Sepsis — life-threatening organ dysfunction caused by infection — contributes to at least 1.7 million adult hospitalizations and 350,000 deaths a year in the United States. Caring for it takes coordination across departments and disciplines, from emergency departments to intensive care units and wards, and hospital sepsis quality programs have been linked to lower mortality, shorter stays and lower costs.
In 2023, CDC published the Hospital Sepsis Program Core Elements, a guide to building such programs. To set a baseline, questions about sepsis programs were added to the 2022 annual survey of CDC's National Healthcare Safety Network (NHSN) — the nation's most widely used patient-safety tracking system.
Who has a sepsis program
5,221 hospitals answered (a 97% completion rate). 3,787 (73%) had a committee that monitors and reviews sepsis care — more common the bigger the hospital:
| Hospital size | Sepsis committee | Leaders given dedicated time |
|---|---|---|
| 0–25 beds | 53% | 35% |
| More than 500 beds | 95% | 78% |
| All hospitals | 73% | 55% |
"Dedicated time" means leading sepsis work was part of the leaders' job description, or they had protected time away from other duties. Larger hospitals also more often had support such as data analysts and IT.
Within sepsis committees:
- 55% included antimicrobial stewardship staff, and 45% infectious disease specialists;
- 61% monitored and reviewed antibiotic use in sepsis care.
Finding sepsis fast
| Approach | Hospitals |
|---|---|
| Electronic health record alerts based on systemic inflammatory response syndrome criteria | 65% |
| Manual screening | 47% |
| Predictive models | 33% |
| No standardized process | 10% — 15% of the smallest hospitals, 1% of the largest |
Managing it
| Protocol that prompts or guides | Hospitals |
|---|---|
| Diagnostic tests | 85% |
| IV fluids | 80% |
| Septic shock care | 79% |
| Preferred antibiotics | 77% |
| Care for specific patient groups | 34% — 21% of the smallest hospitals, 57% of the largest |
| No standardized protocol | 10% — 17% of the smallest, 1% of the largest |
What it means
Most hospitals have some sepsis tools and committees, but smaller hospitals — likely with fewer staff and specialists — lag, and only about half of all hospitals give sepsis leaders dedicated time. Clinical guidelines, state rules such as New York's sepsis regulations, and the federal CMS sepsis management bundle already stress early detection and treatment.
The Sepsis Core Elements, modeled on CDC's Core Elements of Hospital Antibiotic Stewardship Programs, are a manager's guide to creating, structuring and resourcing sepsis programs — including protected time for leaders, specialist involvement, and stewardship staff on sepsis committees to speed the right antibiotics and stop them when infection is ruled out. Future NHSN surveys will track how hospitals adopt them.
Limits
NHSN hospitals are at least 88% of U.S. acute care hospitals, not all; answers were self-reported and unverified; some specialties aren't present at every hospital; and the survey didn't strictly define a sepsis program.
Sources
Based on Dantes RB, Kaur H, Bouwkamp BA, et al., "Sepsis Program Activities in Acute Care Hospitals — National Healthcare Safety Network, United States, 2022," MMWR volume 72, number 34, Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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