Abstract
Background
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.
Objective
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.
Methods
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: March 07, 2023
Accepted:
February 17,
2023
Received in revised form:
February 9,
2023
Received:
November 17,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
