SHEFFIELD — Roger Moore had a routine colonoscopy on a Tuesday in February. By early the next morning, Moore had been admitted to Helen Keller Hospital and diagnosed with sepsis.
He went home from his colonoscopy mid-afternoon and nothing felt off, but by 10 p.m. he was having severe stomach pain, cramps and chills.
“I had my wife bring me every blanket and quilt she could find, and I was still just shaking, Moore said.
It was then the Moores decided to go to Helen Keller Hospital. Moore has a history of Crohn’s Disease, and that was his immediate concern, but he quickly learned his actual diagnosis.
“I hadn’t been back there but a couple of minutes when I heard someone say ‘He’s septic,'” Moore said.
Helen Keller Hospital designed a sepsis protocol, an order of treatment for patients determined to have the potentially lethal infection. Moore fell within this protocol.
Moore was discharged the following Saturday and now he’s counted as a sepsis survivor and denoted on a hospital message board as one of four lives saved that month after a sepsis diagnosis.
Helen Keller Hospital this month earned certification through the Joint Commission’s Gold Seal of Approval for sepsis certification. The hospital is the first in Alabama to earn the approval.
Dr. Bill Meckes, a physician leader with the sepsis treatment program, said the Joint Commission review before issuing the certification evaluated the hospital’s protocols from intake through in-hospital treatment and follow-up care.
“The sepsis project doesn’t mean we can cure everyone, but we can certainly reduce the death rate significantly,” Meckes said.
The Joint Commission is an independent, not-for-profit health care accrediting agency. It certifies or accredits more than 20,000 health care organizations and programs in the United States. It is a two-year certification that requires monthly data submissions related to sepsis care at the hospital, a mid-cycle review after the first year and another site visit before certification is renewed.
Helen Keller Hospital volunteered to be one of five hospitals nationwide in a pilot study to develop sepsis treatment protocols. That was in late 2014. In the two years since entering that program, the sepsis mortality rate at Helen Keller Hospital dropped from 18 percent in 2014 to 9 percent in 2016.
Dr. Larry Carmichael said sepsis was the No. 1 mortality-related discharge at the hospital in that time.
Carmichael was involved in research at Vanderbilt University related to sepsis. At the time, researchers were looking for the “magic bullet” for treatment of sepsis. That has not been found, but Carmichael said what was discovered is that better outcomes were tied to earlier treatment of sepsis.
When a patient enters the emergency department at Helen Keller Hospital now, one of the first characteristics evaluated will be indicators for infection. If there is a known or possible infection, that patient enters the sepsis treatment action plan when the medical staff looks for signs of organ failure, the key indicator of sepsis.
The key to treating sepsis is early intervention with antibiotics and fluids, but LeAnn Crenshaw, the hospital’s performance improvement coordinator, said that’s difficult because sepsis is hard to diagnosis early and patients do not always seek treatment immediately.
“A lot of patients present to a non-physician,” he said. “They will present in our emergency department or a doc-in-the-box in our local community or present in other areas, and if they are not processed quickly they can be three hours before they see a physician in a non-urgent setting, and that doesn’t work for the sepsis therapy.”