This 10-year single-center retrospective cohort showed that the use of PB management of severe sepsis and septic shock was associated with a decreased hospital mortality for patients.

This mortality benefit was preserved over time and through three iterations of the protocol.

Protocolized management of sepsis appears to be advantageous, while a reliance on “usual care” may be detrimental, in our setting.

Finally, unit- or hospital-level interventions can impact the performance of our clinical pathways.

950y adult patients (19 yr old or older) diagnosed with severe sepsis or septic shock, using 2001 consensus definitions, admitted to the ICU from September 2007 to August 2017.

760 patients were in the protocol-based care group versus 190 in the non-protocolized care group.

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