title: Improving sepsis outcomes for acutely ill adults using interdisciplinary order sets.
abstract: OBJECTIVE
  The objective of the study was to measure outcomes following implementation of standardized order sets for managing patients with severe sepsis/septic shock.
  
  
  BACKGROUND
  Sepsis is a severe illness, affecting approximately 750 000 people in the United States, with mortality rates of 28% to 50%, and costing $17 billion each year.
  
  
  METHODS
  An interdisciplinary team was created to improve early recognition and process of care in patients with severe sepsis/septic shock. Education was rolled out over 6 months, and sepsis "bundle" order sets were implemented.
  
  
  METHODS
  Adult patients (N = 674) with a diagnosis of severe sepsis or septic shock who were admitted to an emergency department or critical care unit at a 563-bed tertiary care teaching facility from May 2008 through October 2010 were included in data analysis.
  
  
  METHODS
  A plan, do, study, act methodology was used. Outcomes following project implementation were measured prospectively including appropriate recognition of patients with a diagnosis of sepsis, hospital site where the order set was initiated, and attainment of treatment goals within 6 hours of onset of severe sepsis/septic shock.
  
  
  RESULTS
  When order set usage was analyzed, the use of order sets was significantly associated with meeting "6-hour goals" successfully (χ1 [n = 662] = 36.16, P < .001); order set usage explained 24% of the variation in meeting goals, R = 0.24, F1,661 = 38.51, P < .0001.
  
  
  CONCLUSIONS
  Order sets improved management of septic patients through effective change in delivery systems to support evidence-based medical care.
  
  
  CONCLUSIONS
  Administrative support, team collaboration, and standardized order sets can lead to improved process of care.
authors.affiliation: Ochsner Medical Center, 1514 Jefferson Hwy., New Orleans, LA, USA. fwinterbottom@ochsner.org
authors.forename: Fiona
authors.initials: F
authors.lastname: Winterbottom
authors.forename: Leonardo
authors.initials: L
authors.lastname: Seoane
authors.forename: Erik
authors.initials: E
authors.lastname: Sundell
authors.forename: Jawad
authors.initials: J
authors.lastname: Niazi
authors.forename: Teresa
authors.initials: T
authors.lastname: Nash
mesh_terms: D000328:Adult; D003422:Critical Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007400:Interprofessional Relations; D009720:Nurse Clinicians; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D018805:Sepsis / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000451:nursing / Q000628:therapy