Improving sepsis outcomes with simulation

Simulation in Healthcare



Sepsis is more common than a heart attack, with over 200,000 deaths in US hospitals every year and it can be treated if diagnosed in time. The Agency for Healthcare Research and Quality (AHRQ) has identified sepsis as the most expensive condition treated in U.S. hospitals at over $20 billion annually.

Sepsis will progress, if untreated, to severe sepsis, septic shock and death, with each stage costing more and incurring longer lengths of stay.  With current practices, approximately 37% of all sepsis cases will result in death.  It is well documented that patient mortality increases if sepsis is allowed to progress[1][2], with septic shock having a greater overall mortality than Severe Sepsis, and Severe Sepsis having a greater overall mortality then Sepsis, approximately, 30.1%, 16.7% and 7% respectively[3].

 

Disease progression

DiseaseProgression

Kumar et al[4] suggest that for each hour patient treatment is delayed there is a 7.6% increase in the chance of that patient dying.  For Severe Sepsis, this increase in mortality is approximately 4% for every hour the initiation of treatment is delayed[5].

Whilst there is clear guidance on best practice for diagnostics and treatment, these guidelines have proven challenging to implement consistently for all patients, and the best way of achieving them will be different in each hospital. From dedicated specialist nurses in the Emergency Department, to accessible locations of diagnostic testing machines – there are different solutions to solving the problem depending on the needs and the abilities of each hospital.

 

Our disease progression simulation, which is built on peer-reviewed research evidence, helps staff to test their improvement interventions and anticipate what impact they will have on length of stay, cost and mortality.  This information can then be used to create a business case and an implementation plan to ensure successful deployment of best practices. To access our sepsis simulation, or to discuss how you can use simulation to help prevent sepsis, get in touch with our healthcare team – we’re happy to help.

 

 

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488423/

[2] Knaus WA, Sun X, Nystrom O, Wagner DP (1992) Evaluation of definitions for sepsis. Chest 101:1656–1662

[3] Taken from Arturo Artero,Rafael Zaragoza and José Miguel Nogueira (2012).Epidemiology of Severe Sepsis and Septic Shock, Severe Sepsis and Septic Shock – Understanding a Serious Killer, Dr Ricardo Fernandez (Ed.),ISBN: 978-953-307-950-9,InTech,Available from: http://www.intechopen.com/books/severe-sepsis-and-septicshock-understanding-a-serious-killer/epidemiology-of-severe-sepsis-and-septic-shock

[4]  Kumar et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock Crit Care Med. 2006 June;34(6):1589-1596

[5] Sepsis Action Group. (2013). The Doctor’s Guide to identifying Severe Sepsis & applying the Sepsis Six. http://www.nuh.nhs.uk/media/1725743/sepsis_guides_a4_v4_rgb_internal_print_review_march_2015.pdf

 

Learn more about using SIMUL8 for healthcare process improvement

Find out more about how simulation is used by healthcare providers, read more case studies and access a range of learning resources.