Sepsis is an infectious syndrome that can progress to organ dysfunction, shock, and death. Sepsis has been shown to account for more than $20 billion (5.2%) of total annual US hospital costs. Importantly, mortality from septic shock is high, and increases by 7.6% for every hour that treatment is delayed. Thus the biggest challenge in managing patients with sepsis is early identification and immediate initiation of appropriate resuscitation and therapeutic measures.
Early warning scores have great potential to identify early clinical deterioration. The National Early Warning Score (NEWS), is a ‘track and trigger system’ to identify patients at risk of decompensation using real time extraction of structured data commonly found in an electronic health record (EHR). Sepsis Care Redesign, implemented the NEWS within the Duke University Health System (DUHS) EHR in March 2015. Unfortunately, NEWS is neither sensitive nor specific in identifying patients with sepsis hospitalized within the Health System. Furthermore, this lack of specificity has in resulted in repeated firing of inappropriate alarms and significant alarm fatigue among care teams.
Thus through our DIHI-funded project, we aim to address these challenges via the following :
1) We will develop a new risk score to replace the existing, underperforming, early warning system using Duke University Hospital specific data
2) Develop a sepsis response team to provide real time support to front line staff to help integrate the Maestro-based early warning system into their day-to-day workflow.
Our goal is to change the culture of sepsis recognition and treatment in order to improve sepsis-related morbidity and mortality outcomes for our patients.