In establishing a sepsis quality initiative, the first step is to confront reality and realize that the institution has a problem in how it processes septic patients from the ED to the ICU. Lundberg et al5 reminds us that it is problematic even at academic institutions. Once this reality is accepted, the following steps include: (1) creating early detection or screening for high-risk patients; (2) organizing and mobilizing resources to provide care once the patient is identified, whether ED or ICU; (3) providing a seamless and organized continuum of care from the ED to the ICU; (4) providing education of all involved personnel; and (5) feedback, quality assurance, assessing outcomes, and cost-effective analysis. This is the essence of what Trzeciak et al1 did in their study. They began with establishing a relationship with two departmental interfaces, the ED and the ICU. This ED-ICU relationship was initially recognized and recently solidified by the Surviving Sepsis Campaign.11 This relationship was essential for improving outcomes for acute myocardial infarction, stroke, and trauma, so it must not be overlooked in the care of the septic patient. All of these aforementioned diseases required similar implementation models to realize improved outcomes.