This is the final report from the Australian Institute of Health Innovation, Macquarie University evaluating the pilot of a sepsis alert in the electronic medical record (eMR) at Blacktown hospital.
Evaluation and optimisation of sepsis risk identification toolsThe pilot of the electronic sepsis alert is a collaboration between the Clinical Excellence Commission, eHealth NSW, Western Sydney LHD and Macquarie University. This project is the first to evaluate the Adult Sepsis Pathway and the electronic sepsis alert in NSW, and to compare the performance between these two tools and the qSOFA score. The CEC are working with eHealth NSW on how this can be implemented into eMR across NSW.
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Evaluation is a systematic process to determine the extent of the improvements that have been made. Measurement ensures that clinical practice changes are carried out and provide a source of feedback and learning.
The CEC Sepsis Database provides a tool to collect and analyse data. It is a web-based application, which is accessed by entering hospital facility or LHD username and password on the NSW Health intranet system.
The CEC is working with HealthShare NSW to facilitate integration with other data collection programs. The measures for the inpatient wards, for both adults and paediatrics, have been agreed in consultation with clinicians and clinical governance units, as follows:
- