Utica Observer-Dispatch: ‘Initiative having impact on sepsis’

Amy Neff Roth / aroth@uticaod.com

Read the article at the Utica Observer-Dispatch here.

An initiative to fight a potentially deadly disease began in New York with help from a local nurse.

Now, it’s taking off across the state — and around the country.

Stop Sepsis at Home, an initiative of the Home Care Association of New York State, uses the nation’s first screening and intervention tool to identify home care patients who are at risk for sepsis, who are in the early stages and need treatment, and who have severe sepsis and need emergency care. It also involves training for health care providers and education for patients and families.

Sepsis is a potentially deadly or disabling condition in which the body overreacts to an infection.

The initiative’s clinical director is Amy Bowerman, executive director of Senior Net Health and quality director for the VNA of Utica, both part of the Mohawk Valley Health System.

“Time is very critical (in sepsis),” said Al Cardillo, president and CEO of the Home Care Association. “For every hour that there’s a delay, there’s an 8 percent increase in mortality. And there’s something like 38 amputations a day from sepsis. So we need to respond very, very quickly.”

Growing presence

Piloted, including in Utica, in 2016 and launched officially in 2017, the program has been adopted in 55 New York counties and is moving into all 62. It’s also been adopted in several other states. The state legislature passed a bill last week to support the effort. And the Sepsis Alliance named the initiative one of its 2019 Sepsis Heroes.

“Home care providers are in a unique position in the health care world, working with community members in their home and familiar environments,” read the alliance’s announcement of the award. “Given that more than 80 percent of sepsis cases begin in the community, Stop Sepsis at Home has the ability to have a significant impact on my lives.”

The initiative is in the process of collecting data, but Cardillo said there’s no doubt it’s having an impact. Just one agency identified about 250 patients with early signs of sepsis and about the same number of cases of severe sepsis, he said.

Conservative estimates based on that experience suggest that the program could save $8 million or $10 million a year while bringing down mortality and complications, he said.

Making a difference

Bowerman talked about one patient who proves the initiative makes a difference.

The patient who uses a wheelchair and has a number of medical conditions has had sepsis multiple times. But the screening tool has helped to get him into early treatment and recover enough to come home, she said.

“This screening tool provides the nurses the ability to really nail in and zone in on that criteria for sepsis and bring it to the physician’s attention or get them emergency care they really need immediately,” Bowerman said.

“If he was not being assessed and treated,” she added, “There was a potential for him to have been in septic shock and it could have led to death.”

Getting started

Just a few years ago, there were no protocols — or best practices and guidelines for treatment — for sepsis at any level of care. Then, legislation passed in 2013 establishing them for New York hospitals.

Bowerman remembers working in a hospital at the time. But then she went back to home care. Most sepsis cases begin in the community, not in the hospital.

“One of my questions was what are we doing about sepsis,” Bowerman recalled. “From there, that kind of snowballed into conversations and quality committee and from there, it just kind of flew and developed into a screening tool.”

The patient and family education has been as successful as the staff training, Bowerman said.

“We have patients who will call and say, from the patient education sheet, ‘I have a fever and I just don’t feel very good. … I think I might have sepsis,’” she said.

But this is not the end of the effort. Work continues, Cardillo said, on the continuum of care and maximizing collaboration between home care staff, doctors, hospitals and emergency medical services.

Meanwhile, the protocols are only for adults.

“So we’re working,” Bowerman said, “On a pediatric screening tool.”

Contact reporter Amy Neff Roth at 315-792-5166 or follow her on Twitter (@OD_Roth).

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