Sentara Norfolk General Emergency Department

Norfolk, Virginia

Sepsis Bundle Compliance and mortality rate have been a focus for the Sentara Norfolk General Emergency Department. The

ED staff developed a team to focus on early identification in triage, EMR notification enhancements, and robust training for caring for sepsis patients. Utilizing a sepsis screening tool during triage and developing a sepsis alert evaluation process with providers allowed patients to start receiving treatment as close to arrival as possible. The team was able to initiate labs, fluid resuscitation, and antibiotic administration for those patients who met criteria. With this process, the mortality rate dropped from 14.4 percent in 2022 to 13 percent in 2023. With continued improvements, the rate has since dropped to 12.7 percent by 2024.

Patient flow continues to be an opportunity for all EDs, and Sentara’s was no exception. The ED has implemented an assessed waiting room model for ESI 2 patients awaiting acute care. Using this provider in triage model, door-to-MD times and left without being seen rates declined, and patient experience and nurse satisfaction improved. The LWBS dropped from 10 percent to 2.3 percent since implementation. In 2024 the median length of stay was 219 minutes, which is 17 minutes shorter than 2023.