The Infectious Diseases Society of America (IDSA), American College of Emergency Physicians (ACEP), American Society for Microbiology (ASM), Pediatric Infectious Diseases Society (PIDS), Society of Critical Care Medicine (SCCM), Society for Healthcare Epidemiology of America (SHEA), Society of Hospital Medicine (SHM), and the Society of Infectious Diseases Pharmacists (SIDP) just released the position paper Hospital Strategies to Improve Sepsis Outcomes. 

The recommendations in the position paper cover six key areas: diagnostic testing and pathogen detection, antimicrobial management and delivery, surveillance and performance metrics, adjunctive therapy, program infrastructure and organizational support, and infection prevention.

Today we’re showcasing those recommendations. View the full-text version of the IDSA/ACEP/ASM/PIDS/SCCM/SHEA/SHM/SIDP guidance on hospital strategies to improve sepsis outcomes for the complete overview of the following recommendations and their associated rationale.

Recommendations from the 2026 Hospital Strategies to Improve Sepsis Outcomes Position Paper

Diagnostic Testing and Pathogen Detection

  • Implement multiplex nucleic acid amplification tests (NAATs) for positive blood cultures, paired with active antimicrobial stewardship program support to ensure timely interpretation, treatment optimization, and follow-up.
  • Use clinical decision support strategies to optimize blood culture ordering practices, including appropriate indications for initial and follow-up cultures. 

Antimicrobial Management and Delivery

  • Implement hospital workflows and performance monitoring to optimize time from recognition of septic shock to first antibiotic administration, with a target of <1 hour.
  • Monitor and minimize time from antibiotic order to infusion start in patients with septic shock, with a pragmatic target of <30 minutes.
  • Establish institutional policies that default antipseudomonal β-lactam antibiotics to prolonged infusion, after an initial loading dose, when these agents are ordered for critically ill patients with sepsis.
  • Implement clinical decision support and multidisciplinary education to prioritize β-lactam administration before vancomycin when both agents are ordered in patients with suspected sepsis. 
  • Implement standardized workflows and clinical decision support to ensure timely administration of second antibiotic doses with frequent dosing intervals in patients with suspected sepsis.
  • Develop protocols and clinical decision support to guide antibiotic selection for patients who report penicillin or other β-lactam allergies.
  • Implement EHR-based clinical decision support tools that provide infection site-specific MDRO risk estimates to guide empiric antibiotic selection in suspected sepsis.

Surveillance and Performance Metrics

  • Adopt the CDC adult sepsis event definition to monitor sepsis incidence, outcomes, and care processes, stratified by community-onset and hospital-onset sepsis.
  • Monitor both inadequate and unnecessarily broad empiric antibiotic therapy in patients with suspected sepsis, using automated methods where feasible.
  • Measure de-escalation of anti-MRSA and antipseudomonal therapy among patients with suspected sepsis.
  • Monitor time from sepsis onset to definitive source control in patients requiring procedural intervention, and track timeliness of transfers when on-site source control is unavailable.

Adjunctive Therapy

  • Implement protocols and clinical decision support to promote timely corticosteroid use for appropriately selected patients with severe community-acquired pneumonia.
  • Implement protocols and clinical decision support to promote corticosteroid use for patients with refractory septic shock.

Program Infrastructure and Organizational Support

  • Establish a multidisciplinary sepsis governance structure that includes infectious diseases, antimicrobial stewardship, and clinical microbiology expertise and engages infection-prevention teams through structured collaboration.
  • Integrate antimicrobial stewardship participation into routine ICU rounds to support real-time optimization of antibiotic therapy in critically ill patients.
  • Support the application of pharmacokinetic/pharmacodynamic (PK/PD) principles in antimicrobial dosing for critically ill patients, including access to infectious diseases and critical care pharmacists, clinician and nursing education, and laboratory capacity for therapeutic drug monitoring where appropriate.

Infection Prevention Considerations

  • Implement universal chlorhexidine gluconate bathing and either universal or targeted MRSA nasal decolonization for all ICU patients and for non-ICU patients with invasive devices.
  • Implement structured programs to ensure daily toothbrushing for all hospitalized patients.

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