SHM Converge Scientific Abstract ePoster Gallery-Sepsis Squashing Squadron: Hospital-Wide Floor Sepsis Identification, Treatment, and Expediency

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This hospital-wide quality improvement project evaluated a new “Sepsis Squashing Squadron” (S3), combining a sepsis response team with automated EHR scoring tools to improve sepsis detection, treatment speed, and SEP-1 guideline adherence on general medical floors.<br /><br />From April 19 to May 31, 2023, the team screened 2,453 patients across 13 units at two hospitals. Daily sepsis prevalence was 11.1% (274 patients), and 59.5% of these were new sepsis cases. Among new sepsis patients, only 34.5% were judged to have appropriate recognition and treatment.<br /><br />SEP-1 adherence was low overall: antibiotics had the highest compliance at 60.7%, while total bundle adherence was only 23.3%. Mean time from order to administration/draw was 102 minutes for antibiotics, 126 minutes for blood cultures, 47 minutes for lactate, and 32 minutes for IV fluids, indicating substantial delays in care.<br /><br />The study also assessed automated sepsis score performance. Updated performance was modest to poor, with AUCs ranging from 0.60 to 0.79 and sensitivities as low as 0.04 to 0.67 at low specificity thresholds. This suggests the current automated tools were not sufficiently reliable for strong sepsis detection.<br /><br />Mortality index for sepsis not present on admission was 1.23 overall and 2.07 for bacteremia, both lower than the institution’s Vizient sepsis database value of 2.71, even after accounting for severity.<br /><br />Overall, the project found significant opportunities to improve sepsis recognition, response times, and SEP-1 compliance, while also showing that the existing automated scoring tools need refinement.

Asset Subtitle

Alyssa Yeager

Meta Tag

Author List Alan A. Kubey, Alyssa Yeager, Christopher Haines, Joy Burke, Kimberly Berenbaum, Mark Liotta, Nisreen Jahshan, Sara Groome, Swathi Maddula

Category Research

Concept Sepsis

Concept Hospital-wide Sepsis Response Initiative

Concept SEP-1

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

Concept Time to Antibiotics

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital

Presenting Author Alyssa Yeager

Track Quality Improvement

Keywords

sepsis

quality improvement

SEP-1

EHR scoring

sepsis detection

treatment delays

antibiotic compliance

blood cultures

mortality index

automated sepsis tools

Sepsis

Hospital-wide Sepsis Response Initiative

SEP-1

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

Time to Antibiotics