Background
: The Epic Sepsis Prediction Model (SPM) is a proprietary sepsis prediction algorithm
which calculates a score correlating with the likelihood of an ICD-9 code for sepsis.
Objectives
This study aims to assess the clinical impact of an electronic sepsis alert and navigator
utilizing the Epic SPM on time to initial antimicrobial delivery.
Methods
Retrospective review of a non-randomized intervention of an electronic sepsis alert
system and navigator utilizing the Epic SPM. Data from the SPM site (Site A) was compared
to contemporaneous data from hospitals within the same health system (Sites B-D),
and historical data from Site A. Non-intervention sites used a SIRS-based alert without
a sepsis navigator.
Results
5,368 admissions met inclusion criteria. Time to initial antimicrobial delivery from
ED arrival was 3.33 hours (IQR 2.10-5.37) at Site A, 3.22 hours (IQR 1.97-5.60; P=0.437,
reference Site A) at Sites B-D, and 6.20 hours (3.49-11.61; P<0.001, reference Site
A) at Site A Historical. After adjustment using matching weights, there was no difference
in time from threshold SPM score to initial antimicrobial between contemporaneous
sites. Adjusted time to initial antimicrobial improved by 2.87 hours (P<0.001) at
Site A as compared to Site A Historical.
Conclusion
Implementation of an electronic sepsis alert system plus navigator utilizing the Epic
SPM showed no difference in time to initial antimicrobial delivery between the contemporaneous
SPM alert plus sepsis navigator site and the SIRS-based electronic alert sites within
the same health system.
Keywords
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Article info
Publication history
Accepted:
February 17,
2023
Received in revised form:
February 9,
2023
Received:
November 17,
2022
Publication stage
In Press Accepted ManuscriptFootnotes
Funding source:
This project was funded by the Wake Forest University School of Medicine CTSI award number UL1TR001420.
Acknowledgements:
Gary E Rosenthal, MD, FACP
Thomas K Houston, MD
Alain G Bertoni, MD, MPH
Brian J Wells, MD, PhD
Beverly J Levine, PhD
Morgana Mongraw-Chaffin PhD
Jack White
Erica Hale, MS
Ashley Warlick
Renata Sroglova
Disclosures:
None of the authors have any financial disclosure or conflicts of interest regarding the material included in this manuscript.
Institutional Review Board:
Wake Forest University Health Sciences Institutional Review Board approval was obtained for this project.
Identification
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