The Sepsis Early Recognition and Response Initiative (SERRI).
Approach to Improving Safety
Setting of Care
Early recognition of sepsis is a patient safety issue, due to the time-sensitive nature of delivering evidence-based treatments. This article describes a Centers for Medicare and Medicaid Services–funded initiative to improve sepsis management in 15 facilities in Texas. Components included convening a leadership committee for performance improvement, educating bedside nurses and other staff, developing a screening tool in the electronic health record (EHR), standardizing a second responder protocol (like a rapid response team) for possible sepsis, and conducting audit and feedback for participating institutions. The authors noted challenges given that participating institutions used different EHRs, but they were able to implement EHR-based screening across all systems. Positive screens were evaluated by a second responder, but it is difficult to estimate the amount of second responder time needed for this intervention. Planned outcome measures, which are not yet available, include mortality, length of stay, and costs. A recent WebM&M commentary describes common errors in the early management of sepsis.