Hallie Prescott’s research on sepsis identification and management informs health care policy and practice at the local, state, national and international levels.
Sepsis is a life-threatening condition that requires rapid, multidisciplinary coordination to treat and manage.
Most infections are easy to treat when caught early and properly managed. However, a person’s immune system can sometimes overreact, or fail to control infection. This impaired immune response, known as sepsis, can cause widespread inflammation, tissue and vascular damage, organ failure, and even death. Sepsis is the leading cause of hospitalization in the United States, sending about 1.7 million adults and 70,000 children to the hospital each year, and resulting in over 350,000 deaths annually.
Hallie Prescott, M.D., M.Sc., associate professor of internal medicine at Michigan Medicine, works to improve sepsis identification, management, and outcomes. As physician lead of the Michigan-based Hospital Medicine Safety Sepsis Initiative and an advisor to the Veterans Health Administration (VHA), she examines sepsis care in hospitals across the U.S. She also actively engages with local, state, national, and international stakeholders to inform sepsis care guidelines and policy. In recognition of her many contributions and impacts, Prescott was named a 2025 recipient of the U-M Institute for Healthcare Policy & Innovation’s Policy Impact Award.
Sepsis: Timing is everything
There is no “gold standard” test for identifying sepsis, and hospitals can vary in how they assess and treat this critical condition. This lack of standardization may lead to an increased risk of mortality depending on where a patient receives care.
Sepsis is challenging to identify and treat because infections can originate in many parts of the body, be either bacterial, fungal, parasitic, or viral, and cause different organs to malfunction or fail. Sometimes, sepsis goes unrecognized until it becomes severe. Prescott’s research shows 45% of sepsis patients see a clinician in the week before hospitalization, and 10% are seen in clinic within one day of hospital admission, suggesting potential opportunities for earlier identification.
Bacterial sepsis is the most common form of the condition, and antibiotics are key to treating it. Prescott’s work has shown that administering antibiotics earlier in treatment improves patients’ chances of survival, especially for those in septic shock or who have a compromised immune system, such as those with cancer. However, because of the difficulty in diagnosing sepsis early in presentation, consensus on the optimal timing of antibiotics continues to evolve. Earlier treatment results in better outcomes, but some have cautioned that it may lead to less responsible antibiotic use.
Crucially, Prescott’s work has shown that both timely treatment and appropriate antibiotic use can improve simultaneously. Early antibiotic use is not automatically associated with overuse or unnecessary antibiotic use overall, and a shorter course is as effective as a longer course at treating many infections. Her work has revealed a potential connection between disruptions to the gut microbiome and sepsis, highlighting the need for prudent antibiotic utilization.
In addition to antibiotics, IV fluids and vasopressors, a medication used to raise blood pressure, are vital to treating septic patients. Despite their importance, Prescott found many Michigan hospitals lack guidance on at least one of these treatments.
Standardizing treatment protocols can improve patients’ survival and return to good health. However, Prescott’s research shows approximately 10% of U.S. hospitals have no standardized processes for managing sepsis.
Meanwhile, surviving sepsis is often only the first step in a difficult recovery. Among those who live for 30 days after a sepsis hospitalization, 40% die within two years of discharge. Many adult survivors of severe sepsis are rehospitalized within a year following initial hospitalization, and only 1 in 5 survive the entire year. Prescott found children with severe sepsis also face similar challenges—1 in 6 pediatric survivors are rehospitalized within 30 days, and over 60% of them require more medical care in the year following hospitalization than in the year prior.
Her research shows that among adults, readmissions are most often caused by recurrent sepsis, congestive heart failure, renal failure, or pneumonia. Older age, greater illness severity, and recent nursing facility care use further increase the risk of rehospitalization.
Tracking sepsis cases can help hospitals evaluate how well they identify and treat this life-threatening condition. Prescott assessed various methods for recognizing sepsis hospitalizations, finding that reviewing a patient’s historical lab results from prior visits, when available, is an effective way to track organ function and identify sepsis. This may help clinicians better detect septic patients, as well as allow hospitals to more accurately evaluate cases over time.
