“While getting everyone on board with the new protocol was challenging at times, eventually, everyone understood the importance of why we were doing it. “
The Martin Luther King, Jr. Community Hospital (MLKCH) has been named as one of this year’s Sepsis Heroes. The facility’s staff has made great strides in recognizing sepsis and reducing mortality by implementing protocols that deliver timely evidence-based care to the patients.
MLKCH is located in Los Angeles, CA, and operates as a private, non-profit, safety-net hospital in south LA. The new hospital opened in 2015, offering general medical-surgical services, critical care, labor and delivery, and more. Specifically, and what caught the attention of Sepsis Alliance, is their sepsis protocol, which guides healthcare workers throughout the facility on how to treat infection at any stage. Edna De Leon, RN, MSN, is the vice-president of quality for MLKCH, and one of the people leading the fight against sepsis. When asked how she felt when she was notified of the Sepsis Hero award, Edna said, “I was pleasantly surprised and excited. We started the Sepsis Committee in 2018 and we’ve been working on improving our performances for a long time.” Edna emailed news of the award to the rest of the team, who were all very excited, and she is proud and thankful for MLK’s team.
The multidisciplinary sepsis team includes people from throughout the facility, including medical directors from the ED (emergency department), critical care, and hospitalist service as well as intensivists, nursing leaders, pharmacists, those who work in the labs, and others. The protocol was first launched in the ED, knowing that majority of the population with sepsis diagnosis were patients presenting to the ED with sepsis on arrival. “We identified Sepsis Champions and an ED Sepsis Coordinator to work with the staff and physicians and we reviewed every single fallout [of the sepsis protocol] to see how we can build standard work and system improvements,” Edna explained. This allowed for continuous improvements and continued monitoring of their successes.
The team began by looking at the individual sepsis bundle indicator rates to identify and prioritize the work that needed to be done, in addition to hospital length-of-stay, and sepsis mortality within the hospital. While getting everyone on board with the new protocol was challenging at times, eventually, everyone understood the importance of why we were doing it. One of the toughest challenges on getting the sepsis protocol compliance up was the electronic medical record (EMR), Edna explained. The EMR often had too many places to enter information that could complicate Time Zero, thus affecting the timing of the bundle elements But what worked best, Edna said, was having a nurse in the role of a sepsis coordinator directly in the ED who worked side by side with the physicians and nurses and tracked every step of the bundle compliance.
There are too many things to list that would show how the sepsis team and protocol worked, but one example Edna gave was the importance of education. Part of the protocol requires a second set of blood tests but the lab staff would sometimes cancel the second order, thinking it was a duplicate. Educating the medical directors on the data abstraction guidelines was the biggest win. This enabled them to explain better to the team and providers why the fallout occurred and how to avoid it in the future.
Edna would like to stress to others starting or reworking their sepsis protocols to keep in mind how important it is to have a multidisciplinary team and very strong physician leadership to optimize the chances of a successful program. Edna wants to specifically thank Dr. Casillas, ED Medical Director, Alaine Schauer, ED Sr. Director, and Dr. Varghese, Hospitalist Medical Director for their leadership and support.
Welcome Martin Luther King Community Hospital to the 2020 Class of Sepsis Heroes!
MLKCH and its fellow Sepsis Heroes will be honored during the 9th Annual Sepsis Heroes gala on September 17, 2020.