ONCOLOGY

U-M intensivist Colin Cooke, M.D., M.Sc., along with Theodore Iwashyna, M.D., Ph.D., not pictured), advocates for increased accountability for sepsis diagnosis and care.

Call to action

Sepsis care quality needs to improve

issue 23 | spring 2015

It's been done for acute myocardial infarction. It's been done for congestive heart failure. It's been done for pneumonia. Now it's time to do it for sepsis, say U-M experts. It's time, they say, to harness the power of research and data to ensure consistent, high-quality care for every patient.

Sepsis now affects more hospital patients, and leads to more hospital costs, than any other diagnosis. It kills one in every six people diagnosed with it. More die from sepsis than from prostate cancer, breast cancer and AIDS combined.

In the Journal of the American Medical Association, U-M intensivists Colin Cooke, M.D., M.Sc., M.S., and Theodore Iwashyna, M.D., Ph.D., lay out the case for a national system that would hold hospitals and care teams accountable for sepsis diagnosis and care.

Just as it has done for other diseases, the federal government should set clear standards and targets for the kind of care that gives sepsis patients the best odds of surviving, they say. But unlike in previous efforts, the approach should incentivize better detection, start with regional collaboration to determine the best approaches, and respond to new evidence from rapidly evolving sepsis research.

The authors note that currently, only about one-third of sepsis patients nationwide receive the best possible care — despite national guidelines to help hospitals and doctors recognize and treat it. Late and missed diagnoses are common.

Says Cooke, "We believe that by creating a framework for quality improvement in sepsis care that takes into account evolving knowledge of this condition, we can improve patients' odds of survival and reduce variation in care." Adds Iwashyna,

"Excellent sepsis care requires careful clinical judgment and good teamwork, but at the same time it has to happen fast. This is not easy. But we have to improve our quality of care even when it is not easy."

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