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Seminar led by Rui Moreno, MD, PhD, from the Hospital de Santo António dos Capuchos Unidad de Cuidados Intensivos Polivalente Centro Hospitalar de Lisboa Central- Portugal.
Abstract: The impact of SSC 2012 on the planning and evaluation of my hospital's performance Â The 2012 revision of the Surviving Sepsis Guidelines, together with the new sepsis bundles, will, have a profound impact on the evaluation of the performance of health care systems dealing with the recognition and early treatment of the patient with severe sepsis and septic shock. Â With the application and evaluation of the new bundles (now at 3 hours and 6 hours after triage), most of the evaluation will focus in the very early stages of the process of care, when in a significant number of patients will be still in the Emergency Department (ED). This constitutes a major change when compared to the 2008 revision of the SSC, since at that time part of the evaluation was done after 24 hours of diagnosis, when most of the patients was already on the ICU. Â An immediate consequence of this will be a major pressure on the ED and in the early connection of the ED with the ICU. This will can be done by creating dedicated admission pathways to patients with suspected severe sepsis and septic shock, to the presence of intensivists on the ED or even to the direct admission (by-passing the ED) to the ICU of theses patients. More than focusing in new therapies, the 2012 revision of the SSC will put the emphasis on the planning and creation of systems able to work fast and flexibly, delivering fast care where it is needed more.Â Only systems of care able to control and deal with these timing problems will be in condition to offer first quality care to the patient with severe sepsis and septic shock and consequently to have a good evaluation of their performance.