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

Faheem W. Guirgis, Lisa Jones, Rhemar Esma, Alice Weiss, Kaitlin McCurdy, Jason Ferreira, Christina Cannon, Laura McLauchlin, Carmen Smotherman, Dale Kraemer, Cynthia Gerdik, Kendall Webb, Jin Ra, Frederick A. Moore, Kelly Gray-Eurom

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose Sepsis 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 methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There 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). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.

Original languageEnglish (US)
Pages (from-to)296-302
Number of pages7
JournalJournal of Critical Care
Volume40
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Sepsis
Artificial Respiration
Intensive Care Units
Comorbidity

Keywords

  • Clinical decision support
  • Rapid response teams
  • Resuscitation
  • Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Guirgis, F. W., Jones, L., Esma, R., Weiss, A., McCurdy, K., Ferreira, J., ... Gray-Eurom, K. (2017). Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives. Journal of Critical Care, 40, 296-302. https://doi.org/10.1016/j.jcrc.2017.04.005

Managing sepsis : Electronic recognition, rapid response teams, and standardized care save lives. / Guirgis, Faheem W.; Jones, Lisa; Esma, Rhemar; Weiss, Alice; McCurdy, Kaitlin; Ferreira, Jason; Cannon, Christina; McLauchlin, Laura; Smotherman, Carmen; Kraemer, Dale; Gerdik, Cynthia; Webb, Kendall; Ra, Jin; Moore, Frederick A.; Gray-Eurom, Kelly.

In: Journal of Critical Care, Vol. 40, 01.08.2017, p. 296-302.

Research output: Contribution to journalArticle

Guirgis, FW, Jones, L, Esma, R, Weiss, A, McCurdy, K, Ferreira, J, Cannon, C, McLauchlin, L, Smotherman, C, Kraemer, D, Gerdik, C, Webb, K, Ra, J, Moore, FA & Gray-Eurom, K 2017, 'Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives', Journal of Critical Care, vol. 40, pp. 296-302. https://doi.org/10.1016/j.jcrc.2017.04.005
Guirgis, Faheem W. ; Jones, Lisa ; Esma, Rhemar ; Weiss, Alice ; McCurdy, Kaitlin ; Ferreira, Jason ; Cannon, Christina ; McLauchlin, Laura ; Smotherman, Carmen ; Kraemer, Dale ; Gerdik, Cynthia ; Webb, Kendall ; Ra, Jin ; Moore, Frederick A. ; Gray-Eurom, Kelly. / Managing sepsis : Electronic recognition, rapid response teams, and standardized care save lives. In: Journal of Critical Care. 2017 ; Vol. 40. pp. 296-302.
@article{5406677218ec471496c816197bcb29bc,
title = "Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives",
abstract = "Purpose Sepsis 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 methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There 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). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.",
keywords = "Clinical decision support, Rapid response teams, Resuscitation, Sepsis",
author = "Guirgis, {Faheem W.} and Lisa Jones and Rhemar Esma and Alice Weiss and Kaitlin McCurdy and Jason Ferreira and Christina Cannon and Laura McLauchlin and Carmen Smotherman and Dale Kraemer and Cynthia Gerdik and Kendall Webb and Jin Ra and Moore, {Frederick A.} and Kelly Gray-Eurom",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.jcrc.2017.04.005",
language = "English (US)",
volume = "40",
pages = "296--302",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Managing sepsis

T2 - Electronic recognition, rapid response teams, and standardized care save lives

AU - Guirgis, Faheem W.

AU - Jones, Lisa

AU - Esma, Rhemar

AU - Weiss, Alice

AU - McCurdy, Kaitlin

AU - Ferreira, Jason

AU - Cannon, Christina

AU - McLauchlin, Laura

AU - Smotherman, Carmen

AU - Kraemer, Dale

AU - Gerdik, Cynthia

AU - Webb, Kendall

AU - Ra, Jin

AU - Moore, Frederick A.

AU - Gray-Eurom, Kelly

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Purpose Sepsis 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 methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There 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). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.

AB - Purpose Sepsis 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 methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There 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). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.

KW - Clinical decision support

KW - Rapid response teams

KW - Resuscitation

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=85017476406&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017476406&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2017.04.005

DO - 10.1016/j.jcrc.2017.04.005

M3 - Article

C2 - 28412015

AN - SCOPUS:85017476406

VL - 40

SP - 296

EP - 302

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

ER -