumps with barcodes that automatically populate the EHR
Length of time required to make changes in the EHR
U Iowa: best practice alerts in Epic record
DHMC: SuperSIRS alert in general care areas (validated) with pager alert to sepsis RN
Access to meaningful data
NSLIJ: data analytic team produces reports with interpretation of what the data means for care teams
CONFIDENTIAL - Internal Use Only

6. HVHC Members with Solutions
Changing roles and responsibilities
VMMC: “power hour” nurse protocol
DHMC: Clinical Nurse Specialist who monitors hospital performance on sepsis, educates and trains staff
DHMC: RN initiated sepsis intervention protocol
Communication
BIDMC: personal s from physician champion
NSLIJ: clear goals for improving sepsis are communicated through out the system by senior leaders
Maintaining momentum and focus
NSLIJ: re-commitment to sepsis improvement every year
CONFIDENTIAL - Internal Use Only