title: Methods for reducing sepsis mortality in emergency departments and inpatient units.
abstract: BACKGROUND
  As part of a zero-tolerance approach to preventable deaths, North Shore-LIJ Health System (North Shore-LIJ) leadership prioritized a major patient safety initiative to reduce sepsis mortality in 2009 across 10 acute care hospitals (an 11th joined later). At baseline (2008), approximately 3,500 patients were discharged with a diagnosis of sepsis, which ranked as the top All Patient Refined Diagnosis-Related Group by number of deaths (N = 883). Initially, the focus was sepsis recognition and treatment in the emergency departments (EDs).
  
  
  METHODS
  North Shore-LIJ, the 14th largest health care system in the United States, cares for individuals at every stage of life at 19 acute care and specialty hospitals and more than 400 outpatient physician practice sites throughout New York City and the greater New York metropolitan area. The health system launched a strategic partnership with the Institute for Healthcare Improvement (IHI) in August 2011 to accelerate the pace of sepsis improvement. Throughout the course of the initiative, North Shore-LIJ collaborated with many local, state, national, and international organizations to test innovative ideas, share evidence-based best practices, and, more recently, to raise public awareness.
  
  
  RESULTS
  North Shore-LIJ reduced overall sepsis mortality by approximately 50% in a six-year period (2008-2013; sustained through 2014) and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in the 11 acute care hospitals.
  
  
  CONCLUSIONS
  Improvements were achieved by engaging leadership; fostering interprofessional collaboration, collaborating with other leading health care organizations; and developing meaningful, real-time metrics for all levels of staff.
authors.affiliation: North Shore LIJ Health System, Lake Success, New York, USA.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Doerfler
authors.forename: John
authors.initials: J
authors.lastname: D'Angelo
authors.forename: Diane
authors.initials: D
authors.lastname: Jacobsen
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jarrett
authors.forename: Andrea I
authors.initials: AI
authors.lastname: Kabcenell
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Masick
authors.forename: Darlene
authors.initials: D
authors.lastname: Parmentier
authors.forename: Karen L
authors.initials: KL
authors.lastname: Nelson
authors.forename: Lori
authors.initials: L
authors.lastname: Stier
mesh_terms: D003422:Critical Care / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007297:Inpatients; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration*; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality*; D014481:United States