What if you could do something that made a life saving difference about one time in every eight patients? Would it be even better if you knew that it was saving the system money?
The golden intersection of providing better care, in a cheaper manner is a rarity in medicine. It seems to be too good to be true. However, we know that goal directed sepsis care can attain both of these criteria.
Collectively, we have known since the early 2000’s that the algorithmic approach to sepsis care has a remarkable ability to save lives. Studies have shown that treating as few as 6 – 8 patients with goal directed sepsis care can result in a life saved. The problem has always been translating the knowledge into performance in the hospital setting. Preliminary work at the University of Alberta (Brindley et al) published as letter to CJEM editor in 2007 showed that this knowledge translation can be accomplished with simulation.
Elaine and I attended an impressive seminar in San Diego given by a group from Mercy Hospital in the Dignity Health System. They were faced with an impressive task. Educate hundreds of staff on a limited budget and show improved outcomes combined with cost savings. They were tasked with reducing sepsis mortality within the organization by 5%. They had a 60 month time frame and an overall budget of $1.7 million dollars (that sounds like a lot – but includes the cost of replacing people during their training time!)
The group came up with a program of online lectures and high fidelity simulation. They tested everyone pre and post hi fidelity activities. There was notable staff improvements in confidence, knowledge of the criteria and on fluid management. There was also an overall greater recognition of sepsis within the organization with call volumes to the screening team doubling in the 6 months after training was completed.
What were they able to accomplish in the review after the program roll out?
Mortality cut by 25% Estimated 1296 lives saved Est $50 million (yes million!!) dollars saved – in an organization with approximately 300 inpatient beds!!!
Or to see a few more examples of successful programs using simulation to train staff about sepsis at other centres click here. That seems to be time and money well spent! Simulation is a powerful learning tool that can be translated directly into favorable patient and economic outcomes. ….not to mention that it is fun 🙂
Stay tuned for more…….
Kish