20% Drop in Sepsis Mortality: Inside Ochsner Health’s Life-Saving Strategy

Summary

---

Advancing Health: 20% Drop in Sepsis Mortality—Inside Ochsner Health’s Life-Saving Strategy

Podcast by American Hospital Association | June 23, 2025

Episode Overview

This episode spotlights Ochsner Health’s remarkable 20% reduction in risk-adjusted sepsis mortality across its 48-hospital system. Host Dr. Chris Di Rienzo sits down with Stephen Saenz, PA and sepsis program manager, and Teresa Arrington, Director of Quality and Performance Improvement, to explore the initiative’s origins, innovative solutions, workflow redesign, technological tools, scaling strategies, and national impact. Their discussion provides a candid look at practical challenges, iterative learning, and replicable tactics for complex, system-wide improvement in time-sensitive care.

---

Key Discussion Points & Insights

1. Origins of the Sepsis Quality Initiative

• Early Days and Challenge Identification (01:22–03:40)

  • Initial efforts were case-based and lacked systemization; learning from morbidity and mortality reviews, but failing to consistently apply improvements.
  • Around 2020, Dr. Richard Guthrie (Chief Quality Officer) led a data-driven deep dive, revealing that sepsis accounted for over half of mortality in the system—a clear priority for targeted intervention.
  • Formation of a “system drive team” including leadership, quality professionals, and frontline physician thought-leaders to create foundational structures for sepsis improvement.

• Quote:
  “In fact, [sepsis] is associated with more than half of the mortalities in our system. So it felt like a really great place to start.”
  – Teresa Arrington (02:06)

---

2. Structuring for Success: The Multidisciplinary Team

• Novel Roles and Collaboration (03:40–05:33)

  • Uniquely broad physician involvement included not just hospitalists and ED doctors, but those deeply versed in informatics, bridging clinical practice and health IT.
  • Focus on multi-stakeholder buy-in—core CDC recommendation—and on dynamic, tech-driven workflow design with direct clinical input.

• Quote:
  “When you can combine that clinical acumen as well as some of the tech... you really start to get somewhere that feels like... it’s manageable and making a difference.”
  – Teresa Arrington (04:39)

---

3. Reducing Alert Fatigue and Smart Workflow

• Example: Instead of frequent interruptive alerts (“OPAs”), only actionable prompts are deployed, keeping clinicians focused and reducing burnout—a decision shaped directly by those experiencing the workflows day-to-day.
  • Quote:
    “If there is not an action associated with it... we’re not going to push that to you. And thereby it reduces some of that alert fatigue and helps to harness the attention where it needs to be.”
    – Teresa Arrington (05:07)

---

4. Standardization and Flexibility Across Hospital Types

• Unified Approach with Local Adaptation (06:24–09:15)

  • Systemwide standard of care made possible by unified EMR (Epic) and consistent workflows; ensures all patients receive the same baseline quality.
  • Local site leaders are empowered to tailor how national protocols (like the CMS “Total Perfect Care” sepsis bundle) are achieved, acknowledging resource and workflow diversity from major academic centers to small critical access hospitals.
  • Focus on enabling excellence, not rigid uniformity.

• Quote:
  “We have the certain tenets that we have to follow... but in terms of how to operationalize that, we have left that largely to the leadership at the individual facilities because they know their resources and their constraints and their culture better than we ever could at a system level.”
  – Teresa Arrington (08:20)

---

5. Technological Innovation: Predictive Algorithms & AI

• Proactive Tools and Early Alerts (09:15–11:06)

  • Leveraging “the vast information that’s input into Epic,” the system offloads risk stratification and early warning to predictive models, triggering timely sepsis screenings and interventions—especially empowering for nursing workflows.
  • Ochsner positions itself as a leader on the applied-AI front in clinical care.

• Quote:
  “We’re really, I feel like here at Ochsner, kind of leading on the AI front... to help protect patients, as well as developing all the workflows to help then support that decision when it’s made.”
  – Stephen Saenz (10:46)

---

6. Measurable Outcomes and Scaling Impact

• Dramatic Mortality Reduction and National Reach (11:06–13:17)

  • 20% decrease in primary sepsis risk-adjusted mortality over two years—across all 48 hospitals.
  • Tools and workflows developed with Epic are disseminated nationwide, used by other health systems.
  • Process characterized by iterative feedback, real-time learning, and continued willingness to adapt solution design.

