The 1,000-bed Texas Children’s Hospital has been at the forefront of a growing national effort to address the sepsis crisis in U.S. hospitals. In an article in the May issue of Health Affairs entitled, “Reimagining Systems and Engaging Patients,” Charlotte Huff, a health and business journalist based in Fort Worth, Texas, describes some of the advances taking place at Texas Children’s.
As Huff notes in the article, “Between 8 and 21 percent of children with sepsis die, sometimes, within only a handful of days, according to a frequently cited 2014 study in Pediatric Critical Care Medicine. Meanwhile, she writes that, “While the mortality rate at Texas Children’s falls below that, the pediatric hospital system has made the life-threatening condition one of its major quality improvement targets in the past two years and is determined to drive the number of deaths lower. Texas Children’s is by no means the only pediatric hospital tackling sepsis, and it’s joined a national pediatric sepsis collaborative that was recently formed by the Children’s Hospital Association.3 But in interviews and an on-site tour, doctors, nurses, and other clinicians describe a multipronged effort that will ultimately touch nearly every corner of the health system.”
As a result, Huff writes in the article, “To date, clinicians at Texas Children’s have developed and continue to refine a computerized algorithm that runs in the background at the bedside in nearly all inpatient units, with the goal of catching emerging sepsis sometimes…before the doctors or nurses diagnose it. They’ve made sepsis huddles more routine, organizing key clinicians to make treatment decisions within minutes. They’re steadily working to shave down the time it takes to get the first dose of a sepsis-fighting antibiotic to a patient, even if that requires a nurse to deliver it from the pharmacy in person. And they described broader communication training that’s been ongoing (it had reached nearly 1,000 clinicians by the end of 2018) as key to encouraging nurses, physician assistants, and other clinicians to speak up if they have a sepsis-related concern or one about another type of treatment.”
And, notes Charles Macias, an emergency physician and co-leader of the Texas Children’s sepsis initiative, “Already, Texas Children’s clinicians are using a similar machine-learning model to create a computer algorithm to catch developing central line–associated bloodstream infections. We realized when we were doing the sepsis work that this could be applied to a lot of complex conditions,” Dr. Macias adds.
