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Cited by 950

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

The Surviving Sepsis Campaign: Results of an international guideline-based performance improvement program targeting severe sepsis*

Open access
Levy, Mitchell M., Dellinger, R Phillip, Townsend, Sean R., Linde-Zwirble, Walter T., Marshall, John C., Bion, Julian, Schorr, Christa, Artigas, Antonio, Ramsay, Graham, Beale, Richard, Parker, Margaret M., Gerlach, Herwig, Reinhart, Konrad, Silva, Eliezer, Harvey, Maurene, Regan, Susan, Angus, Derek C.·2010·Critical Care Medicine
DOI 10.1097/ccm.0b013e3181cb0cdc
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Abstract

OBJECTIVE: The Surviving Sepsis Campaign (SSC or "the Campaign") developed guidelines for management of severe sepsis and septic shock. A performance improvement initiative targeted changing clinical behavior (process improvement) via bundles based on key SSC guideline recommendations. DESIGN AND SETTING: A multifaceted intervention to facilitate compliance with selected guideline recommendations in the intensive care unit, emergency department, and wards of individual hospitals and regional hospital networks was implemented voluntarily in the United States, Europe, and South America. Elements of the guidelines were "bundled" into two sets of targets to be completed within 6 hrs and within 24 hrs. An analysis was conducted on data submitted from January 2005 through March 2008. SUBJECTS: A total of 15,022 subjects. MEASUREMENTS AND MAIN RESULTS: Data from 15,022 subjects at 165 sites were analyzed to determine the compliance with bundle targets and association with hospital mortality. Compliance with the entire resuscitation bundle increased linearly from 10.9% in the first site quarter to 31.3% by the end of 2 yrs (p < .0001). Compliance with the entire management bundle started at 18.4% in the first quarter and increased to 36.1% by the end of 2 yrs (p = .008). Compliance with all bundle elements increased significantly, except for inspiratory plateau pressure, which was high at baseline. Unadjusted hospital mortality decreased from 37% to 30.8% over 2 yrs (p = .001). The adjusted odds ratio for mortality improved the longer a site was in the Campaign, resulting in an adjusted absolute drop of 0.8% per quarter and 5.4% over 2 yrs (95% confidence interval, 2.5-8.4). CONCLUSIONS: The Campaign was associated with sustained, continuous quality improvement in sepsis care. Although not necessarily cause and effect, a reduction in reported hospital mortality rates was associated with participation. The implications of this study may serve as an impetus for similar improvement efforts.

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Citations

Cites

Research works printed but not linked: 27

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Metadata

Authors
Levy, M. M., Dellinger, R. P., Townsend, S. R., Linde-Zwirble, W. T., Marshall, J. C., Bion, J., Schorr, C., Artigas, A., Ramsay, G., Beale, R., Parker, M. M., Gerlach, H., Reinhart, K., Silva, E., Harvey, M., Regan, S., & Angus, D. C.
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-02
Volume
38
Issue
2
Pages
367-374
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/ccm.0b013e3181cb0cdc
OpenAlex
W1968201338
Cited by
950
References
6
FWCI
65.00
Type
journal article
Language
en
Open access
green

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