HCA’s home care sepsis screening tool (known as the Home Care Services Adult Sepsis Screening – SBAR Form) includes protocols and electronic health record integration with system partners, such as hospitals or physician practices, offering enormous promise in battling the sepsis crisis where interventions are needed most: at home.
The tool is designed as a series of question prompts, first instructing clinicians to consider whether a patient’s medical history, physical examination or findings suggest an infection; it also asks the clinician to check off certain other systemic criteria of sepsis risk.
Depending on the clinician’s answers to these questions, he or she can determine whether a baseline level of sepsis risk is present or whether to check for some additional warning signs related to organ or system functions.
The screening tool uses all of these patient-specific response criteria in an algorithm that determines whether the patient meets the criteria for sepsis or severe sepsis.
The tool is easy to use and draws on the clinician’s existing knowledge about infection risk in a way that simply directs focus and attention to the specific etiology of sepsis.
A series of interventions are then advised, from a lower-risk intervention of patient education about sepsis to the more severe end of the spectrum, with instructions stating that the patient has met the criteria for potential sepsis or severe sepsis, and that the patient requires immediate intervention in consultation with the physician and other medical/emergency medical partners.
The home care sepsis screening tool was first incorporated as part of a federally funded sepsis intervention effort led by IPRO, New York State’s Medicare quality improvement organization, in partnership with HCA, the Sepsis Alliance and the Rory Staunton Foundation for Sepsis Prevention.
Use of the Tool Now
Following clinician testing and piloting of the tool, HCA and IPRO held a four-part webinar series in the fall of 2016 and winter of 2017 for home care providers to learn the sepsis risks, preview the tool, and hear presentations from electronic medical record vendors on integration of the tool into provider information technology systems. The webinar also provided further train-the-trainer methods to help clinicians maximize use of the tool and interventions at their agencies.
Under a user agreement, providers have already begun incorporating the tool into their operation, putting this powerful resource into action in the field. Our Stop Sepsis at Home campaign will broaden access and training in use of the tool and related protocols to help home care clinicians battle the sepsis crisis.
HCA gratefully acknowledges the New York State Health Foundation (NYSHealth) for its support of this work. The mission of NYSHealth is to expand health insurance coverage, increase access to high-quality health care services, and improve public and community health. The views presented here are those of the authors and not necessarily those of the New York State Health Foundation or its directors, officers, and staff.