Defining, Developing and Understanding Pediatric Sepsis Outcomes

The Improving Pediatric Sepsis Outcomes (IPSO) collaborative is dedicated to reducing sepsis-attributable mortality and improving survivor outcomes. As IPSO participants lead these quality improvement efforts, their teams are evaluating data to drive long-term progress. Some of the peer-reviewed, published results include:

Bundle of Care Improves Outcomes: IPSO's modified, evidence-based bundle of care, including utilization of recognition processes and timely administration of fluids and antibiotics, is associated with significantly lower sepsis-attributable mortality. 

Evaluating Pediatric Sepsis Definitions: A description of IPSO definitions' effectiveness and feasibility for large-scale data abstraction, identifying patients treated for sepsis, as well as practical utility for use in quality improvement. The definitions also indicated strengths in content validity, convergent construct validity, and criterion validity; weakness in reliability.

Developing a Quality Improvement Collaborative: A description of the development of the learning collaborative that details the aims and key drivers based on treatment guidelines, evidence and baseline data.

Metric Development: A comprehensive data dictionary was developed for the largest pediatric sepsis QI collaborative, optimizing automation and ensuring sustainable reporting. These approaches can be used in other large-scale sepsis QI projects where researchers leverage EHR data abstraction.

Association Between Intravenous Fluid Volume and Mortality: In children with hypotensive septic shock, receiving a timely first-fluid bolus within the first hour of ED care is more important than the volume of fluid.