article · American Journal of Respiratory and Critical Care Medicine
An international survey across 1,023 hospitals in 69 countries, predominantly in Europe, examined the adoption of sepsis guideline recommendations and institutional readiness. Screening for sepsis was present in 54.2% of emergency departments, 47.9% of general wards, and 61.7% of intensive care units. Standardised management protocols were deployed in 57.3% of emergency departments, 45.2% of wards, and 70.7% of intensive care units. The study found that comprehensive quality improvement initiatives were linked to notable increases in both screening and standardised management across all hospital units. However, ongoing quality improvement initiatives were present in only 9.8% of hospitals, and just 4.6% had dedicated financial investments in sepsis programmes. Overall, significant gaps remain across early identification, infrastructure, and standardized care protocols in acute-care hospitals.
Sepsis is a medical emergency where rapid identification and standardised treatment are critical to saving lives. Demonstrating that screening and standard protocols are absent in nearly half of hospital wards and emergency departments highlights vital systemic vulnerabilities. Recognising these deficits enables healthcare leaders to focus on instituting structured quality improvement initiatives and dedicated hospital programmes.
The findings point to an operational need for clinical decision support tools, diagnostic workflows, and hospital management software that facilitate sepsis screening and standardised care. The primary users would be acute-care hospitals, emergency departments, and intensive care units. However, because this study is an observational survey assessing current hospital practices, the abstract does not indicate a specific commercialisation pathway or proprietary technology.
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Abstract Rationale Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital’s sepsis plan. Objectives To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.
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DOI: 10.1164/rccm.202406-1167oc
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