On Sepsis Care Equity: A Message From Our CEO
January 29, 2021
Earlier this week, Sepsis Alliance publicly announced its pledge and action plan for fostering equity, diversity, and inclusion (EDI) in our work. It’s something we’ve been discussing internally for some months, and I felt a sense of pride to see it finally published and shared. I think of it as a clear declaration—to our Sepsis Alliance community of supporters, and to the wider world—about our organizational commitment to a broad and vital movement.
There are strong, fact-based justifications for such a pledge. Those of us who work in the health sector encounter it anecdotally every day: we hear stories of implicit bias on the part of doctors; we learn of inaccessible and non-culturally reflective medical care; and we know about the differences in treatment quality and outcomes dictated by social determinants of health (like race, socioeconomic status, and geography). Each of the stories we hear has a human face behind it—a person who interacted with the American health system, who was failed, and who perhaps suffered. When we take these stories together, we begin to see problems with enormous scope.
In 2020, we witnessed a necessary reckoning with racial and ethnic discrimination and disparity in every corner of American life, including in healthcare. Sepsis care is no exception. While considering the greater movement toward health equity and the disproportionate impact of COVID-19 (an on-ramp to sepsis) on communities of color, Sepsis Alliance set out last year to better understand inequities in the sepsis care landscape. In part with support from Roche Diagnostics, we created a Sepsis and Equity Fact Sheet. We found that across all indicators—awareness, incidence, severity, and mortality—sepsis patients of color lagged dramatically behind white patients. The numbers outlined in the fact sheet are staggering.
Those of us in the Sepsis Alliance orbit are already accustomed to discussing overwhelming sepsis numbers. We regularly educate the public about how sepsis is the leading cause of death in U.S. hospitals, the highest cost of hospitalizations each year, and the number one cause of readmission for survivors. We know the tremendous burden sepsis places on the communities and hospital systems it touches—but we now see, with greater clarity, that that burden is not evenly distributed. This is damning, and unacceptable.
So, as an organization committed to mitigating sepsis-related suffering, we asked ourselves: what are we going to do about it?
With the guidance and support of our EDI Steering Committee—a diverse group with collective knowledge in clinical practice, health systems, and sociology—we’ve recognized the necessity to act and developed an equity, diversity, and inclusion pledge as a way to increase our efforts in the EDI sphere. We’ve structured it to be both actionable and global. It includes a step-by-step plan to ensure we’re truly “walking the walk”—not as a standalone initiative, but as an approach impacting everything we do.
Per the EDI pledge, we will implement changes to our public education and outreach aimed at closing gaps in sepsis awareness. We will retool our provider education—including integrating implicit bias training—to better facilitate culturally responsive sepsis care. We will shape advocacy strategy with equity in mind, and we will institute changes internally to help us better reflect the diverse communities we serve.
Finally, we will aim for EDI sustainability. We want to be transparent about our progress and to keep our efforts ongoing, so we will regularly report on our EDI efforts to the Sepsis Alliance community. We’ll hold ourselves accountable and, with an understanding of our limitations and imperfections, we’ll commit to making adjustments where necessary.
One of my first admissions of imperfection is that this pledge could have come sooner. Health inequity is not a new problem; we are merely looking at it with renewed urgency, in large part because of the tireless voices of healthcare activists and leaders from disproportionately impacted communities. Sepsis Alliance is the nation’s first and leading sepsis organization, so it is incumbent upon us to take part in this work. Today, we take a significant step in that direction.
I hope you’ll read more about the new commitments we’ve made, and that you’ll join us in this fight. As you know, Sepsis Alliance’s mission has always been to reduce the harm caused by sepsis. By pledging to promote equity in sepsis awareness and care and to help eliminate preventable disparities in sepsis incidence, morbidity, and mortality, we are continuing to do just that.