Improving early detection and treatment of sepsis is now a priority for Illinois hospitals, which were mandated to adopt, implement and routinely update sepsis protocols when Governor Bruce Rauner signed Gabby’s Law in August.
The law is named for 5-year-old Gabby Galbo, who tragically succumbed to sepsis in 2012, becoming one of approximately 8,000 sepsis-related deaths recorded in Illinois each year. For decades, the challenges of sepsis – subtlety of the initial symptoms, shared symptoms with other common conditions, rapid progression, etc. – have left healthcare providers struggling to curb mortality and morbidity.
An Overview of Gabby’s Law
The law requires hospitals to implement sepsis protocols that “include components specific to the identification, care, and treatment of adults and of children, and must clearly identify where and when components will differ for adults and for children seeking treatment in the emergency department or as an inpatient.”
These protocols must be developed using current, evidence-based guidelines and must also include a process for identifying and documenting patients who meet the criteria for treatment and those who can be ruled out. The source of the infection must then be identified and treated with early broad spectrum antibiotics. The law also requires regular staff training and protocol updates.
Sepsis protocols will be established by the State of Illinois and will at minimum establish evidence-based sepsis definitions and metrics. Protocols will also establish the methodology for collecting, analyzing, and reporting sepsis-related data collected by hospitals.
Keys to Statewide Success
Protocols are important, but they can be made even more effective with advanced clinical decision support (CDS) tools. Our recent study in the Journal of the American Medical Informatics Association (JAMIA) offers Illinois hospitals actionable information to use in achieving the overarching goal of Gabby’s Law: reducing sepsis mortality. In order to show a significant reduction in mortality rates, hospitals should take advantage of CDS tools that streamline and accelerate the early identification and treatment of sepsis patients. The effective use of technology, combined with change management, allows hospitals to more easily comply with the new state mandates. Electronic surveillance systems that are specifically created for the early detection and treatment of sepsis, such as POC Advisor, automatically collect and interpret patient data and put into action the necessary protocols that Gabby’s Law mandates.
Our study in JAMIA details a 53 percent reduction in sepsis mortality rates by combining POC Advisor with change management programs. Change management is essential in meeting the objective of the law. Empowering hospital faculty, especially nursing staff, through education is the first step in speeding the detection of sepsis.
During the study, POC Advisor successfully alerted clinicians to septic patients with 95 percent sensitivity and 82 percent specificity. This means that POC Advisor was able to identify sepsis patients with relatively few false positive alerts. These results are unprecedented in published literature and demonstrate that Health IT has matured to a point that providers can leverage these tools to save lives.
While the struggle against sepsis is decades old and, while Gabby’s law might seem challenging to healthcare providers, it doesn’t have to be. With the right technology and protocols, hospitals throughout the nation can drastically improve sepsis care and make high mortality rates a thing of the past.