Original Contributions|Articles in Press


  • Adam R. Schertz
    Reprint Address: Adam R. Schertz, MD, MS, Atrium Health Wake Forest Baptist, 1 Medical Center Boulevard, Winston-Salem, NC 27157
    Department of Internal Medicine, Section on Pulmonology, Critical Care, Allergy, and Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Sydney A. Smith
    Department of Biostatistics and Data Science, Division of Public Health Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Kristin M. Lenoir
    Department of Biostatistics and Data Science, Division of Public Health Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Karl W. Thomas
    Department of Internal Medicine, Section on Pulmonology, Critical Care, Allergy, and Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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      The Epic Sepsis Prediction Model (SPM) is a proprietary sepsis prediction algorithm that calculates a score correlating with the likelihood of an International Classification of Diseases, Ninth Revision code for sepsis.


      This study aimed to assess the clinical impact of an electronic sepsis alert and navigator using the Epic SPM on time to initial antimicrobial delivery.


      We performed a retrospective review of a nonrandomized intervention of an electronic sepsis alert system and navigator using the Epic SPM. Data from the SPM site (site A) was compared with contemporaneous data from hospitals within the same health care system (sites B–D) and historical data from site A. Nonintervention sites used a systemic inflammatory response syndrome (SIRS)–based alert without a sepsis navigator.


      A total of 5368 admissions met inclusion criteria. Time to initial antimicrobial delivery from emergency department arrival was 3.33 h (interquartile range [IQR] 2.10–5.37 h) at site A, 3.22 h (IQR 1.97–5.60; p = 0.437, reference site A) at sites B–D, and 6.20 h (IQR 3.49–11.61 h; 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 h (p < 0.001) at site A compared with site A historical.


      Implementation of an electronic sepsis alert system plus navigator using 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 care system.


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