Article title: A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes
Sepsis is an inflammatory response to infection that’s known to develop in hospital settings and can turn deadly when it’s not discovered early on. In this study, a hospital surveillance program focusing on reducing the risks of sepsis, known as the two-stage Clinical Decision Support (CDS) system, was found to reduce the risk of adverse outcomes, such as death and hospice discharge for sepsis patients, by 30% over the course of one year.
The authors studied data from a hospital that uses the two-stage sepsis CDS system to encourage early detection of sepsis. This alert system utilizes cloud-based technology and is run continuously. If it detects that a patient has indications of sepsis, such as signs of infection, it issues an electronic alert to the patient’s nurse. Of the 16,527 hospitalizations that occurred at the hospital within a year, 1,541 non-intensive care patients activated a CDS alert and were suspected of infection. The researchers attributed the hospital’s advances against sepsis to health providers’ acceptance of the sepsis program, the integration into clinical workflow, and the hospital’s requirements that providers immediately examine patients who activated alerts.
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.
Robert C. Amland, James M. Haley, and Jason J. Lyons
A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes
American Journal of Medical Quality 1062860615606801, first published on October 21, 2015 doi:10.1177/1062860615606801