A 300-bed , Level 2 Trauma, teaching hospital and part of a large, high-performing health system was inconsistently meeting the sepsis quality benchmarks set by both the health system and CMS. As a designated safety net hospital and location within the inner city of a major metropolitan area, the hospital provided healthcare for all population including an underserved population often presenting with untreated and unknown comorbid conditions.

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Severe Sepsis and Septic Shock totaled more than 850 cases per year, and the hospital was challenged with an ICU Length of Stay (LOS) and sepsis mortality rates higher than the national average. Sepsis remains the most expensive reason for hospitalization in the U.S. One key element of the Septic Shock Early Management Bundle is timely and effective use of IV fluids. Despite meeting other recommendation set out in the sepsis bundles, fall-outs associated with fluid resuscitation are commonly associated with the inadequate fluid administered or the failure to perform and document a fluid re-assessment within the recommended time.