Beacon Children’s Hospital recognized in pediatric sepsis study

From left, back row: Kate Dutkiewicz, MD, Pediatric Hospitalist and Beacon Children’s Hospital Medical Director; Jennifer Tonkovich, RN, Director of Children’s Services; Jim Galasso, RPH, Medication Safety Officer and Clinical Pharmacy Specialist; Nikhil Patankar, MD MBA, Pediatric Intensivist and Director for Quality, PICU; Julie Gumm, RN, Clinical Data Analyst, Quality Management
From left, front row: Mary Jo Johnson, RN, PICU and Pediatrics Nursing Educator; Tamara Fuller, RN, PICU and Pediatrics clinical care coordinator

Beacon Children’s Hospital has been recognized as the highest performer in a key indicator of the Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) study. 

Out of 56 participating children’s hospitals from around the nation, Beacon Children’s had the fastest time to fluid bolus for pediatric patients with severe sepsis. 

Sepsis is an overwhelming infection in the body, according to Jen Tonkovich, Director of Children’s Services at Beacon Children’s Hospital. It can result in shock, a drop in blood pressure, organ failure and even death. 

The IPSO study monitors five key process indicators that determine timely recognition and management of sepsis in children. One of them is the timely administration of IV fluid bolus. A fluid bolus is an amount of IV fluids injected into a patient’s vein in a very short amount of time – ideally within 20 minutes – after recognition of severe sepsis. This helps in improving blood supply to vital organs like the brain, heart, and kidneys, and also helps increase blood pressure. 

IPSO recognized Beacon Children’s Hospital as the top performer in this category. Beacon Children’s consistently achieved this metric for the past year and averaged at 19 minutes. Beacon Children’s Hospital was the only participating hospital in the IPSO collaborative to do so under 20 minutes.

Dr. Nikhil Patankar, Tonkovich, Dr. Kate Dutkiewicz and others have all played pivotal roles in Beacon’s improvement in pediatric sepsis outcomes. Patankar, the IPSO project’s lead physician, said the honor was an “a-ha moment” for Beacon. “For us to be recognized on a national scale was a very proud moment for the hospital,” he said. 

For the past two years, Beacon Children’s Hospital has participated in the Improving Pediatric Sepsis Outcomes study through the CHA. “We try to have a culture of safety and high clinical excellence,” says Dutkiewicz, medical director of Beacon Children’s Hospital. “So this is just another example.”

Patankar credited Beacon’s size, compared to some of the association’s larger members, as a benefit to the program. “The thing that made me excited about this project was that there were fewer hoops to jump and things can happen a lot quicker in a smaller setting like ours.”

Patankar and Dutkiewicz also thanked Beacon leadership. Dutkiewicz worked with Beacon’s Clinical Excellence team to add sepsis care to hospital-wide quality priority lists known as scorecards. “Having it on the scorecard made it more important,” Patankar said.

Patankar says the project couldn’t have been so successful “without the support of [Beacon Chief Clinical Officer] Dr. Sam El-Dalati and [Executive Director of Quality] Amy Floria and executive leadership.”

Dr. Dutkiewicz says communication was essential to the study. “Communication is frequently the biggest issue,” Dutkiewicz says. “When you’ve got different departments, sometimes getting everyone on the same page can be difficult. But we’ve worked hard to communicate our intent.”

The standardization of severe sepsis care and inclusion of key antibiotic Cefepime in a machine called a Pyxis were also big wins, according to Patankar. The Pyxis is a medicine dispensing machine that allows healthcare providers at BCH to quickly access certain treatments.

Beacon Children’s Hospital also recently created an “order set” to speed up the process. An order set is a standardized treatment plan that takes certain criteria into account, such as weight and age, without requiring a caregiver to input every medication. Because sepsis care is so time-sensitive, an order set is immensely helpful to both patients and providers.

Dr. Patankar singled out Julie Gumm, Clinical QM Data Analyst RN, as essential to the improvement process. Gumm ensured that all data from the program was entered into the record. “For any quality improvement project, it’s important to have baseline data and continuing collection,” Patankar said. “It wouldn’t have been a well oiled machine like it is today if it wasn’t for Julie.”

Gumm, Patankar, Dutkiewicz and Tonkovich were all appreciative of the recognition as the top performer in the program. They also mentioned how exciting it was to look forward to how their work can help others and save the lives of children across the country. “The goal for this study is not to say that we’re the best,” Tonkovich said. “The goal is to improve outcomes for all children.”