2024 Children's of Alabama/UAB Annual Report

Children’s Sepsis Efforts Leading to Improved Outcomes

Pediatric sepsis is a significant global health issue, leading to considerable morbidity and mortality. Despite the challenges of caring for sepsis patients, Children’s of Alabama has made significant progress on sepsis outcomes over the last few years.

Sepsis Coordinating Council, which oversees the hospital’s sepsis work, is a group of nurses, administrative leaders, performance improvement experts, information technologists, pharmacists and physicians who have led the charge on these improvement efforts. The council is led by Mary Orr, M.D.

Since 2017, the hospital has improved in three areas: reducing the rate of hospital-onset sepsis cases from 1.24 to 1.03 per 1,000 (17% decrease), cutting the average time to administer the first fluid bolus from 52 minutes to 38 minutes (27% decrease) and driving down the average time to first antibiotic from 116 minutes to 73 minutes (37% decrease). The success is attributable, in part, to Children’s use of the Improving Pediatric Sepsis Outcomes (IPSO) collaborative definitions to identify sepsis patients. These definitions emphasize the clinical decision to initiate sepsis treatment, focusing on five key process measures related to screening and Early Goal-Directed Therapy (EGDT) delivery to improve outcomes: sepsis screening, sepsis huddles, order set utilization, time to first fluid bolus and time to first antibiotic administration.

17 %

Staff in the emergency department also have been vital. “They are the foundation of sepsis care at Children’s of Alabama,” said Amy Hobbs, director of quality and patient safety at Children’s said. “Our emergency department has demonstrated sustained excellence in sepsis care, particularly in antibiotic administration, for more than five years.” Moving forward, the Sepsis Coordinating Council aims to continue improving outcomes with new strategies. Children’s completed its IPSO work in 2024 and will continue to maintain IPSO outcomes. But starting this year, the team will use definitions established through the release of the Phoenix Criteria. “There are opportunities to determine the future of sepsis care at Children’s of Alabama in the coming years,” Hobbs said. “We are currently exploring how we can best utilize this tool.”

Reduction in the rate of hospital- onset sepsis

27 %

Decrease in the time needed to administer first fluid bolus.

37 %

A multidisciplinary approach also plays a key role in Children’s success. The Children’s of Alabama

Reduction in the average time receiving first antibiotic

2024 Academic Annual Report

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