HealthApril 26, 2017

New York state's sepsis legislation saves lives

In 2012, The New York Times released an article covering the tragic death of 12-year-old Rory Staunton, who died from sepsis days after cutting his arm in a fall at school.

Death rates fell after New York imposed "Rory's Regulations," a directive to providers on how to treat sepsis. In 2019, a study published in JAMA, the journal of the American Medical Association, revealed that 'these regulations had their intended effect of reducing mortality.' 

The Rory Staunton Foundation, founded in April 2012 by Rory’s parents, Orlaith and Ciaran Staunton, was a catalyst that led New York State to require that all the state’s hospitals use evidence-based sepsis protocols that improve early diagnosis and accelerate treatment. New York’s program was the first of its kind to address sepsis, which remains the deadliest condition to treat in critical care units and the most expensive, costing nearly $24 billion each year. Following New York’s initiative, the State of Illinois passed Gabby’s Law in August 2016, named for 5-year-old Gabby Galbo who tragically lost her life to sepsis in 2012. Like the New York program, the law requires hospitals to implement sepsis protocols based on current, evidence-based guidelines with an emphasis on proper identification and documentation to improve early detection and treatment.

Early results for New York Report on Sepsis Care Improvement Initiative revealed that the program’s impact on early detection and care resulted in a decrease in sepsis-related mortalities since its origination in 2014. Adults who received the protocol-based treatments outlined in the regulations had a decline in the probability of death compared to those who did not receive similar treatments. Further, patients who received the protocol-based treatments within three hours experienced a decline in probability of death. According to the state, similar initiatives adopted by hospital networks between 2011 and 2015 resulted in 4,727 saved lives.

Despite the progress, Howard A. Zucker, M.D. J.D., Commissioner of Health for New York State, cites an obstacle that still remains: initial signs of sepsis such as fever and rapid heartbeat often appear as symptoms of common illnesses, making it difficult for clinicians to diagnose. Based on the outcomes of the initiative, the New York State Department of Health and the Sepsis Advisory Group recommended additional measures to improve outcomes. These elements include innovative approaches to early identification, rapid response of early interventions and workforce sepsis training and education.

Additionally, the Health Department recommends using advanced clinical decision support (CDS) systems to continue to move the needle on outcomes. Hospitals should not rely solely on the SIRs-based alerting provided by EHRs that tend to exacerbate alert fatigue. In theory, CDS systems should aid in early identification, yet they often present a multitude of challenges, such as an abundance of false-positive alerts that lead to alert fatigue and clinician rejection. In fact, most CDS systems fail to achieve alert specificity rates higher than 50 percent. This emphasizes the need for electronic CDS surveillance systems, such as POC Advisor, to be built upon foundational elements that include best practices, evidence-based guidance and highly accurate alerts.

As evidenced in a recent peer-reviewed study, POC Advisor has proven to deliver these three elements.

By achieving an 82 percent specificity rate and 95 percent sensitivity rate, POC Advisor reduced sepsis mortality by 53 percent and 30-day readmissions by 30 percent. The robust platform leverages natural language processing, which is an AI technology, to analyze real-time, patient-specific data and sends rapid alerts and recommended treatments to the point of care. The platform’s scalability allows it to deliver alerts to the correct care provider without disrupting workflow. With continual updates reflecting best practices, clinicians can trust that the relayed information is accurate and supports optimal, timely care and outcomes.

By leveraging our clinical surveillance system, along with the integration of awareness initiatives and key clinical practices, sepsis outcomes can be vastly improved. Healthcare organizations are increasingly utilizing CDS solutions as part of their sepsis care plan to improve outcomes, reduce expenditures and provide optimal care to prevent deaths like Rory’s and cultivate healthier communities throughout the nation.

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