She sees a problem. She addresses the problem.
It's just her dedication.
Sepsis causes 10 times as many deaths in our hospital
as heart attacks.
It's a huge, a huge priority for us.
She looked at the data and said,
We need to be the best in the United States.
It wasn't actually until 2008 that we really got serious
about trying to fix our sepsis problem.
She really took the bull by the horns and started to organize
sepsis care across the hospital.
We realized the most important thing was how could we
identify patients with sepsis early in their course?
The Early Goal-Directed Therapy, or EGDT bundle,
which actually has been adopted by our whole region,
it involves specific things being done all within six hours.
When a patient comes through the emergency department,
the first thing is identification.
They can look quite well and sometimes even patients
that look ill may not be diagnosed with sepsis,
so early identification and education is very important.
We wanted physicians and nurses and anyone else
who thought about sepsis to actually ask the question,
Could this patient be septic?
Very early on, a change was made in HealthConnect
where whenever you order a blood culture,
a lactic acid is also included in that order.
The lactic acid came back elevated...
If the lactic acid comes back high or if the patient otherwise
looks like they're meeting criteria for
Early Goal-Directed Therapy, we implement our sepsis alert.
Can I ask you to call a Sepsis alert for Mrs. Norcal
in red 3 please?
The team comes down from the Intensive Care Unit
and also a cadre of other people including a pharmacist
and our house supervisor,
and we also have a rapid response nurse.
They all come and convene in the patient's room
and decide, What are we going to do for this patient?
Do they need to have a central line put in and come to the ICU
for Early Goal-Directed Therapy?
In 2011, we came up with a clock.
The goal is to have measures.
So within an hour you want that antibiotic;
two hours, that central line; and then in three hours
you want to re-evaluate the patient.
We had trouble keeping track of the clock.
With HealthConnect, one of the things that we did was we
built a smart form.
Once you enter in the time zero,
it calculates for you all the subsequent times.
What really made a difference was bringing together
all the people with front-line knowledge.
The sepsis committee was formed by Diane.
It actually harnessed clinicians on the front line to educate
and reinforce sepsis care.
This is a committee that was making a difference
in people's lives.
Another tool I think is really valuable for us
is giving feedback after every case.
We actually fill out a little feedback form that we send
to everyone who was involved with that case,
and I think it's been really valuable
keeping it visible for people.
At Santa Clara itself, our mortality rate for patients
coming in with severe sepsis and septic shock
has dropped to less than 10 percent.
We really wrap our arms around the patient being at the
center with all aspects of our care.
Patients were getting diagnosed early, treated early
and surviving.
And we saw that it decreased the length of stay
in the hospital as well.
There's different models and things are going to work
differently based on your size and your structure.
There has been a lot of sharing.
And the region, under Alan Whippy's leadership,
really developed a great sort of scorecard,
so every month you can see how you're doing
compared to the other facilities.
In the state New York, Governor Cuomo was looking for
a model and what they decided upon is the model from the
Permanente Medical Group in Northern California as the best
model to save lives and improve mortality rates from sepsis.
The impact that she has had on the tens of thousands or
hundreds of thousands of people who will be alive in the future
with their families and with their friends in their life
as a consequence of her work has just been remarkable.
She's a true national hero.