Partnering Together to Reduce Sepsis Mortality： A Novel Approach  

作　　者：Boris Khodorkovsky Nancy Riebling Sara Gonzalez Cynthia Benson Zebulan Frayne Shaghayegh Norouzzadeh 

机构地区：[1]North Shore-LIJ Health System, Emergency Medicine, Staten Island University Hospital 475 Seaview Ave, Staten Island, NY10305, USA [2]North Shore-LIJ Health System, Center for Learning & Innovation, 1979 Marcus Ave Suite 101, Lake Success, NY 11042, USA [3]North Shore-LIJ Health System, Quality, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, USA [4]North Shore-LIJ Health System, Nursing, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, USA

出　　处：《Journal of Health Science》2014年第10期491-502,共12页健康科学（英文版）

摘　　要：Each year 750,000 Americans are diagnosed with sepsis and approximately 220,000 of those patients die. In addition to the toll on human life, sepsis is the most expensive disease to care for in the hospital costing approximately 17 billion dollars annually. National and international initiatives have demonstrated the benefits of recognition, early fluid resuscitation and broad spectrum antibiotics to reduce sepsis mortality. The Surviving Sepsis Campaign recently issued the third iteration of clinical bundles for the management of severe sepsis and septic shock. Robust Process Improvement （RPITM） which integrates the principles of Six Sigma, Lean and Change Management was applied to increase overall compliance to implement the elements of the three hour sepsis bundle in a complex healthcare system. The elements of the three hour sepsis bundle are drawing blood cultures before ordering antibiotics, timely antibiotic administration, obtaining lactate and administering fluid bolus. It has been demonstrated for severe sepsis and septic shock that bundle compliance is associated with a reduction in hospital mortality. The results of this study indicated that the overall bundle compliance increased by 30% which resulted in reducing the sepsis mortality rate by 27%.

关 键 词：SEPSIS BUNDLE Robust Process Improvement MORTALITY Six Sigma Change Management. 

分 类 号：R161[医药卫生—公共卫生与预防医学]