This measure will be calculated with 2 performance rates: 1. Percentage of patients aged ≥ 18 years visiting the emergency department with sepsis or septic shock resulting in hospital admission or transfers and who had an order for all the following: a serum lactate level, antibiotics, and >= 1 L of crystalloids. 2. Percentage of patients aged ≥ 18 years visiting the emergency department with septic shock resulting in hospital admission or transfers who had an initial and repeat lactate performed, where the first serum lactate result (>2mmol/L) is elevated and a lactate clearance rate of >= 10% achieved during the emergency department visit.