Here are two references from the 2012 Surviving Sepsis Campaign guidelines.

Jones AE, Shapiro NI, Trzeciak S, et al; Emergency Medicine Shock
Research Network (EMShockNet) Investigators: Lactate clearance vs
central venous oxygen saturation as goals of early sepsis therapy: A
randomized clinical trial. JAMA 2010; 303:739-746

Jansen TC, van Bommel J, Schoonderbeek FJ, et al; LACTATE study
group: Early lactate-guided therapy in intensive care unit patients: A
multicenter, open-label, randomized controlled trial. Am J Respir Crit
Care Med 2010; 182:752-761

Terry P. Clemmer, MD
Director of Critical Care Medicine
LDS Hospital
8th Ave and 'C' Street
Salt Lake City, Utah 84143

Phone 801-408-3661
E-mail: [email protected]<mailto:[email protected]>


"Confidential Report for Improvement of Hospital, Facility and Patient 
Care--Not Part of Medical Record and Not to be Used in Litigation--Prepared 
Pursuant to Utah Code Ann. § 26-25-1 et seq., or Idaho Code Ann. § 39-1392 et 
seq."

From: [email protected] 
[mailto:[email protected]] On Behalf Of John Brady
Sent: Tuesday, August 06, 2013 9:28 AM
To: Pitkofsky, Charles; Bianca Chung; [email protected]
Subject: Re: [Sepsis Groups] Cost Savings from Early Detection & Better 
Management of Sepsis

We are having challenges with our inpatient physicians ordering lactate levels. 
 We seem to be able to attain an order for the first lactate but they are 
reluctant to do serial lactate levels. I have a recent article from Emergency 
Medicine that talks about lactate as a predictor for mortality. Does anyone 
have an article that they feel gives a clear picture of how important lactate 
levels are.

John Brady RN,BSN,CCRN,CNRN
Quality Nurse Manager
St. Mary Medical Center
760 242 2311 ( 5369)

From: 
[email protected]<mailto:[email protected]>
 [mailto:[email protected]] On Behalf Of Pitkofsky, 
Charles
Sent: Monday, August 05, 2013 12:49 PM
To: Bianca Chung; 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] Cost Savings from Early Detection & Better 
Management of Sepsis


We have been tracking lives saved a cost saved as part of our outcomes 
reporting for a grant. Here is the formula that we have been using"

BMR = baseline mortality rate for combined severe sepsis and septic shock. We 
are using 2008 for our baseline mortality rate.
BALOS = baseline average length of stay for combined severe sepsis and septic 
shock patients (this is the sum of all patient LOS/total # patients) - we are 
using 2008 for BALOS

If you are looking at lives saved for 2013 Q1:

Lives saved = (total number of severe sepsis/septic shock patients for 2013 Q1 
x BMR) - actual # expired severe sepsis/septic shock patients for 2013 Q1

For cost saved, calculate patient days saved first:

Patient days saved = (total number of severe sepsis/septic shock patients for 
2013 Q1 x BALOS) - the sum of patient LOS days for 2013 Q1

Cost saved = Patient days saved x direct hospital costs per day

Hope this helps,

Chuck
Charles Pitkofsky, RN, MSN
Quality Manager
Department of Quality Management
Mills-Peninsula Health Services
1501 Trousdale Drive
Burlingame, CA 94010-4506
Phone: 650.696.7880
Cell: 650.605.7684
 "If you always do what you always did, you will always get what you always 
got."  - Albert Eintstein
[cid:[email protected]]
Confidentiality Notice:  This transmission and any attached documents may be 
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Please delete the entire message and its attachments.  Thank you

From: 
[email protected]<mailto:[email protected]>
 [mailto:[email protected]] On Behalf Of Bianca Chung
Sent: Monday, July 29, 2013 1:44 PM
To: 
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] Cost Savings from Early Detection & Better 
Management of Sepsis
Importance: High

Hello,

Has anyone in the group been tracking direct hard cost savings as a result of 
implementing a sepsis quality initiative? If you have had success, what costs 
could you tie to the sepsis program (e.g. cost of supplies, nurse overtime 
reduction, ICU bed/ day, etc.)?

We are putting a ROI business case to executive management showing that 
implementing a sepsis program will result in hard dollar benefits.

Thank you in advance for your advice. In the spirit of sharing, it is much 
appreciated.

Sincerely,

Bianca Chung




________________________________
Notice from St. Joseph Health System:
Please note that the information contained in this message may be privileged 
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