SHM Converge Scientific Abstract ePoster Gallery-Sepsis Squashing Squadron: Expediting Floor Sepsis Recognition and Treatment

Pdf Summary

The poster describes a pilot quality-improvement project called the “Sepsis Squashing Squadron” aimed at improving recognition and treatment of sepsis on general hospital floors. Because early antibiotics and prompt recognition are key to reducing sepsis mortality, the team built on an earlier Epic “sepsis score” alert by creating a multidisciplinary sepsis response process that combined manual chart review with automated electronic health record (EHR) scoring tools and summary displays.<br /><br />In the first pilot, a team member reviewed patients on one unit each morning. Patients with suspected infection and elevated SOFA or SIRS scores were assessed for compliance with SEP-1 bundle elements. If needed, the reviewer contacted the primary team and nursing staff with recommendations and offered extra support to complete tasks. The team also tested optimized combinations of Epic-derived scores to reduce unnecessary manual review.<br /><br />From May 16 to June 2, 2022, 190 patients were screened; 97 had probable or known infection. Only three patients required intervention for SEP-1 nonadherence. Average review time was 2 minutes per patient. Sepsis prevalence depended on the definition used, ranging from 5% with qSOFA to 24% with SOFA. Individual automated scores had limited performance for identifying floor sepsis: jMEWS was more sensitive but less specific, the Epic sepsis score was more specific but poorly sensitive, and the deterioration index was intermediate. A combined threshold using jMEWS, deterioration index, and/or SOFA improved screening performance to 93% sensitivity and 50% specificity.<br /><br />A second pilot in October–November 2022 screened 109 patients, found 11 SIRS-defined cases, and reduced average review time to 1 minute while maintaining 100% bundle adherence. Overall, the project suggests that combined EHR scores may streamline sepsis screening on general floors, but further refinement is needed.

Asset Subtitle

Mark Liotta

Meta Tag

Author List Alan A. Kubey, Alyssa M. Yeager, Chantel Venkataraman, Christopher Haines, James Lee, Joy Burke, Kimberly Berenbaum, Mark Liotta, Nisreen Jahshan, Sara Groome

Category Research

Concept Sepsis

Concept Early Antibiotic Administration

Concept Centers for Medicare and Medicaid Services Severe Sepsis and Septic Shock Early Management Bundle

Concept Sepsis Recognition

Concept Sequential Organ Failure Assessment

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital

Presenting Author Mark Liotta

Track Quality Improvement

Keywords

sepsis

quality improvement

early recognition

antibiotic treatment

electronic health record

EHR scoring

SEP-1 bundle

SOFA score

SIRS criteria

hospital floors

Sepsis

Early Antibiotic Administration

Centers for Medicare and Medicaid Services Severe Sepsis and Septic Shock Early Management Bundle

Sepsis Recognition

Sequential Organ Failure Assessment