Sunil Desai, MD
I had not heard about sepsis before I began studying to be a doctor. I first learned about sepsis while I was in medical school, but only in a limited way. I was able to learn much more as a resident and as pulmonary and critical care fellow.
The medical education that I received during medical school did not cover sepsis in much detail. Only as an internal medicine resident and pulmonary critical care fellow did I have intense exposure to this devastating syndrome. At this level, the training I received was excellent.
As a practicing critical care medicine physician (Intensivist), I have had to deal with severe sepsis and septic shock almost on a daily basis. Much of the early issues in the care of the inpatient with sepsis were the lack of standardized definitions and lack of early recognition of this serious syndrome. Since the advent of the Surviving Sepsis Campaign and with the latest guidelines for severe sepsis and septic shock (now in its third generation), the awareness of sepsis has been improving as are patient outcomes. However, we still have much work to do.
With health care reform and the implementation of EMR (electronic medical records), there is still a lack of a systems-based approach to severe sepsis and septic shock. On an organizational level, changing this aspect of care will benefit the most patients in the most cost effective manner.
As the eICU (electronic intensive care unit) medical director at Presence Health in Bolingbrook, Illinois, working with a dedicated team of administrative and nursing staff, we have a tremendous opportunity to lead our health system in the dissemination and implementation of evidence based medicine (EBM) and best practices, specifically relating to severe sepsis and septic shock. This includes meaningful data collection to drive compliance with EBM. This ongoing endeavor has evolved since its inception in 2007. Since then, we have been able to demonstrate a reduction in severe sepsis and septic shock mortality from 40 percent to approximately 21 percent.
