Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives☆,☆☆,☆☆☆

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PurposeSepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program.Materials and methodsRetrospective review of patients ≥ 18 years treated for sepsis.ResultsThere were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p = 0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p = 0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39–0.99, p = 0.046), mean intensive care unit LOS (2.12 days before, 95%CI 1.97, 2.34; 1.95 days after, 95%CI 1.75, 2.06; p < 0.001), mean overall hospital LOS (11.7 days before, 95% CI 10.9, 12.7 days; 9.9 days after, 95% CI 9.3, 10.6 days, p < 0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p = 0.007), and total charges with a savings of $7159 per sepsis admission (p = 0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p = 0.18).ConclusionA hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.HighlightsEHR-based, sepsis-recognition tool provided hourly, hospital-wide sepsis screening.Adjusted MEWS-SRS score was tailored to screen for sepsis at our institution.Nurse-led Rapid Response Team was instrumental in sepsis care delivery on the wards.Hospital-wide sepsis alert order set was based on a simplified 3 h bundle.Associated reductions in mortality, length of stay, and mechanical ventilation use.

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