THREE PHASES
Phase I
The Society of Critical Care Medicine, the European Society of Intensive Care Medicine and the International Sepsis Forum joined
forces to develop a three-phase Surviving Sepsis Campaign. During the first phase, campaign leaders introduced the initiative at major
international critical care medicine conferences. They developed a six-point action plan to reduce global mortality from severe sepsis by
25% by 2009. The agenda includes:
• Building awareness of sepsis among healthcare professionals,governments, health and funding agencies, and the general public.
• Improving early and accurate diagnosis.
• Increasing the use of appropriate treatments and interventions.
• Educating all healthcare professionals about diagnosis, treatment, and management of sepsis.
• Improving access to post-ICU care for sepsis patients.
• Developing global standards of care.
Phase II
The second phase of the campaign focused on creating guidelines for sepsis management. A group of international critical care and
infectious disease experts representing 11 organizations convened in Windsor, UK, in June 2003 to begin that process. Publication of the guidelines in the March 2004 issue of Critical Care Medicine and April 2004 Intensive Care Medicine completed phase two.
Phase III
Phase three of the campaign involves translating the guidelines into clinical practice. To that end, campaign leaders partnered with the Institute for Healthcare Improvement (IHI) to develop two sepsis bundles and to create a database–centered change measurement process. These bundles and the supporting evidence based guidelines form the basis for best practice recommendations. The campaign also developed and has now widely distributed the Chart Review Database. Each unit or hospital participating in the Surviving Sepsis Campaign can easily enter its data into the database and produce graphs that show the amount of improvement over time for specific goals and the effects of specific interventions. For organizations new to quality improvement science, this Web site introduces the Model for Improvement, the improvement methodology at the heart of IHI’s approach. There are links to supporting materials on the Internet and a community forum where clinicians can share their experiences. The user manual on this website is a guide for teams participating in the Surviving Sepsis performance improvement initiative.
The success of the Surviving Sepsis Campaign depends on its ability to demonstrate a convincing change in mortality, and the tools described here can help us accomplish that. Campaign leaders have invested countless hours to support regional networks in areas across the globe. Regional user-group meetings have been held to discuss the change concept and the electronic data collection process that is available. As additional studies are completed, the guidelines and the sepsis bundles will be updated. The next revision is scheduled for 2010. “We want people to go to the Web site, look at the measures, download the tools, and tell us what you think,” says Mitchell Levy, MD, FCCM, a member of the executive committee of the Surviving Sepsis Campaign and SCCM past President. “This initiative can work only if clinicians implement these tools in their institutions, begin to measure their results."
Phase IV
Will there be a Phase IV? This is under consideration presently. Current activities include scientific analysis of the aggregate database and plans to publish those results. The first publication: The Surviving Sepsis Campaign: Results of an international guideline-based performance improvement program targeting severe sepsis is available in the February 2010 issue of the SCCM journal, Critical Care Medicine ESICM's journal Intensive Care Medicine. A guidelines update meeting was held at the Society of Critical Care Medicine's 39th Annual Congress in Miami. More news will be available as the world experts convene to discuss new evidence and what impact that evidence may have on the guidelines. Meantime, hospitals from across the world continue with their work and utilize the community list serve to report back, ask questions and support those who are new to the campaign. It is a vibrant and growing community - in many ways the work has just begun.