In August 2018, members of the Great Plains Quality Innovation Network (GPQIN) Nebraska team began meeting monthly with healthcare representatives from the Norfolk community to bring forward each organization’s efforts related to sepsis. Self-named the Norfolk Area Sepsis Community Action Team (SCAT), they developed a mission and vision statement to guide their efforts going forward.
Mission: Healthcare leaders raising awareness of sepsis through education, communication, and resource management to reduce its impact on mortality and harm in our community.
Vision: Our community without sepsis – “know” sepsis
With knowledge that sepsis is the #2 cause of hospital admission and #1 cause for hospital readmission in Nebraska, the team knew they would have to pull together to address sepsis at the community level. This aligned with the goals of the Great Plains QIN team, which was to bring community members together to knock down the silos between organizations and work, as a community, to learn from one another and utilize available resources and local subject matter experts.
The Norfolk SCAT began meeting regularly and recruited new members; participation continued to expand throughout the community. Each partner has provided a unique perspective on sepsis care and opportunities for improvement. Representatives included hospitals, long-term care facilities, assisted living facilities, emergency medical services, public health departments, physician offices, urgent care clinics, community college nursing program and local pharmacies.
With sepsis being a medical emergency that goes largely unrecognized in the community, evidenced by the fact that 80 percent of patients have sepsis symptoms prior to hospitalization, the team focused on education for staff, clinicians and the community. Efforts included nursing home staff education and implementation of sepsis screening tools and algorithms similar to those used by nurses in the hospital.
As a result, the community has already began to see the rewards of their efforts.
Norfolk Fire Division has developed a sepsis screening protocol to employ during rescue calls to aid in early sepsis recognition. After extensive EMS training, any case of suspected sepsis is now treated as a medical emergency and is immediately communicated to the receiving Emergency Room physician, prior to patient arrival, to expedite care in this critical time.
Elkhorn Logan Valley Public Health includes sepsis questions on their annual community health assessment to get a better understanding of sepsis awareness in the community. Many team members attended the area PATCH health fair where information was distributed to several hundred people.
“I wish I had known about sepsis before now; my husband died with sepsis last year,” stated a local Medicare beneficiary at the PATCH health fair.
At a hospital level, Faith Regional has increased staff and physician education to identify and prioritize sepsis as a medical emergency. With new software implementation in the next few months, hospital patients will be continuously screened for the development of sepsis. The software will automatically alert nursing staff, within 15 minutes of critical vital signs and labs, in addition to regular sepsis screening protocols during each shift. Faith Regional has also focused efforts on patient involvement in their own care. At discharge, patients are provided sepsis education, which includes a list of signs and symptoms to monitor at home and provides guidance on what to do if any signs and.or symptoms of sepsis should develop.
“Perhaps the most impactful outcome of the Norfolk Sepsis Community Action Team was the opportunity for networking throughout the spectrum of healthcare in our community. The opportunity to get together and find out what each entity’s strengths and weaknesses were involving sepsis care allowed us to address the needs of our community. As a coalition, we hope to serve as a model and a resource for other communities in Nebraska. We plan to continue our efforts in sepsis education and care coordination, emphasizing that the patient is always at the center, and should always be a key person in discussion and education about their care.” Dr. Jenna Preusker, Antimicrobial Stewardship Pharmacist at Faith Regional Health Services.