State Sepsis Policies

September 07, 2017|3:58 p.m.| ASTHO Staff

Sepsis occurs when a body’s immune system overwhelmingly responds to an infection and triggers widespread inflammation. The inflammation leads to blood clots and leaky vessels which can result in organ damage and death. Sepsis is a significant burden to health in the United States: it is the most expensive hospital condition to treat, accounting for more than 23 billion dollars in healthcare costs annually.

Patients are more likely to survive sepsis if the condition is detected early and evidence-based interventions are promptly initiated. To ensure early diagnosis and treatment, the New York Department of Health revised its regulations by requiring hospitals to develop and implement sepsis protocols beginning in 2014. These protocols, which are submitted to the department of health, describe how hospitals identify sepsis cases and outline the interventions and timelines for treatment. The department also requires hospitals that have treated patients with sepsis to submit outcome data and other measures to evaluate whether hospitals adhere to the protocols and effectiveness of the interventions. Though still early, the results are promising. In a recent report, the department found that adult patients with severe sepsis and septic shock who received the protocol-driven treatments within three hours of arriving at the emergency department were less likely to die as compared to patients who did not receive the recommended treatments.

Other states have followed New York’s example. In 2014, the legislature in Hawaii passed a resolution calling for a state sepsis taskforce. The taskforce issued its report in 2015, recommending the establishment of a sepsis best practices group. In 2016, Illinois lawmakers amended the state’s hospital licensing act requiring hospital to “adopt, implement, and periodically update evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis, or septic shock,” subject to appropriations. Additionally, state hospital associations in Wisconsin and Ohio have implemented quality improvement projects to address sepsis.

In 2017, ASTHO has tracked state legislation that addresses sepsis. In Hawaii, lawmakers considered a bill to create pilot programs to develop and disseminate educational materials about sepsis (SB 188) as well as two resolutions (SCR 33 and SR 7) requesting that the department of health establish a sepsis best practice working group. Bills in Missouri (SB 97) and New Jersey (A 2105) would require hospitals to adopt sepsis protocols. In New York, legislators considered several bills to expand education on sepsis. AB 5800 and SB 4850 would require the department of education, in collaboration with the department of health, to develop a program to educate students, parents, and school personnel about sepsis prevention, while AB 6053 and SB 4917 would require healthcare providers to receive education about sepsis during their infection control training.

Action to educate the public is also happening at the federal level. Recently, CDC launched Get Ahead of Sepsis, an educational initiative geared towards patients and healthcare providers to raise awareness about the symptoms of sepsis and steps that can be taken to prevent the disease. As state policymakers and state and federal health agencies take critical steps to detect and treat sepsis, ASTHO will continue monitor their progress.