• Quote:
  “We are excited to share that we have, over the past two years, dropped our primary sepsis risk adjusted mortality by 20%, which is incredible, especially... at this large system level, not at a singular campus.”
  – Teresa Arrington (11:39)

• Quote:
  “We've developed a lot of tools in collaboration with Epic... We're happy to share that information at Epic conferences, at other medical conferences, and then across, you know, anyone who's using the Epic system for their EHR.”
  – Stephen Saenz (13:26)

---

7. Continuous Improvement & Broader Application

• Forward Momentum and Replicability (13:17–14:44)

  • Emphasize that the journey is ongoing—“Improvement is a journey, not a destination.”
  • The “recipe for success” is being adapted to other critical care pathways like stroke and STEMI.
  • Willingness to share learning widely and maintain a posture of continuous adaptation.

• Quote:
  “We believe we have found a recipe for success in how to bring attention and drive change in time-sensitive disease states. And we are excited to be replicating this same structure... with stroke and with STEMI.”
  – Teresa Arrington (14:26)

---

Memorable Moments & Quotes

• On the Power of Systemization:
  “You really have to support that team in making their workflow work for everybody... Really everyone had to be on the same page.”
  – Stephen Saenz (07:00)

• On Reaching National Impact:
  “Other hospitals are kind of being inspired by some of the work that we're doing, but we're not done yet. There’s still a lot more to keep at.”
  – Stephen Saenz (13:46)

---

Important Timestamps

• 01:22 – How the sepsis journey began at Ochsner
• 03:40 – Multidisciplinary, informatics-driven leadership structure
• 05:07 – Tackling “alert fatigue” and actionable workflow redesign
• 07:00 – Standardized care systemwide and the challenge of local adaptation
• 09:15 – Use of predictive algorithms and AI in sepsis detection
• 11:39 – 20% reduction in mortality: What it means and how it was achieved
• 13:17 – Scaling tools to other systems and continual improvement
• 14:26 – Applying the sepsis strategy to stroke and STEMI pathways

---

Takeaways

Ochsner Health’s sepsis improvement initiative stands as a model for large-scale, data-driven, and clinician-led quality improvement. Its mix of standardized protocols, flexible local deployment, technology-enabled workflows, and real-time adaptation led to a 20% drop in sepsis mortality. By collaborating both internally and with health IT partners like Epic—and by actively sharing their tools and insights—Ochsner is setting a new national bar for acute care improvement and system-level learning.

---

Transcript

[A]

Welcome to Advancing Health. Sepsis, essentially an extreme and life threatening.

[B]

Reaction of the body's immune system to.

[A]

An infection, is a problem in many hospitals and at one point accounted for more than half of the mortality rate for Ochsner Health. In today's podcast, we hear how Ochsner tackled the problem with great success.

[C]

I'm Dr. Chris Di Rienzo. Thank you, thank you all again for listening in to this episode of our podcast. This is another one of our on location podcasts and we could not be more excited to be down in Louisiana today visiting with the spectacular team at Ochsner health. They're a 48 hospital system covering everything in size from large academic medical centers to small critical access hospitals. And the reason that we're here is because their work on sepsis is leading the way nationwide. Our visit today has actually been funded by a CDC grant around the sepsis core elements and I'm super excited to get to spend some time on our podcast. Speaking with Stephen Saenz, who's a PA and is the sepsis program manager for Ochsner, in addition to Teresa Arrington, who is the director of quality and performance improvement. Thank you both so much for being willing to do this on site today. It is a real privilege to get to record this with you.

[A]

Happy to be here.

[B]

Thank you for having us.

[C]

Well, let's jump right in. So again, you all have have managed to make substantial strides in sepsis outcomes like risk adjusted mortality across your health system. Let's just start where you start. So how did this journey begin and where did it start?

[B]

This journey? We've been on it for a number of years and in the prior iterations, I was a stakeholder but not really involved in any kind of leadership capacity. And, and we would often review sepsis cases, sit around a table. It would be conducted a lot like an M and M review with physicians where we would discuss what did we do right here, what our opportunities were, and I think that the teams would come away with some knowledge. But we had trouble systemizing the things that we were learning and the trends we were seeing. Around 2020, Dr. Richard Guthrie, who is our chief quality officer for our system, he really started to do a deep dive into mortality as a whole and what the drivers of mortality might be. And we knew that se sepsis was absolutely one of those arms. In fact, it is associated with more than half of the mortalities in our system. So it felt like a really great place to start. And we put together as an initial step a system drive team which was comprised of Dr. Guthrie as our champion and sponsor, myself as a change management professional who reports that through the quality structure. And then we had initially an anesthesiologist who was just fantastic in terms of structure and started on that journey. What we did is we tried to craft just some structure that we felt would be foundational in moving anything we wanted to do with sepsis forward. When I say structure, I mean things like identifying what kind of roles you might need to be successful if you were to stand up a sepsis committee or council at a local campus. And then, you know, from there it grew into tools and whatnot. But we've come some ways and the anesthesiologist, he was a thought leader, stepped back and in came Dr. Lisa Fort, who is an ED physician as well as an associate chief medical information officer, as well as Dr. Jason Hill, who represented the hospital medicine side as a clinician and as a chief medical information officer. And I think between that group we started to put things together.

