A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes.
Sepsis is an inflammatory response triggered by infection, with risk of in-hospital mortality fueled by disease progression. Early recognition and intervention by multidisciplinary sepsis programs may reverse the inflammatory response among at-risk patient populations, potentially improving outcomes. This retrospective study of a sepsis program enabled by a 2-stage sepsis Clinical Decision Support (CDS) system sought to evaluate the program's impact, identify early indicators that may influence outcomes, and uncover opportunities for quality improvement. Data encompassed 16 527 adult hospitalizations from 2014 and 2015. Of 2108 non-intensive care unit patients screened-in by sepsis CDS, 97% patients were stratified by 177 providers. Risk of adverse outcome improved 30% from baseline to year end, with gains materializing and stabilizing at month 7 after sepsis program go-live. Early indicators likely to influence outcomes include patient age, recent hospitalization, electrolyte abnormalities, hypovolemic shock, hypoxemia, patient location when sepsis CDS activated, and specific alert patterns.
Cerner Corporation, Kansas City, MO Bamland@cerner.com.
Robert C
RC
Amland
Unity Hospital, Rochester, NY.
James M
JM
Haley
Unity Hospital, Rochester, NY.
Jason J
JJ
Lyons
D000368:Aged; D000369:Aged, 80 and over; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D015397:Program Evaluation; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
2-stage sepsis clinical decision support (CDS); early recognition of sepsis; multidisciplinary sepsis program; sepsis quality improvement and patient safety