The collaborative aims to reduce mortality and hospital onset severe sepsis through a data driven initiative grounded in improvement science and best evidence.
As your organization evaluates enrollment in the Improving Pediatric Sepsis Outcomes (IPSO) collaborative, here’s information to help clarify the kinds of data IPSO uses and associated resources.
Sepsis terminology can be a source of confusion. IPSO uses practical criteria to approximate the sepsis continuum for quality improvement purposes.
IPSO definitions:
- Severe sepsis and septic shock definitions align with the Goldstein terminology
- Non-severe sepsis definition aligns most closely with the existing Goldstein category of sepsis
IPSO hospitals use standardized intervention bundles for severe sepsis prevention, recognition, evaluation, resuscitation, and de-escalation of care in EDs, PICUs/CICUs, cancer care and transplant, and general care settings.
IPSO participants receive access to many resources for data collection and reaction including the data dictionary, tools, webinars, consultation, and EMR techniques. While planning for participation, evaluate IPSO data readiness and scope the needed resources in three ways.
- Map sepsis data. Use the data summary tables in this guide to map the sources of sepsis data in your current environment. Remember that you will be collecting data in EDs, PICUs/CICUs, cancer care and transplant settings, and general care settings. Data sources may be different across those settings.
- Identify sepsis episodes. What is the incidence of severe sepsis/septic shock at your hospital? How are patients with severe sepsis/septic shock documented, and are those patients reliably flagged? If the system relies on ICD10 coding, is it accurately applied?
- Data collection strategies. Review current sepsis data tools. Does your hospital use sepsis order sets, alerts or dashboards? Is sepsis data centralized? Can you query EMRs for sepsis data?
Participants submit monthly data to the IPSO collaborative database via a web-based platform developed for IPSO by Prometheus Research. Submission methods are flexible to minimize data burden:
- Extract data from the EMR and submit via a .csv or excel template
- Export data from REDCap or similar form-based applications and submit via a .csv or excel template
- Use web-based data capture forms
The web-based platform also provides performance reports, user access management tools, and a technical support interface.
In addition to the data infrastructure, CHA provides enrolled hospitals with data QA tools, documentation, training, webinars, office hours and a help desk.
To track how reliably bundles are implemented and to see trends in patient outcomes, hospitals collect process data related to bundles and key patient outcomes for each sepsis episode. Sources for data elements may include the EMR, patient charts, MAR and lab data.
IPSO Severe Sepsis/Septic Shock Data Set Summary
IPSO Severe Sepsis/Septic Shock Data Set Summary
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Core Variables (19 total)
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Used For
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- Patient disposition by Day 30 from time zero
- Arrival timestamp
- Outside hospital transfer
- Discharge or death timestamp
- Hospital admissions
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Patient Outcome Metrics: Mortality, hospital-onset severe sepsis, length of episode
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- Initial sepsis screen timestamp
- Sepsis huddle timestamp
- Sepsis order set timestamp
- Functional Time Zero
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Recognition Bundle Process Metrics: Sensitive, specific, efficient and timely recognition of severe sepsis
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- Bolus 1 timestamp
- Bolus 3 timestamp
- First antibiotic timestamp
- First pressor timestamp
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Resuscitation/Stabilization Bundle Process Metrics: Appropriate, timely, and effective and treatment (resuscitation/stabilization) of severe sepsis
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- Number IV ABX days
- Number of pressor days
- Number of ICU days
- Number of vent days
- Use of chronic vent
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De-escalation Bundle Process Metrics: appropriate and timely care de-escalation of Care
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- Severe Sepsis/Septic Shock Episode ID
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Record unique identifier
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Optional Variables (26 total)
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Used For
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Birth date
Weight
Time zero location
Bolus volumes
Bolus2 time
Time first hypotension
First pressor type
Organ dysfunction
Cvl time
SVO2 time
Lactic acid
Blood CX positive
Surgical infection source control timestamp
Transfer timestamp (within hospital)
ECMO
Risk score & method
High risk conditions
Clinically derived time zero
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Patient Stratification and Special Analyses
(not used for routine process or outcome metrics in IPSO)
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IPSO Non-Severe Sepsis Data Set Summary
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Core Variables
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Used for
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- ABX ordered timestamp
- ABX administered timestamp
- Blood culture ordered timestamp
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Prevention Bundle Process Metrics: Appropriate and timely treatment of non-severe sepsis (NSS) that may lead to severe sepsis
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- Severe Sepsis/Septic Shock Episode ID
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Record unique identifier
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There are no optional variables for the IPSO Non-severe Sepsis Data Set
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