State Policies Aim to Improve Sepsis Prevention and Treatment

September 19, 2019|11:59 a.m.| ASTHO Staff

September is Sepsis Awareness Month, a time to highlight a serious, life-threatening condition. Sepsis occurs when a body’s immune system overwhelmingly responds to an infection and triggers widespread inflammation, leading to blood clots and leaky blood vessels, which can result in organ damage and death. Sepsis can be caused by a wide range of infections, but is most commonly linked to infections of the lungs, kidneys, skin, and gut. Sepsis occurs in patients across the lifespan, but most commonly in infants and individuals over 65. People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease, or with weakened immune systems are also at risk for sepsis. While sepsis is cause for daily concern, it is also a national security issue, as those who survive in the aftermath of a chemical, biological, radiological, or nuclear event are at a high risk of also developing sepsis.

Sepsis claims nearly 270,000 American lives annually, and is a significant driver of healthcare costs. It is the most expensive hospital condition to treat, accounting for more than $23 billion in annual healthcare costs. Despite these alarming numbers, sepsis remains a relatively unknown condition, with less than a third of adults able to identify the signs and symptoms of sepsis. To improve the identification of signs and symptoms, the Sepsis Alliance promotes use of the TIME acronym: Time, Infection, Mental Decline, Extremely Ill. For each hour that sepsis treatment is delayed, the risk of death increases, meaning that awareness and education, including early recognition and timely treatment, is critical to reducing complications and saving lives. Increasing sepsis education and awareness and policy initiatives, such as those regulating clinical protocols to manage sepsis, can improve outcomes for patients with sepsis.

A recent JAMA report noted that after New York state implemented sepsis regulations in 2013, new clinical protocols for sepsis recognition and treatment in New York hospitals were associated with reduced sepsis mortality compared to states without these regulations. The Rory Staunton Foundation provided input to these regulations. During the recent legislative session, several other states have initiated policy efforts to address factors related to sepsis, such as raising awareness about sepsis and implementing protocols for preventing, detecting, and managing sepsis. Below is an overview of recent state legislative activity aimed at addressing sepsis.

The governor of Indiana signed a bill requiring hospitals to adopt, implement, and periodically update evidence-based sepsis guidelines for recognizing and treating patients with sepsis, severe sepsis, or septic shock. The bill also establishes a sepsis treatment guideline task force that will identify evidence-based sepsis guidelines, educational materials, and screening standards.

Rhode Island
In Rhode Island, the house of representatives enacted a resolution requesting the state health agency to develop statewide evidence-based sepsis protocols for sepsis early diagnosis and treatment. The resolution language noted that sepsis is the most common cause of death in hospitalized children in both Rhode Island and the rest of the United States, and that using best practice guidelines to identify and treat sepsis can greatly reduce the risk of death from sepsis.

New York
A New York bill would authorize the state health agency to provide support for activities to promote community-based sepsis prevention, screening, intervention, and education, including:

  • Integrating systems of a standardized sepsis screening and intervention tool for home care that meets adopted industry standards.
  • Timely and synchronized health information exchange between providers on behalf of patients meeting sepsis criteria.
  • Establishing and implementing sepsis collaboratives under the hospital-home care-physician collaboration program.
  • Home care agency sepsis education and training.
  • Community outreach and public and provider education.

State health agencies can play an important role in advocating for clinical sepsis protocols for timely and effective treatment and policies to support provider and public sepsis training and education. Resources such as CDC’s Get Ahead of Sepsis Campaign also provide crucial public health, clinical, and community-level sepsis awareness and education. Effective vaccination promotion and programs can also reduce the likelihood that vulnerable individuals will contract the infections that lead to sepsis. Finally, efforts to strengthen sepsis surveillance can allow public health agencies to improve on what works and identify new opportunities to prevent and treat sepsis. As state policymakers and state health agencies take critical steps to detect and treat sepsis, ASTHO will continue to monitor their progress.