The goal of the Surviving Sepsis Campaign is to reduce mortality by 25 percent within five years (by the year 2009). To achieve this goal, everyone involved with the care of the severe sepsis patient must be included, work processes must be carefully scripted and standardized, and awareness and commitment to this effort must be elevated. This must be a team effort that crosses disciplines and departments; it requires leadership and support from the entire organization and buy-in from all stakeholders involved with the care of these patients.
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 There are three different levels of participation in creating successful change:
- Active working team responsible for daily planning, documenting, communications, education, monitoring, and evaluation of activities
The working team must be multidisciplinary, with representation from all departments involved in the change processes — doctors, nurses, pharmacists, respiratory therapists and other staff with roles in the specific change process, such as clerks and technicians. Team members should be knowledgeable about the specific aims, the current local work processes, the associated literature, and any environmental issues that will be impacted by these changes.
- Leadership group or person who helps remove barriers, provides resources, monitors global progress, and gives suggestions from an institutional perspective
The working team needs someone with authority in the organization to overcome barriers that arise, and to allocate time and resources the team needs to achieve its aim. Leadership needs to understand both the implications of the proposed changes for various parts of the system and the more remote consequences such a change might trigger.
- Providers, including all stakeholders who have an interest in the change
Procedures are needed to keep providers and other stakeholders informed, provide a hassle-free mechanism to receive their feedback, and assure them that their responses are respected and will influence the changes. This helps give them some ownership and facilitates implementation and utilization of the new processes.
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Example 1: Effective Work Team
Aim: Diagnose patients with severe sepsis or septic shock in the emergency department (ED) within 2 hours of admission
Core Working Team: The overall core team must be interdisciplinary and must include, at a minimum:
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ED physician
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Triage nurse
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Staff nurse
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Laboratory technician
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Laboratory supervisor
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Admissions clerk
Additional team members may include:
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Example 2: Effective Work Team
Aim: Ventilated septic patients will have tidal volumes near 6 ml/kg ideal body weight and plateau pressures less than 30 cm H2O
Core Working Team: The overall core team must be interdisciplinary and must include, at a minimum:
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CCM physician
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Respiratory therapist
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Staff nurse
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Pharmacist
Additional team members may include:
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Example 3: An Effective Leadership Team (Optional)
Aim: ED and CCM will join together to implement best possible care for septic patients, using the known evidence that fits their institution
Core Leadership Team: The overall leadership team must be interdisciplinary and must include, at a minimum:
- Administrator over ED and CCM
Additional team members may include:
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