According to CHA, 80,000 children are hospitalized annually for sepsis with 5,000 deaths. Sepsis can be difficult to diagnose, and management requires high levels of coordination. A team of ED RNs along with strong MD support including Dr. Fortenberry as the executive champion and Dr. Iyer as the MD leader joined the Children's Hospital Association Sepsis Collaborative. Rebekah Carter, ED Quality ARN led the team with ED nursing and physician leadership and frontline nurses and created an IPSO (Improving Patient Sepsis Outcomes) Guiding Team to include Quality Improvement Specialist Hannah Thummel, and members of data analytics, clinical informatics, quality and EPIC teams. The guiding team met monthly and developed a comprehensive plan to improve the care of patients with suspected sepsis. The guiding team started with the development of sepsis huddles. They used high-fidelity simulation to test their theory of how to accomplish these huddles in a high volume, high acuity emergency department. They also used weekly guiding team meetings led by Rebekah to monitor and guide changes to the process. The huddle process was led by boots on the ground using our frontline nurses on the team to educate, support, and monitor the sepsis huddles in the department. This approach resulted in exceptional buy-ins from our staff and providers. Huddle compliance has remained above 90% each month, with some reaching 100% compliance. The primary goals were to maintain huddle reliability, maintain IPSO-defined targets for time to bolus and time to IV antibiotic with 3 key outcomes: Increasing % of patients with huddles when flagged by trigger tool Reducing time to first fluid bolus Reducing time to first IV Abx Studies show prompt administration of a fluid bolus along with IV antibiotics reduces patient morbidity. Pre-IPSO sepsis huddles: Time to Antibiotics: 97 mins; Time to Fluid Bolus: 53 mins post-IPSO sepsis huddles: Time to Antibiotics: 79 mins; Time to Fluid Bolus: 38 mins Targets = 80 and 45 The theory was that improved time to treatment would cause a reduction in mortality rates. Of patients recognized to be septic while in the ED, Sepsis-Attributable Mortality Rates decreased from 5.4% to 3.3% since the initiation of IPSO huddles. Of patients recognized to be septic >72hrs after admission, Mortality Rates decreased from 17.9% to 8.6% since joining IPSO initiative. These efforts of this multidisciplinary team were recognized by CHA as best practice and they were asked to present their efforts during the CHA Quality conference and they also presented their work at an Improvement in Action rounds for Children's to share their successful approach with other clinical teams. This team is very worthy of being recognized for the evidence-based work and improved outcomes of this fragile population. The inpatient units are also utilizing this process as the efforts have been so successful. This is such a strong reflection of our Children's values: Care about People, Passionate about Kids, Dedicated to Better, and Committed to Self.