The last thing Tammy Sullivan remembers was lying in her hospital bed, staring blankly at the call bell in her room at WellSpan Good Samaritan Hospital. A nurse for 29 years, Sullivan is very familiar with a call bell. Her mind simply could not figure out how to use it.
At that moment, Sullivan's heart rate was spiking. Her temperature was high. Her white blood cell count was high too. She was experiencing severe sepsis, a life-threatening infection in her body, losing her ability to think clearly and about to lose consciousness.
Fortunately, WellSpan's Central Alert Team was virtually monitoring her condition on that February night in 2019.
The team, a group of nurses with critical care and emergency department experience, are on duty 24/7 from a remote "bunker," to support the work of bedside teams in hospitals. The team monitors a patient’s electronic health record for dangerous changes in vital signs and lab tests that may signal an onset of sepsis. The team quickly notifies a patient's bedside caregivers, so they can determine if the patient may be septic or clinically unstable, and consider administering life-saving drugs, fluids and other interventions.
WellSpan's innovative Sepsis Central Alert Team program has received national recognition, including the prestigious 2019 John M. Eisenberg Patient Safety and Quality Award from The Joint Commission and the National Quality Forum. The award recognizes the innovation in safety and quality exhibited by the team, which brings together the expertise of experienced nurses and real-time data from a patient's electronic health record.
Since its inception, the program is estimated to have saved about 350 people who have been diagnosed with sepsis.
Count Sullivan among them.
Just before she passed out, Sullivan remembers a nurse running into her room and yelling her name. When she woke up, a team of clinicians was swarming her bed, taking care of her.
"If I wasn’t being monitored, no one would have found me," Sullivan said, noting that shortly before she passed out, she told her nurse that she was tired and going to sleep, asking her to close her door. "I don't even want to think about what would have happened to me."
Angela Mays a nurse with 20 years of experience, was the Central Alert Team nurse on duty the night that Sullivan's vital signs triggered an alert.
"She was very sick," Mays said. "She had an infection inside her abdominal cavity. It could have been lethal."
The Central Alert Team monitors patients who are at highest risk for sepsis, based on an algorithm developed by WellSpan expert clinicians. The team typically responds to alerts on 50 to 80 patients every day in the WellSpan system, at five hospitals across southcentral Pennsylvania. During cold and flu season, the team can receive more than 100 patient alerts a day.
During the coronavirus pandemic, their work has been particularly important because patients have had to be placed in isolation.
"The Central Alert Team is here to support the bedside clinicians. These nurses are an extra, critical set of eyes on a patient, monitoring their test results, vital signs and other signals," said Jodi Cichetti, senior director of quality and accreditation at WellSpan Health. "Timing is critically important in sepsis identification and intervention, and this monitoring model has provided positive and rewarding results."
There is an art to the science in the Central Alert Team, which marries the nurses' experience with real-time data.
"We look at the big picture and the trends and the notes that are being written by the bedside team, looking for those small nuances that gives us the gut feeling: this one is sick, something is not right here and I'm going to intervene on their behalf," Mays said. "It's our job to be that safety net."
Tammy Sullivan is very grateful for their work.
Sullivan, case management manager at WellSpan Good Samaritan Hospital, started feeling ill on her 48th birthday. At first, she thought her belly hurt because she had eaten too much birthday cake, which is her favorite dessert.
Her 49th birthday was a special one, she said, marked by a family dinner and a beautiful snowfall. She and her 13-year-old daughter, Julie, baked her favorite chocolate cake for dessert. Sullivan had a big piece.
"It was definitely on my mind that I almost did not see another birthday," she said. "How grateful I am to all of those people who saved my life. It’s a surreal feeling."