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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1002/rnc.1081

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1432-1238

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The Surviving Sepsis Campaign results of an inter

Authors: Mitchell M Levy R Phillip Dellinger Sean R Townsend Walter T LindeZwirble John C Marshall Julian Bion Christa Schorr Antonio Artigas Graham Ramsay Richard Beale Margaret M Parker Herwig Gerlach Konrad Reinhart Eliezer Silva Maurene Harvey Susan Regan Derek C Angus
Publish Date: 2010/01/13
Volume: 36, Issue: 2, Pages: 222-231
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Abstract

The Surviving Sepsis Campaign SSC or “the Campaign” developed guidelines for management of severe sepsis and septic shock A performance improvement initiative targeted changing clinical behavior process improvement via bundles based on key SSC guideline recommendations on process improvement and patient outcomesA multifaceted intervention to facilitate compliance with selected guideline recommendations in the ICU ED and wards of individual hospitals and regional hospital networks was implemented voluntarily in the US Europe and South America Elements of the guidelines were “bundled” into two sets of targets to be completed within 6 h and within 24 h An analysis was conducted on data submitted from January 2005 through March 2008Data from 15022 subjects at 165 sites were analyzed to determine the compliance with bundle targets and association with hospital mortality Compliance with the entire resuscitation bundle increased linearly from 109 in the first site quarter to 313 by the end of 2 years P  00001 Compliance with the entire management bundle started at 184 in the first quarter and increased to 361 by the end of 2 years P = 0008 Compliance with all bundle elements increased significantly except for inspiratory plateau pressure which was high at baseline Unadjusted hospital mortality decreased from 37 to 308 over 2 years P = 0001 The adjusted odds ratio for mortality improved the longer a site was in the Campaign resulting in an adjusted absolute drop of 08 per quarter and 54 over 2 years 95 CI 25–84The Campaign was associated with sustained continuous quality improvement in sepsis care Although not necessarily cause and effect a reduction in reported hospital mortality rates was associated with participation The implications of this study may serve as an impetus for similar improvement efforts

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