SHM Converge Scientific Abstract ePoster Gallery-Improving Length of Stay: Patients With Septic Shock Upon Admission

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This project aims to reduce the time from emergency department presentation to antibiotic administration for patients with septic shock at Emory Saint Joseph’s Hospital from an average of about 2 hours 22 minutes to 1 hour, in alignment with CMS SEP-1 guidelines. <br /><br />Data from FY2022 showed that 276 septic shock cases present on admission were associated with a high length-of-stay burden and excess care costs of about $1.3 million. Process analysis identified the biggest delays as: time from first provider evaluation to STAT antibiotic ordering (mean 65 minutes, median 36 minutes) and from antibiotic order to administration (mean 52 minutes, median 29 minutes). The gap between mean and median times suggests that outliers may be contributing to delays. <br /><br />Planned interventions focus on improving early recognition of septic shock in triage, increasing ED provider awareness and communication, and improving pharmacy prioritization of STAT antibiotic orders. The team also plans to address process inefficiencies, revise the ED sepsis order set to include STAT antibiotics, strengthen staff training and protocol use, establish an ED sepsis code team, and use existing tools such as the Epic Sepsis Navigator. <br /><br />The project will use descriptive statistics to monitor change, tracking average and median time from septic shock identification to antibiotic administration, and will also assess provider perceptions through surveys. The long-term goal is to improve patient outcomes, satisfaction, and reduce costs by ensuring faster treatment of septic shock.

Asset Subtitle

Mary Ann K. Hall

Meta Tag

Author List Liliana Guevara, Mary Ann K. Hall, Sandeep Bhargava

Category Research

Concept Sepsis

Concept Antibiotic administration

Concept Presentation-to-Antibiotic Time

Concept Treatment Delay

Concept Provider Recognition

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine, Division of Hospital Medicine

Presenting Author Mary Ann K. Hall

Track Quality Improvement

Keywords

septic shock

emergency department

antibiotic administration

CMS SEP-1

Emory Saint Joseph’s Hospital

time to treatment

STAT antibiotics

sepsis order set

Epic Sepsis Navigator

process improvement

Sepsis

Antibiotic administration

Presentation-to-Antibiotic Time

Treatment Delay

Provider Recognition