New York’s Sepsis Management Protocol Reduces Death Rate

A study published in July 2019 in The Journal of the American Medical Association (JAMA) explored the outcomes of New York State regulations mandating evidence-based protocols for sepsis management. Researchers, who analyzed records from over 1 million adult sepsis admissions in New York plus four control states (Florida, Maryland, Massachusetts and New Jersey), found that “in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states that did not implement sepsis regulations.”

New York’s Department of Health implemented mandated sepsis protocols – which require “all hospitals licensed to operate in NYS to have in place evidence-based protocols for the early detection and treatment of patients with severe sepsis and septic shock” – in 2013 after a pediatric patient died from undiagnosed sepsis.

Reporting on the lower death rates resulting from the mandates, Science Daily says, “In the years before the regulations went into place, 26.3% of the people diagnosed with sepsis in New York died while hospitalized, compared to a rate of 22% in the control states. Following the regulations, New York’s sepsis mortality rate dropped 4.3% to 22%, but the death rate only fell 2.9% to 19.1% in the control states.” In other words, as the study’s lead author Jeremy Kahn told Science Daily: “It seemed to work.”

As other states consider taking a similar approach, however, Fierce Healthcare reports that “the lesson is not so straightforward.” And here’s why, according to the publication:

• “Mortality rates in New York were already higher than most other states, so part of the program’s success could have been related to how far hospitals had to go.”
• “New York’s solution came about in what Kahn calls a ‘perfect storm’ featuring an engaged department of health, active hospital associations and groups who acted as willing partners, plus grassroots advocacy.”

Still, says Fierce Healthcare, “From a policy perspective, the study demonstrates that, under the right circumstances, it’s possible to produce positive changes in the healthcare system through properly administrated regulatory actions.” Kahn states it this way: “We should all be doing evidenced-based practice, and when we do that, good things happen.”

MLMIC recognizes the achievements reflected by this decrease in the mortality rate as a result of the NYS mandated sepsis protocols and encourages our insured facilities and providers to maintain vigilance in the early identification and prompt treatment of blood-stream infections.