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dc.contributor.authorLevy, Mitchell M.
dc.contributor.authorDellinger, R. Phillip
dc.contributor.authorTownsend, Sean R.
dc.contributor.authorLinde-Zwirble, Walter T.
dc.contributor.authorBion, Julian
dc.contributor.authorSchorr, Christa
dc.contributor.authorArtigas, Antonio
dc.contributor.authorRamsay, Graham
dc.contributor.authorBeale, Richard
dc.contributor.authorParker, Margaret M.
dc.contributor.authorGerlach, Herwig
dc.contributor.authorReinhart, Konrad
dc.contributor.authorSilva, Eliezer
dc.contributor.authorHarvey, Maurene
dc.contributor.authorAngus, Derek C.
dc.contributor.authorMarshall, John C.
dc.contributor.authorRegan, Susan
dc.date.accessioned2011-04-23T18:01:32Z
dc.date.issued2010
dc.identifier.citationLevy, Mitchell M., R. Phillip Dellinger, Sean R. Townsend, Walter T. Linde-Zwirble, John C. Marshall, Julian Bion, Christa Schorr, et al. 2010. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Medicine 36(2): 222-231.en_US
dc.identifier.issn0342-4642en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4874821
dc.description.abstractObjective: The Surviving Sepsis Campaign (SSC or “the Campaign”) developed guidelines for management of severe sepsis and septic shock. A performance improvement initiative targeted changing clinical behavior (process improvement) via bundles based on key SSC guideline recommendations on process improvement and patient outcomes. Design and setting: A multifaceted intervention to facilitate compliance with selected guideline recommendations in the ICU, ED, and wards of individual hospitals and regional hospital networks was implemented voluntarily in the US, Europe, and South America. Elements of the guidelines were “bundled” into two sets of targets to be completed within 6 h and within 24 h. An analysis was conducted on data submitted from January 2005 through March 2008. Main results: Data from 15,022 subjects at 165 sites were analyzed to determine the compliance with bundle targets and association with hospital mortality. Compliance with the entire resuscitation bundle increased linearly from 10.9% in the first site quarter to 31.3% by the end of 2 years (P < 0.0001). Compliance with the entire management bundle started at 18.4% in the first quarter and increased to 36.1% by the end of 2 years (P = 0.008). Compliance with all bundle elements increased significantly, except for inspiratory plateau pressure, which was high at baseline. Unadjusted hospital mortality decreased from 37 to 30.8% over 2 years (P = 0.001). The adjusted odds ratio for mortality improved the longer a site was in the Campaign, resulting in an adjusted absolute drop of 0.8% per quarter and 5.4% over 2 years (95% CI, 2.5–8.4%). Conclusions: The Campaign was associated with sustained, continuous quality improvement in sepsis care. Although not necessarily cause and effect, a reduction in reported hospital mortality rates was associated with participation. The implications of this study may serve as an impetus for similar improvement efforts.Electronic supplementary material The online version of this article (doi:10.1007/s00134-009-1738-3) contains supplementary material, which is available to authorized users.en_US
dc.language.isoen_USen_US
dc.publisherSpringer-Verlagen_US
dc.relation.isversionofdoi:10.1007/s00134-009-1738-3en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826633/pdf/en_US
dash.licenseLAA
dc.subjectsevere sepsisen_US
dc.subjectseptic shocken_US
dc.subjectknowledge transferen_US
dc.subjectperformance measuresen_US
dc.subjectsurviving sepsis campaignen_US
dc.subjectperformance improvementen_US
dc.subjectsepsis bundlesen_US
dc.subjectquality improvementen_US
dc.titleThe Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsisen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalIntensive Care Medicineen_US
dash.depositing.authorRegan, Susan
dc.date.available2011-04-23T18:01:32Z
dash.affiliation.otherHMS^Medicine-Massachusetts General Hospitalen_US
dc.identifier.doi10.1007/s00134-009-1738-3*
dash.authorsorderedfalse
dash.contributor.affiliatedRegan, Susan


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