Sepsis Awareness Month: Meet the Physicians at the Forefront of Nova Scotia Health’s Emergency Department Sepsis Improvement Package

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For Doctors Vanessa Sweet and Valerie Ross implementing the Sepsis Improvement Package is about more than following protocols – it’s about breaking down barriers to deliver better care.

“The main goal of this improvement package is to make it easier for healthcare providers to do the right thing,” said Sweet, an anesthesiologist and sepsis co-lead for Nova Scotia Health’s Central Zone. “With the right tools and processes in place, it removes barriers and supports them in delivering the care they know patients need.”

Sepsis is a leading driver of mortality in hospitals and has long been a challenge for Nova Scotia Health. Recognizing this, Sweet and Ross, along with other physician colleagues, healthcare providers, and quality improvement team members started work on system-wide improvement and a clinical area in urgent need of focus: the identification and treatment of sepsis.

“One of the areas where we had been consistently falling short within Nova Scotia Health was on sepsis,” Sweet said. “It shows up in our hospital mortality, in quality reviews, and in a variety of different places. Sepsis is everyone’s problem. It permeates across services and networks, which makes it tough to tackle, but also vital.”

The cornerstone of the new improvement package is timeliness and ensuring patients receive antibiotics within three hours of arriving in the emergency department. “Even if we can’t prevent everyone’s sepsis from progressing, if we catch it early enough, we can limit the severity of it,” Sweet noted. “That means fewer ICU admissions, shorter lengths of stay, and ultimately, fewer deaths.”

Ross is an emergency department physician and head of emergency medicine at the Cobequid Community Health Centre in Lower Sackville. She underscored the complexity of sepsis and the importance of early action. “Anybody can present with a fever, but it’s often the constellation of symptoms—rapid heart rate, low blood pressure, the patient’s age—that signal something critical,” she explained. “We knew that at times we might over-treat somebody, but the purpose was not to miss anyone. That’s where the treatment of antibiotics can make all the difference.”

One of the most significant changes is empowering nurses and paramedics to initiate treatment before a physician assessment. Ross said that shift required trust and teamwork. “We worked very closely with nurses to make them aware of the criteria. My part was ensuring physicians were on board with the rationale and why empowering nurses to start treatment mattered,” she said.

While some staff were initially hesitant, the data quickly began to change their minds. “There will always be people who are resistant to change,” Ross acknowledged. “But the data from our project showed real improvement.”

Sweet agreed that empowering frontline staff has been central to the project’s success. “It’s really empowering for our nurses and, in some cases, other healthcare providers to be able to work to their full scope of practice. It lets us make the best use of the resources we have.”

Both physicians are clear: for the improvement package to succeed long-term, it must become part of the culture, just as protocols for stroke or heart attack are now ingrained in emergency practice. “We don’t think twice about giving clot-busting drugs for stroke or opening up arteries for heart attack,” Ross said. “That’s where we want to get with sepsis—where it’s automatic, part of the algorithm, starting right at triage.”

Sweet emphasized that the project’s success depends on teamwork. “It would be impossible to overstate the importance of engagement from frontline staff,” she said. “This wasn’t about swooping in and telling people what to do. It was about co-designing solutions with the healthcare providers who care for patients every day and helping remove the barriers they identified.”

As Nova Scotia Health rolls out the Sepsis Improvement Package province-wide, both Sweet and Ross see it as a turning point, not only in sepsis care, but in how the system tackles improvement more broadly. “By working on sepsis, we’ve made meaningful progress in patient outcomes,” said Sweet. “But we’ve also shown how we can scale and spread improvement across the organization.”

For Ross, the lesson is equally clear. “This project showed us that frontline collaboration, trust, and data-driven results can transform care,” she said. “At the end of the day, it’s about making sure no patient gets missed.”

September is Sepsis Awareness Month, and Sept. 13 is World Sepsis Day.  

Nova Scotia Health has made sepsis care a top priority, with a strong commitment to early detection and timely treatment.