CDC launches anti-sepsis program for US hospitals

Key takeaways:

• Only 55% of U.S. hospitals report that team leaders have time to manage their sepsis programs.
• One in three people who die in a hospital has sepsis during their hospitalization.

The CDC launched a new anti-sepsis program for U.S. hospitals that was modeled after the agency’s “Core Elements” framework for developing antibiotic stewardship programs.

Sepsis is an extreme bodily reaction to an infection — even COVID-19, influenza and respiratory syncytial virus can lead to sepsis, the CDC noted — that can cause tissue damage, organ damage and death in a lot of cases.

Typically, there are at least 1.7 million cases and 350,000 sepsis deaths among U.S. adults each year, according to the CDC.

“Sepsis is taking too many lives,” CDC director Mandy Cohen, MD, MPH, said in a press release. “One in three people who dies in a hospital has sepsis during that hospitalization. Rapid diagnosis and immediate appropriate treatment, including antibiotics, are essential to saving lives, yet the challenges of awareness about and recognition of sepsis are enormous. That’s why CDC is calling on all U.S. hospitals to have a sepsis program and raise the bar on sepsis care.”

The seven core elements of the CDC’s new sepsis program are identical to its seven core elements of antibiotic stewardship, except for one change: Instead of drug expertise, the CDC recommends that sepsis programs include multiprofessional expertise —or, engaging key partners throughout the hospital or health care system.

“CDC has seen success from the ‘Core Elements’ approach [that has] helped establish robust antibiotic stewardship programs across most U.S. hospitals,” Raymund B. Dantes, MD, a medical advisor to the CDC, told Healio.

“At the same time,” Dantes said, “our partners in the University of Michigan and Michigan Hospital Medicine Safety Consortium have accumulated a wealth of knowledge from the experiences of many sepsis programs in their network. We brought together these experiences to create the new CDC Hospital Sepsis Program Core Elements, in order to provide guidance, or a ‘manager's guide’ for hospitals to improve the support and structure of sepsis programs.”

The other six elements, as explained by the CDC, are:

• leadership commitment: dedicating the necessary human, financial, and information technology resources;
• accountability: appointing a leader or co-leaders responsible for program goals and outcomes;
• action: or implementing structures and processes to improve the identification of, management of, and recovery from sepsis;
• tracking: measuring sepsis epidemiology, management and outcomes to assess the impact of sepsis initiatives and progress toward program goals;
• reporting: providing information on sepsis management and outcomes to relevant partners; and
• education: or providing sepsis education to health care professionals, patients and family caregivers.

An MMWR report published to coincide with the launch of the program found that in a survey of 5,221 American hospitals, 73% reported having sepsis teams, but only 55% reported that team leaders were provided with dedicated time to manage sepsis programs.

The report, which Dantes co-authored, outlined the seven elements, which are meant to, in Cohen’s words, “provide an organizational framework and key concepts that guide hospitals as they work to improve early recognition and treatment to save lives.”

“One of the most common misconceptions is that sepsis primarily develops in the hospital,” Dantes said. “However, over 80% of sepsis is present on admission to the hospital. The CDC Hospital Sepsis Program Core Elements emphasizes the importance of having multiprofessional [representation] in your sepsis committee, including representatives from the emergency department, who are best positioned to recognize and initiate rapid treatment for the majority of sepsis patients.”

“These data highlight opportunities, particularly in smaller hospitals, to improve the early identification of, care for, and outcomes among patients with sepsis in the United States by

ensuring that all hospitals have sepsis programs with protected time for program leaders,” Dantes and colleagues wrote in the MMWR report.

References:

CDC. Hospital sepsis program core elements. https://www.cdc.gov/sepsis/core-elements.html. Accessed Aug. 24, 2023.

CDC launches new effort aimed at strengthening survival and recovery rates for all sepsis patients. https://www.cdc.gov/media/releases/2023/s0824-sepsis-patients.html#print. Published Aug. 24, 2023. Accessed Aug. 24, 2023.

Dantes RB, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7234a2.