Groundbreaking 'Rory's Regulations' Serve as National Model for the Identification and Prevention of Sepsis
New Report Details Connection Between Enhanced Hospital Compliance and Reduction in Mortality Rates
Governor Andrew M. Cuomo today announced that New York has achieved a consistent reduction in sepsis mortality rates as a result of the groundbreaking Rory's Regulations. Named for the late Rory Staunton and first championed by Governor Cuomo in 2013, these regulations established first-in-the-nation protocols for hospitals to improve identification and treatment of sepsis.
"New York has been leading the fight against sepsis and, as these new figures show, our efforts are working to save lives and increase early detection and treatment of this deadly condition," Governor Cuomo said. "I commend Ciaran and Orlaith Staunton for their advocacy and fighting in Rory's memory to prevent further tragedies. It is our hope the rest of the nation recognizes the success that can be achieved by using Rory's Regulations as a model for combatting and ultimately ending sepsis infections once and for all."
Sepsis is a progressive shutdown of the body's organs and systems caused by systemic inflammation following infection that enters the blood or soft tissue. Those who don't die often experience life-altering consequences like missing limbs or organ dysfunction. Studies have shown that early detection combined with appropriate interventions can significantly improve the chances of survival.
A new study comparing quarterly data from 2014 and 2016 has confirmed a 20 percent increase in the identification of sepsis patients from 10,970 at the onset of the study to 13,126 at its conclusion. In this same timeframe, mortality rates in adults steadily declined from 30.2 percent to 25.4 percent.
Thanks to the leadership of Governor Cuomo, New York adopted Rory's Regulations in 2013 and became the first state in the nation to not only proactively fight back against the sepsis, but create a model that other states could follow. The regulations were named for Rory Staunton, a 12-year old boy from Queens who died of sepsis in April 2012 after a fall in the school gym caused a skin abrasion that became infected. His parents Ciaran and Orlaith Staunton became advocates in the fight to improve sepsis care in New York hospitals.
Ciaran and Orlaith Staunton said, "Rory continues to live in our hearts every day and through his memory, tremendous strides have been made in the fight against sepsis. Thanks to the leadership of Governor Cuomo, the nation now has a model for winning this battle and this study proves that it is working. We hope that the rest of the country takes note of the progress that has been made under Rory's Regulations, follows the example that New York State has set and takes this kind of bold action so that no more lives are senselessly lost."
Under Rory's Regulations, hospitals are required to implement protocols that screen patients to identify those with sepsis, severe sepsis and septic shock earlier, as well as establish guidelines for treatment, including the early delivery of antibiotics. The study, conducted by the State Department of Health, has shown that the increased rate of sepsis identification has enabled hospitals in compliance with the regulations to implement the protocols earlier and more effectively.
Specifically the study found:
- The overall percentage of sepsis patients who received the formal protocol increased to 84.7 percent from 73.7 percent for adults and to 85.3 percent from 80.6 percent for children;
- The percentage of child patients who successfully received all recommended early treatments within a one-hour time span, more than tripled reaching 17.6 percent from an initial 4.9 percent;
- The percentage of adults receiving sepsis care in a hospital within a three-hour time span increased more than 13 percent, increasing from 41.5 percent in 2014 to 55.2 percent in 2016; and
- The percentage of adults receiving sepsis care in a hospital within a six-hour time span also increased more than 13 percent 36.4 percent from 22.6 percent.
New York State Health Commissioner Dr. Howard Zucker said, "Thanks to Governor Cuomo's leadership on this issue and the Staunton's unwavering commitment to sepsis awareness and advocacy, significant progress is being made in New York's hospitals as we work together to address this life-threatening condition. This report demonstrates that early detection and appropriate interventions can have a major impact on the survival of patients who develop sepsis."
Greater New York Hospital Association President Kenneth E. Raske said, "This promising report reflects the deep commitment of New York's hospitals to improve the care of patients with severe sepsis or septic shock. It also reflects New York State's leadership and vision in becoming the first state to adopt protocols for the early identification and treatment of sepsis. GNYHA will continue to work with our member hospitals and the New York State Department of Health to ensure that hospitals sustain and build on these improvements."
Healthcare Association of New York State President Bea Grause, RN, JD, said, "HANYS commends the Staunton family, Governor Cuomo, Commissioner Zucker, and the New York State Department of Health for their leadership in this groundbreaking initiative. HANYS is so proud of our members' progress. New York hospitals are making important contributions to the body of knowledge on how to deal with sepsis, and this is resulting in improved care, and outcomes for all patients. HANYS will continue to support these efforts through our participation on the New York State Sepsis Advisory Committee, the HANYS' Statewide Sepsis Support Network and the New York State Partnership for Patients Initiative."
Following the release of this study, the Department of Health is now not only focusing on continuing to increase the hospital compliance rate with the regulations, but working with the Sepsis Advisory Group to further explore the specific clinical practices and delivery systems that have been most successful. This ranges from identifying innovative approaches to early identification of high risk patients and rapid response of early interventions to new workforce sepsis training and education initiatives.
More than 750,000 Americans get sepsis each year, and over 200,000 die from it, making it the leading cause of death in hospitals and the eleventh leading cause of death overall in the United States, killing more people annually than AIDS, prostate cancer, and breast cancer combined. Given its prevalence and consequences, sepsis is a huge driver of medical costs, accounting for an estimated $17 billion annually in national health care expenses.