Nurse Christine Chan regularly receives clinical advisories from the EHR. They are designed to notify her about steps she needs to take for patients with specific conditions and to highlight potential risks like drug interactions. In addition to the numerous advisories the EHR already delivers, her hospital recently added new notifications to identify patients at risk for sepsis.
Nurse Chan likes the idea of the sepsis risk notifications, but there are two problems: First, nearly half of them are false-positives. Second, they get mixed in with the routine pop-ups she's become accustomed to briefly skimming and clicking through, and that she only sees when she is using the EHR. Before long, she starts to ignore the sepsis notifications altogether. This puts patients at risk.
Sepsis, according to The Sepsis Alliance, is “the body's overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death.” It is a leading cause of death in the U.S., where 750,000 people die each year from it.1 With $24B spent annually, it is the costliest medical condition to treat in this country.2 But strong evidence shows that early, tailored intervention can significantly reduce the likelihood of sepsis-related complications and death. A recent study has shown that deploying a comprehensive sepsis program can reduce mortality rates by more than 50% and 30-day readmissions by 30%.3 And a growing body of research indicates the most statistically significant variable in sepsis treatment is time.
Many hospitals deploy automated systems as part of a sepsis program to identify patient risk so the appropriate therapies can be initiated quickly. These systems typically use an algorithm that combines patient data from the EHR such as demographics, vital signs, medications, and lab values.
As Nurse Chan experienced, many systems are highly sensitive, but they're not specific enough. That is, they may detect common risk factors but don't account for the complex comorbidities that can alter a patient's condition, thereby triggering false positives. For example, factors related to liver disease, heart failure, and chemotherapy treatment can commonly trigger false-positive alerts for sepsis.
Even if a system is sensitive and specific, it might not provide actionable information to the right person, in the right way, quickly enough to initiate the right response. This can lead to ineffective care and preventable patient complications.
An effective sepsis surveillance and clinical decision support system needs to be accurate (highly sensitive and specific). It needs to be reliable, reaching the appropriate caregiver with the right information, at the right time, in the right way. And it needs to be actionable, providing clear instructions about what to do next.
Vocera partners with providers of sepsis and other clinical surveillance solutions to deliver accurate, reliable and actionable alerts. Deploying the right workflows and technology, driving care team engagement, and managing performance improvement against a defined set of goals are keys to a successful sepsis program. Do it right, and you can significantly improve patient outcomes.
Related links: Rapid Sepsis Response at Halifax Health
Want to learn more about how we can help you improve patient outcomes through faster sepsis risk response? Contact us.