[C]

Let's pause on that for a moment because your sepsis implementation team here looks a little bit different in an important way than some things I've seen elsewhere. In that we know that it's important to have multi stakeholder buy in. Obviously that is one of the CDC's hospital sepsis core elements. But how you've approached that on the physician and app side with not just ED and hospitalists as part of the team, but also an ED provider and a hospitalist provider who understand informatics and can help translate how you're trying to solve for sepsis outcomes into workflows. That's really quite novel. I'd love to hear you share a little bit with our audience around the unique nature of those sepsis workflows.

[B]

Yeah, it has been fantastic and it's certainly, it's something I'm very aware of as a gift that we've had in the organization. You know, it's been important. Of course you need clinicians at the table. But when you can combine that clinical acumen as well as some of the tech and is and it supported workflows, you really start to get somewhere that feels like you're. It's manageable and making a difference. I'll give an example that comes to mind. Interruptive. Some people call them BPAs, OPAs. It's now what we refer to them as within our system. You know, clinicians, while they recognize that they can be valuable, there's also a tremendous amount of alert fatigue. So in having clinicians who have led the program and understand what that feels like On a day to day basis, we've moved say from an OPA that would fire only to say be aware of X, Y and Z to we're not going to ever shoot over an OPA to say be aware. We want to prompt an action. So if there is not an action associated with it or something we want you to do, we, we're not going to push that to you. And thereby it reduces some of that alert fatigue and helps to harness the attention where it needs to be. So that's just an example that comes to mind of one of the benefits.

[C]

It's a wonderful example. And Steven, I'm wondering if you have something to add there as well.

[A]

Yeah. As you can imagine, physician who knows informatics is in high demand for other projects. So we got sepsis off of the ground and there's still work to be done. And my role as a clinician as well and understanding the ins and outs of a big hospital system is really being in those tools. Every single day I am in those dashboards, I am looking at sepsis care, identifying problems quickly, understanding how to triage, who needs to know, who can help me fix it. You know, there's going to be leadership at an executive level who's pushing these big projects forward, but you really need somebody in the day to day nitty gritty understanding how to best utilize the tools, send up suggestions on how to make things better and then watching those process metrics change from there.

[C]

Indeed, leadership engagement, again, one of those CDC sepsis core elements. Let's talk about action a little bit though, because again, how you have scaled this work across a multi stage endeavor really, I think is worthy of some deep conversation. When we look at sort of the red to green conversions, for example, of your ED president on admission sepsis workflow. Talk to us about how not only that works here, we're recording this podcast today at a large flagship academic medical center site, but perhaps out in Ochsner Rush or some of your other critical access locations.

[A]

I really do think that the system as a whole really made this the standard of care. Ochsner was going to be taking care of patients with sepsis in a standardized way across the whole system. You have to listen to how different hospitals work and understand that there may be some different variation in how they work, but you really have to support that team in making their workflow work for everybody. Because if the main hospital needed a change, we can't have a different iteration at a different hospital. Really everyone had to be on the same page. And that's been from the beginning with even just going live with EPIC in general, having everybody on the same system, having everybody with the same workflows helps in standardizing a message across all the hospitals.

[C]

Teresa, I'm curious, in your travels across all of the different hospitals in the system, do you see any differences in approach to implementation? For example, in a critical access emergency department that doesn't have in house pharmacy 247 as compared to a larger community hospital or an academic center where you have to tweak how the protocols are implemented in order to be able to get a patient who would present in both settings to the same excellent outcome.

[B]

We've actually purposely tried to not be overly prescriptive. We have the certain tenets that we have to follow and things that we're held to. For example, CMS's Total Perfect Care sepsis bundle, which is built into the checklist that you referenced with the red and green. And we know that that's going to be critical for a patient's chances of survival no matter what ED they present to. They're expecting that level of care. But in terms of how to operationalize that, we have left that largely to the leadership at the individual facilities because they know their resources and their constraints and their culture better than we ever could at a system level. You know, using the example of you might have an academic site with 247 pharmacy support in the ED, but then what about, you know, a smaller hospital? In a case like that, it might be more important that we're very forward thinking about keeping our pyxis stopped with exactly what we need in that moment to be available to our patients. So it's taking the broad goal of what we have and then saying no matter how you get there like that, it's okay how you get there if it looks different, but get there excellent.

