Virginia Mason Institute: "Sepsis Power Hour"
At baseline, the time to recognize a patient who developed sepsis during the course of hospitalization (versus reason for admission) was 8 hours due to delays in provider assessment, diagnosis and confirmatory lab values. The improvement team at Virginia Mason Institute worked together to create the Sepsis Nurse Initiated Protocol, known as the “Sepsis Power Hour,” which gave nurses the authority and tools needed to quickly initiate evidence-based sepsis treatment. The protocol triggers, based on standardized nursing-observed changes in a patient’s condition, provided critical setup for provider decision making. This work built on previous improvement efforts, including the rapid identification of sepsis when a patient presented to the emergency department and a reframing of the protocol that the diagnosis and treatment depended on the presence of the physician. Implementation of the Power Hour reduced inpatient sepsis recognition time from 8 hours — all the way down to 30 minutes. In addition to quicker identification, the Power Hour supported compliance with defined best practices or bundle elements. Based on a review of Power Hours completed between July 2014 and February 2015, 75 percent of patients received specific bundle elements within one hour, compared to only 32 percent of regular care patients for the same elements.