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HD 2021

An Act relative to establishing protocols for the early detection and treatment of patients with sepsis

194th Legislature (2025-2026) Introduced by Chris Flanagan

Massachusetts facilities must implement standardized, protocol-driven sepsis screening and treatment, with nurse-initiated care and ongoing quality monitoring.

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Bill Summary · HD 2021

Summary: An Act relative to establishing protocols for the early detection and treatment of patients with sepsis (HD 2021)

Purpose and intent

This bill aims to standardize and improve the early detection and treatment of sepsis, severe sepsis, and septic shock in facilities licensed in Massachusetts. It directs the Department of Public Health (DPH) to develop and disseminate best-practice guidelines and requires facilities to implement structured sepsis protocols across evaluation, treatment, and hand-offs.

Key definitions

  • Sepsis: known or suspected infection with at least 2 or more SIRS criteria.
  • Severe sepsis: infection with at least 2+ SIRS criteria plus tissue hypoperfusion or organ dysfunction.
  • Septic shock: sepsis-induced hypotension despite adequate IV fluid resuscitation or evidence of tissue hypoperfusion.
  • SIRS criteria: as defined by the American College of Chest Physicians/S Society of Critical Care Medicine.

Major provisions

  • Guidance and best practices (Section 1(a)-(c))

    • DPH must provide facilities with best-practice information for sepsis care, including:
    • An evidence-based screening tool for initial evaluation (adult and pediatric).
    • An evidence-based, time-specific treatment protocol for both adults and children.
    • Nurse-driven testing protocols enabling nurses to initiate care for suspected sepsis.
    • Incorporation of sepsis tools into electronic health records (where possible).
    • Mechanisms to escalate care and, if needed, transfer to higher-level facilities.
    • Clear hand-offs and regular reassessment procedures.
    • Hospital-specific antibiotic guidelines with a process to reevaluate and de-escalate antibiotics based on culture results.
    • Staff education on sepsis policies during onboarding and at least annually, plus updates when guidelines change.

  • Quality and monitoring (Section 1(c))

    • Each licensed facility must form a multi-disciplinary committee to implement policies, educate staff, and oversee quality measures related to recognition and treatment of severe sepsis.
    • Facilities must collect and report data to assess adherence to their sepsis protocols, including timing targets and all protocol components for adults and children.

Implementation timeline and effective dates

  • Regulations: DPH must promulgate regulations by September 1, 2025, implementing the guidelines described in Section 25Q of Chapter 111.
  • Effective date: The act would take effect on October 1, 2025.
  • Status notes: The bill is a proposed act introduced in the 2025-2026 session (House Docket No. 2021) and is being advanced through the Public Health committee process.

Affected entities

  • Hospitals and other facilities licensed under Chapter 111 of the General Laws.
  • Health care professionals and administrators responsible for sepsis care, quality improvement, and compliance with hospital protocols.

Potential impact

  • Standardization of sepsis screening and treatment across MA facilities.
  • Enhanced nurse autonomy in initiating sepsis care.
  • Improved antibiotic stewardship through protocol-driven de-escalation.
  • Increased data collection on adherence and patient outcomes to drive quality improvement.

Compiled from official sources — confirm details with the bill’s official record.

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