[C]

And so important. I mean, the patchwork tapestry of America's hospital landscape. There's never going to be one perfect solution, one perfect implementation, but what you've created and there's a standard protocol with a flexible approach to implementing it. Now, I know in that approach to implementation, technology obviously plays a big role. We touched a little bit on the nature of the workflow, which really leverages human factors and in some ways almost gamifies the approach to hitting every element. Because as humans we just love making red things green. And of course, within that you have appropriate clinical knowledge and understanding. But what other kinds of technology are you leveraging within your broader sepsis program as you seek to scale again across a large multi state 48 hospital enterprise.

[A]

Some of the other things we've done are around predictive algorithms. So using all the vast information that's input into epic, whether it's coming from a flow sheet, whether it's coming from a past medical history, surgical history, kind of all the intangibles that we know as clinicians but have a hard time getting the computer to understand. And so what we've done is offload some of that thinking onto EPIC to help us provide risk levels for different patients, to alert us earlier to a potential sepsis diagnosis, and then really supporting the workflow on the nursing side to get a screening done for those particular patients. So we're really, I feel like here at Ochsner kind of leading on the AI front, using those tools that are available to us in a way that can help protect patients, as well as developing all the workflows to help then support that decision when it's made.

[C]

I learned early in my career at healthcare that if you're going to embark down a technology pathway, you've got to involve those who are going to be using it from the very beginning. And that's baked into your model. Teresa, as you were sharing your wheelchair, you know, has those bedside clinicians as part of, as part of that dialogue, which again, clearly a leading practice. And again, one of the reasons that we're, we're down visiting with you in Louisiana today, I think we've only got a couple more minutes, and so I would love to give you a chance just to share some of the incredible outcomes with our listeners that, that you shared with us.

[B]

Absolutely. We are excited to share that we have, over the past two years, dropped our primary sepsis risk adjusted mortality by 20%, which is incredible, especially we're talking about at this large system level, not at a singular campus. And to be able to move the needle at scale like this, it is challenging. And we are so very proud of the work that has been done. We've had tremendous success, as Steven mentioned earlier, with some of our AI and just the direction we're headed with virtual nursing support, being on that cutting edge. It is so exciting to see the care that we're providing for our patients.

[C]

Those numbers translate into hundreds of people who are now going home where in the past, given the severity of their illness, they would have succumbed. And so I cannot congratulate you enough. I get to spend a lot of time in hospitals, and the outcomes that you are driving here really are leading across the country. And I think that's one of the notes I'd like to leave our listeners on, which is when you go through that list of hospital sepsis core elements, one of the last ones, if not the last one, I think, is education. And you obviously have done not only a spectacular job of educating your own teams, but also the entire health systems teams. And as I understand it, the workflows you've developed have been so impressive that they're actually being scaled to other health systems across the country through the EMR platform. Would you touch a little bit on that? Because I heard today about your mission to not only serve patients here, but if there's a way to help share that story and other health systems who want to learn from that and implement some of the tools that you have implemented, you're up for it.

[A]

Yeah, we've developed a lot of tools in collaboration with epic. We've really pushed them to kind of help bring our idea to life. And we're happy to share that information at EPIC conferences, at other medical conferences, and then across, you know, anyone who's using the EPIC system for their ehr. You know, I will add that this wasn't a perfect rollout. You know, we learned as we went to get that type of success requires you to have an idea, roll it out and then take feedback and change it. Understanding how it's working in real time with the people, with the clinicians, with the nurses. This is still a learning process for us. And we're happy that other hospitals are kind of being inspired by some of the work that we're doing, but we're not done yet. There's still a lot more to keep at.

[C]

Improvement is a journey, right? It is not a destination. In your words, you are preoccupied with sepsis. And I'm confident that no matter how good you get, you will always be finding ways to get even better. Teresa, any closing thoughts?

[B]

Just, you know, we believe we have found a recipe for success and how to bring attention and drive change in time sensitive disease states. And we are excited to be replicating this same structure that we have for sepsis with stroke and with STEMI now as we're moving forward as an organization. So I think that Ochsner Health has a lot to share on the horizon.

[C]

That is a perfect place to leave it again, y', all, it is such a privilege to spend the day with you today. If you want to learn more about sepsis, come to New Orleans because these folks here are really leading the way. And thank you so much for your time. We really appreciate it.

[A]

Of course. Thank you.

[B]

Thank you.

[A]

Thanks for listening to Advancing Health. Please subscribe and rate us 5 stars on Apple Podcasts, Spotify or wherever you get your podcasts.