How Lee Health's Sepsis Survivor Program is Saving Lives

Imagine your body's response to an infection going into overdrive, damaging your organs and putting your life at risk. That's sepsis – a dangerous condition that affects about 1.7 million American adults every year. At least 350,000 of these patients die in hospitals or move to hospice care, making sepsis one of the top causes of death in U.S. hospitals.

"It's truly a life-threatening condition. It's the leading cause across the country for in-hospital mortality. These patients really require a lot of attention, priority, and every program and every resource that a hospital has to offer," says Physician Assistant Philip Nicotera, who’s also Sepsis Program Manager at Lee Health.

Creating a sepsis team that works

Lee Health decided to tackle this serious problem head-on. About 10 years ago, it started with basic screening for sepsis. However, things changed in 2021 when it hired a dedicated sepsis manager who could focus completely on the program.

This manager brought together what they call a "sepsis village" – doctors, nurses, pharmacists, IT experts, and quality staff. Together, they followed guidelines from the Centers for Disease Control and Prevention (CDC) and used a special computer model from Epic that can spot patients at risk of sepsis up to eight hours before it starts.

"The idea was to increase priority on these patients who really underwent a significant illness,” Philip says.

Finding sepsis early, but smartly

A big challenge was getting the alerts right. Earlier systems often give false alarms. Tom Walsh, Information Technology Supervisor at Lee Health, explains that they needed "a balance between finding every single patient possible and focusing attention on the patient population that needs it most."

The team listened to feedback from nurses and found something interesting – nurses were often ignoring alerts because they had already spotted the sepsis risk themselves. By updating their system to check if nurses had already ordered tests like blood cultures, they made the alerts smarter.

Dr. William Carracino, Chief Digital Health Executive at Lee Health, points out that technology is just one part of the solution: 

"The computer model is one tool in the toolbox, but it's not enough on its own,” Dr. Carracino tells EpicShare. “Technology doesn't replace clinical expertise, and it's important to understand where it fits in."

Quick treatment saves lives

When it comes to sepsis, time matters – a lot. For every hour treatment is delayed, the risk of dying goes up by about 9 percent. That's why Lee Health created a special set of orders in their computer system so doctors can start treatment quickly.

This standard approach helped cut the average hospital stay for sepsis patients by two days. The team made sure everyone knew how to use these tools through tip sheets, presentations, and even a sepsis "escape room" training exercise.

Caring beyond the hospital

What makes Lee Health's program special is how it continues to care for patients after they leave the hospital. They created a "sepsis survivor registry" that flags patients for 90 days after they go home.

"It's on the patient's chart anywhere they go for 90 days after discharge from the hospital,” Philip says. “This helps us really track these patients but also make sure that all their needs are met in that recovery period that happens after the discharge home.”

This flag is visible to anyone looking at the patient's records, he adds. 

"Our inpatient team can add this sepsis survivor flag. And then if they go to their primary care, if they get a call from a nurse, if the pharmacy calls them, this flag is present to them on the patient chart no matter who looks at it."

Patients also receive an action plan in their after-visit summary and through MyChart. This is important because studies show only 63 percent of American adults know what sepsis is, and just 15 percent can identify symptoms that need emergency care.

READ: Heard About MyChart? Lee Health’s secure way to access your medical records anywhere, anytime, anywhere

"For a lot of people, especially in those first two months afterwards, significant care is needed to check their blood pressure, their mental status, all sorts of minimal changes because your body takes a while to get back into equilibrium afterwards," Philip explains.

Remote monitoring at home

Sepsis survivors also receive 30 to 60 days of remote monitoring. Each patient gets a kit with devices to measure heart rate, oxygen levels, blood pressure, and temperature, plus help from staff on how to use them.

"Remote patient monitoring is a really great system we have here. Patients go home, and their vitals are sent to a central monitoring nursing station where they can check up on these patients and how they're recovering while they're at home right after their hospital stay," Philip says.

Real results that save lives

The results speak for themselves. Lee Health has seen an 18 percent drop in sepsis deaths over a year – saving 110 lives. They've also cut 30-day readmissions by 45 percent, from 79 to 43 per 100 patients.

"By increasing this sort of prioritization and just even just flagging charts that this patient needs attention, what you're doing is you're taking those patients that may linger in the hospital for two weeks, three weeks, and that's where you really make a lot of your gains. And I think for those patients, you're saving much more than two days," Philip notes.

The program continues to grow. Based on its success with adults, Lee Health has created a similar program for children at Golisano Children's Hospital of Southwest Florida.

"We've saved over 100 lives simply by increasing priority, by really kind of getting extra eyes and care for these patients," Philip says. "There should be a different response to care for the patient if their issues were truly at the stage of being life-threatening. And I think that's what this provides."

WATCH HEALTH MATTERS: Why Lee Health created a Sepsis Survivor Program