How to Decrease Deaths Attributable to Pediatric Sepsis

Each year, sepsis claims the lives of three million children around the world. The work of the Improving Pediatric Sepsis Outcomes (IPSO) collaborative promises to reduce the number of children who die from the condition.

In 2016, members of the IPSO collaborative embarked on a journey to help health care teams identify sepsis in children sooner so treatment can begin earlier. Over eight years of the initiative, the collaborative’s strategies saved an estimated 570 children’s lives.

The work is now publicly available as a change package. This improvement toolkit equips hospitals with strategies to reduce pediatric deaths attributable to sepsis and improve long-term outcomes for children who develop the condition.

What is sepsis?

Sepsis occurs when the body overreacts to an infection in the body. When this happens, the immune system sets off a chain reaction throughout the body, harming organs and tissues. A virus, a surgical procedure, or even a simple scratch can be the impetus for sepsis.

Sepsis is a leading cause of death among hospitalized children. It is difficult to recognize and can spread rapidly through children's bodies, causing irreversible damage in a short time. Therefore, it’s crucial to identify and treat the condition as soon as possible.

A life-saving bundle of care

The 66 hospitals in the IPSO collaborative shared learning that led to the development of a bundle of care for timely recognition and effective treatment of pediatric sepsis. It includes:

• Formal sepsis recognition through a sepsis screen, huddle, or order set.
• Fluid administration within 60 minutes of recognition.
• Antibiotic administration within 180 minutes of recognition.

The bundle makes a substantial difference in outcomes. Following the bundle is associated with nearly 50% lower mortality in patients critically ill with sepsis and 80% lower mortality in patients suspected of having sepsis.

Charting the path forward

When the collaborative started in 2016, data on pediatric sepsis was scarce. There was little information, evidence, or best practices to guide hospitals in caring for patients with sepsis.

Eight years later, the collaborative built a data set with more than 100,000 pediatric sepsis episodes from 66 children’s hospitals. This data has allowed the IPSO collaborative to publish findings and add to the body of evidence supporting effective sepsis care. Thanks to the collaborative’s work, a growing list of peer-reviewed, published results is available.

Additionally, the findings have been presented at clinical and quality improvement-focused conferences and featured in journals including Pediatrics and Critical Care Medicine. Participating hospitals have also shared the IPSO care bundle with myriad pediatric providers and institutions, including pre-hospital settings, critical access hospitals, and children’s hospitals that did not participate in the collaborative. 

Advancing best practices

The formal IPSO collaborative concluded in 2023, but the Children’s Hospital Association continues to facilitate a community of practice and support sepsis data tracking and benchmarking for children’s hospitals.

The Sepsis Community of Practice offers learning opportunities, including webinars, an online discussion forum, and a library of resources. Data collection allows for ongoing trending and benchmarking of key performance metrics. The Community of Practice is open to any CHA member while data tracking is limited to hospitals that participate in CHA’s data programs.

Sharing the change package

Any hospital or health care provider can access the IPSO collaborative’s work where you’ll find the change package and a library of more than 70 tools, articles, and other resources.

We encourage you to share this lifesaving body of work with peers. If you have questions about the IPSO collaborative’s work, please reach out to quality.programs@childrenshospitals.org.