99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB1862

 

Introduced 2/20/2015, by Sen. Chapin Rose

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 2310/2310-314 new
210 ILCS 85/6.23a new

    Amends the Hospital Licensing Act. Requires hospitals to adopt, implement, periodically update, and submit to the Department of Public Health evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis, or septic shock that are based on generally accepted standards of care. Requires the protocols to contain certain components, including components specific to the identification, care, and treatment of adults and of children. Requires hospitals to submit the protocols to the Department no later than 6 months after the effective date of the amendatory Act. Provides that protocols shall be resubmitted at the request of the Department, but not more frequently than once every 2 years unless the Department identifies hospital-specific performance concerns. Requires hospitals to report certain sepsis-related data to the Department. Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department to publish guidelines to assist hospitals in developing the sepsis protocols. Contains provisions concerning rulemaking.


LRB099 09958 RPS 30177 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB1862LRB099 09958 RPS 30177 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Department of Public Health Powers and
5Duties Law of the Civil Administrative Code of Illinois is
6amended by adding Section 2310-314 as follows:
 
7    (20 ILCS 2310/2310-314 new)
8    Sec. 2310-314. Sepsis screening protocols.
9    (a) The Department shall publish guidelines to assist
10hospitals in developing the sepsis protocols required in
11Section 6.23a of the Hospital Licensing Act. The guidelines
12published by the Department shall include, but not be limited
13to, an appropriate process for screening all patients to ensure
14early recognition of patients with possible sepsis and, once
15possible sepsis has been documented, establishing clear
16timeframes for the administration of antibiotics and full
17protocol implementation.
18    (b) The Department shall adopt rules to implement Section
196.23a of the Hospital Licensing Act.
 
20    Section 10. The Hospital Licensing Act is amended by adding
21Section 6.23a as follows:
 

 

 

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1    (210 ILCS 85/6.23a new)
2    Sec. 6.23a. Sepsis screening protocols.
3    (a) As used in this Section:
4    "Sepsis" means a proven or suspected infection accompanied
5by a systemic inflammatory response.
6    "Septic shock" means severe sepsis with persistent
7hypotension or cardiovascular organ dysfunction despite
8adequate intravenous fluid resuscitation.
9    "Severe sepsis" means sepsis plus at least one sign of
10hypoperfusion or organ dysfunction.
11    (b) Each hospital shall adopt, implement, periodically
12update, and submit to the Department evidence-based protocols
13for the early recognition and treatment of patients with
14sepsis, severe sepsis, or septic shock (sepsis protocols) that
15are based on generally accepted standards of care. Sepsis
16protocols must include components specific to the
17identification, care, and treatment of adults and of children,
18and must clearly identify where and when components will differ
19for adults and for children. These protocols must also include
20the following components:
21        (1) a process for the screening and early recognition
22    of patients with sepsis, severe sepsis, or septic shock;
23        (2) a process to identify and document individuals
24    appropriate for treatment through sepsis protocols,
25    including explicit criteria defining those patients who
26    should be excluded from the protocols, such as patients

 

 

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1    with certain clinical conditions or who have elected
2    palliative care;
3        (3) guidelines for hemodynamic support with explicit
4    physiologic and biomarker treatment goals, methodology for
5    invasive or non-invasive hemodynamic monitoring, and
6    timeframe goals;
7        (4) for infants and children, guidelines for fluid
8    resuscitation with explicit timeframes for vascular access
9    and fluid delivery consistent with current, evidence-based
10    guidelines for severe sepsis and septic shock with defined
11    therapeutic goals for children;
12        (5) a procedure for identification of the infectious
13    source and delivery of early antibiotics with timeframe
14    goals; and
15        (6) criteria for use, where appropriate, of an invasive
16    protocol and for use of vasoactive agents.
17    (c) Each hospital shall ensure that professional staff with
18direct patient care responsibilities and, as appropriate,
19staff with indirect patient care responsibilities, including,
20but not limited to, laboratory and pharmacy staff, are
21periodically trained to implement the sepsis protocols
22required under subsection (b). The hospital shall ensure
23updated training of staff if the hospital initiates substantive
24changes to the sepsis protocols.
25    (d) Each hospital shall submit the sepsis protocols
26required under subsection (b) to the Department for review no

 

 

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1later than 6 months after the effective date of this amendatory
2Act of the 99th General Assembly. A hospital must implement
3these protocols no later than 45 days after receipt of a letter
4from the Department indicating that the proposed protocols have
5been reviewed and determined to be consistent with the criteria
6established in this Section. A hospital must update protocols
7based on newly emerging evidence-based standards. Protocols
8shall be resubmitted at the request of the Department, but not
9more frequently than once every 2 years unless the Department
10identifies hospital-specific performance concerns.
11    (e) Each hospital shall be responsible for the collection,
12use, and reporting of quality measures related to the
13recognition and treatment of severe sepsis for purposes of
14internal quality improvement and reporting to the Department.
15These measures shall include, but not be limited to, data
16sufficient to evaluate each hospital's adherence rate to its
17own sepsis protocols, including adherence to timeframes and
18implementation of all sepsis protocol components for adults and
19children.
20    Each hospital shall submit data specified by the Department
21to permit the Department to develop risk-adjusted sepsis
22mortality rates in consultation with appropriate national,
23hospital, and expert stakeholders. This data shall be reported
24annually, or more frequently at the request of the Department,
25and shall be subject to audit at the discretion of the
26Department.