TTSH Initiative Improves Early Detection and Treatment of Sepsis

A team of doctors and nurses at Tan Tock Seng Hospital (TTSH) in Singapore has created a program that helps patients get treated for a dangerous illness called sepsis much faster than before. The program, called Safe from Sepsis, trains nurses to spot warning signs early and get patients the medicine they need quickly. It has already helped hundreds of patients across the hospital, and leaders hope to spread it to more hospitals across Singapore.

Sepsis is a very serious condition that happens when the body overreacts to an infection. When this happens, chemicals the body releases to fight germs can accidentally harm the body itself, slowing down blood flow to important organs. If it is not treated quickly, sepsis can cause organ failure or even death. Around the world, there were about 166 million cases of sepsis in 2021, and more than 21 million people died from it that year, according to a study in the medical journal The Lancet Global Health.

Getting antibiotics — medicines that fight bacterial infections — to patients quickly is one of the most important steps in treating sepsis. Before Safe from Sepsis began, it took an average of 220 minutes, or nearly four hours, for sepsis patients at TTSH to receive antibiotics. Only 37 percent of patients got their medicine within 180 minutes, which is the time window that gives patients the best chance of survival.

The Safe from Sepsis team set a goal for at least 80 percent of patients to receive antibiotics within that 180-minute window. The program was led by nurses, who play a big role because they spend the most time with patients and are often the first to notice small changes in a patient's condition. Dr. Huang Wenhui, the medical lead for the project, said nurses are 'more in tune with the patients' and can pick up on early warning signs.

To help nurses act fast, the program introduced a special checklist tool. Nurses use the tool to look for early signs of sepsis, such as fever, trouble breathing, or confusion. If a nurse suspects a patient has sepsis, she or he quickly reports it to a doctor so the patient can get a medical check, a blood test, and antibiotics — all within 180 minutes.

The program started as a one-year pilot in September 2024, and it proved to be a success. By September 2025, it was expanded to 62 wards across TTSH and several nearby care centers, including the National Centre for Infectious Diseases and Ren Ci Community Hospital. Senior nurse manager Caren Mok, the nursing lead for Safe from Sepsis, helped guide the expansion.

Over nine months, the program tracked 1,395 sepsis cases, and three out of four patients — 75 percent — received antibiotics within 180 minutes. That was much better than the 37 percent rate before the program started. The average time from spotting a fever to giving antibiotics dropped by 76 minutes, falling from 220 minutes down to just 114 minutes.

More than 1,700 nurses were trained under the program, including senior staff nurse Fan Shuwan. At first, some nurses worried the new steps would add more work to their already busy days. But Fan said catching sepsis early actually makes things easier in the long run, because it is much harder to care for a patient who has gotten very sick. Fan also serves as a 'nurse champion,' encouraging her coworkers to follow the program's steps.

Dr. Huang also pointed out that treating sepsis early is becoming more important as Singapore's population gets older. Older patients often have more health problems at once, which can make sepsis more likely and more dangerous. He noted that hospital data showed doctors were still prescribing antibiotics in the right cases, easing worries about overuse.

Safe from Sepsis has also earned praise beyond Singapore, winning a Gold Award for Clinical Effectiveness Improvement at the Hospital Management Asia Awards in Bangkok. That event honors the best in healthcare across the region each year. In the future, TTSH hopes to bring the program to other hospitals in Singapore's NHG Health public healthcare cluster and eventually even further.