{
  "abstract": "Description In early 2023, our hospital’s critical/severe sepsis mortality rate was double the pediatric national benchmark ( figure 1) despite continued committee work. We will share how we used IHI improvement methodology and principles of ‘mass customization’ to rapidly reduce sepsis mortality across our hospital system.Attendees will participate in simulations to compare ‘sepsis screens’ and identify the varying needs of the emergency department (ED), intensive care unit (ICU), and inpatient wards. They will then employ standard work to build ‘treatment plans.’ The activities will be analogous to how we designed a quality initiative to reduce sepsis mortality.We developed a formal quality improvement (QI) team with stakeholders across two campuses and used QI methodology to identify key drivers and implement rapid Plan, Study, Do, Act (PDSA) cycles (figure 1). We implemented unit-specific screening tools, huddle processes, and treatment pathways with informatics integration to improve recognition and treatment of sepsis.From May 2023 to December 2024, our team achieved a 67% 12-month mortality rate reduction from 1.04/1000 admissions to 0.34, now outperforming the national benchmark (figure 2).We applied rigorous QI methodology to substantially decrease sepsis mortality (figures 2 and 3) by decreasing care variation (figures 4 and 5) while customizing to the needs of each unit. This project models how to leverage system-wide QI teams to drive rapid improvement in priority quality outcomes.Abstract 50 Figure 1System critical/severe sepsis key driver diagram (KDD). The key driver diagram (KDD) developed from mortality reviews and evidence-driven sepsis bundles was used to guide system improvementsAbstract 50 Figure 2System critical/severe sepsis mortality rate rolling 12-month graph. The implementation of the screening tools and standardized huddle and treatment processes resulted in the critical/severe sepsis mortality rate improving from 1.04/1,000 hospital admissions (rolling 12-month rate) in May 2023 to 0.34/1,000 hospital admissions in December 2024 - a 67% reduction in critical/severe sepsis mortality across the organizationAbstract 50 Figure 3System critical/severe sepsis mortality rate SPC graph. Comparing baseline period (January 2022 – May 2023) to the implementation period (June 2023 – March 2025), showing a centerline decrease from 1.04/1000 hospital admissions to 0.27/1000Abstract 50 Figure 4System critical/severe sepsis screening compliance p chart. Comparing the baseline period (Jan 2022 – May 2023) to the implementation period (June 2023 – March 2025). The 55% centerline shifted to 81% postimplementationAbstract 50 Figure 5System critical/severe sepsis huddle compliance p chart. Comparing the baseline period (Jan 2022 – May 2023) to the implementation period (June 2023 – March 2025), in which the centerline of 69% shifted to 92% post-implementation",
  "authors": [
    {
      "affiliations": [
        "Children’s Health System of Texas"
      ],
      "name": "Sachin Shah"
    },
    {
      "affiliations": [
        "Children’s Health System of Texas"
      ],
      "name": "Josiah David"
    },
    {
      "affiliations": [
        "Children’s Health System of Texas"
      ],
      "name": "Kristin Cummins"
    },
    {
      "affiliations": [
        "Children’s Health System of Texas"
      ],
      "name": "Brian Wagers"
    }
  ],
  "title": "50 Surviving sepsis: integrating standardization and customization for system-wide change",
  "uid": "6959a9c2-da47-54d4-9d8d-a8b7745416b6"
}