Her work also highlights potential strategies for supporting patients’ post-hospital recovery. Pre-discharge blood testing may help identify patients at an increased risk of rehospitalization, and hospital assistance in guiding patients back to primary care through timely, coordinated handoffs can ensure patients receive the care necessary to avoid further health complications.
Policy engagement and sustained impact
Prescott uses her expertise as both a researcher and clinician to inform sepsis practice and policy at the local, state, national, and international levels.
Prescott currently leads the Michigan-based Hospital Medicine Safety Sepsis Initiative (HMS-Sepsis), launched in 2021 with support from Blue Cross Blue Shield of Michigan (BCBSM). The program brings together 69 hospitals in Michigan to develop guidelines for improving sepsis outcomes statewide. In this role, Prescott analyzes sepsis practices across participating hospitals, which has led to several vital insights, including the development of a new model to better predict sepsis mortality.
As an advisor to the VHA’s Inpatient Evaluation Center, a role she has held since 2015, Prescott has conducted vital research relevant to all health systems, including assessing the CDC Adult Sepsis Event measure for tracking sepsis hospitalizations. She also helps the VHA track both sepsis readmissions and hospital effectiveness, among other quality improvement efforts.
Since 2022, Prescott has served as a subject matter expert to the Centers for Disease Control and Prevention (CDC), where she has helped assess the state of U.S. hospital sepsis programs and develop the CDC’s Hospital Sepsis Program Core Elements, a guide for creating effective, multidisciplinary hospital sepsis programs. She has also worked to promote the Core Elements, including by participating in an American Medical Association webinar series which physicians can watch for Continuing Medical Education credit. She is currently tracking uptake across the country.
In addition, Prescott serves on the Centers for Medicare & Medicaid Services (CMS) technical expert panel focused on developing a new sepsis outcome measure. To support this effort, she has led an examination of various methods to benchmark sepsis outcomes in real-time.
Her work with HMS-Sepsis has also garnered attention at the national level. In 2023, she was invited to present at the National Forum on Sepsis, and, in 2024, the Agency for Healthcare Research and Quality (AHRQ) highlighted the initiative in a report to Congress. As a result of the AHRQ report, she was invited to join a White House Roundtable on Sepsis later that year.
At the international level, Prescott has contributed to the development of the Surviving Sepsis Campaign (SSC) Guidelines since 2018. The SSC is the definitive international guide for clinical sepsis management and is sponsored by experts from across the Americas, Middle East, Asia, Africa, and Oceania. She previously served as Vice Chair, Convener of the Patient and Public Advisory Panel, and is currently co-chair of the SSC Adult Guidelines. Prescott contributed to the development of the 2021 SSC Adult Guidelines, which include a risk-based approach to antibiotic timing, and provided crucial guidance on treating sepsis during the COVID-19 pandemic. She has also contributed to international sepsis management guidance for resource-limited settings.
Prescott’s work has been cited in numerous policy documents around the world, including those published by the European Union, Pan American Health Organization, World Health Organization, and over 20 foreign governments. In the U.S., her research has been referenced by the Assistant Secretary for Planning and Evaluation, CDC, CMS, Department of Health and Human Services, Department of Homeland Security, the National Academy of Medicine, and the U.S. House of Representatives, among others.
Throughout her work at every level, Prescott remains committed to centering the patient experience in sepsis care. The 2021 SSC Adult Guidelines and the CDC Hospital Sepsis Core Elements both highlight the importance of elevating the voices of patients and their families in care planning. She also partners with organizations committed to advocating for patients and improving public understanding of sepsis, including the Sepsis Alliance and END SEPSIS.
Future research
Prescott’s future research will focus on the management of viral sepsis to address misconceptions and potential discrepancies between treatment for viral and bacterial forms of the condition. She is also currently working on the 2026 SSC Adult Guidelines.
More information about Hallie Prescott’s work can be found on her IHPI Profile and in Michigan Experts.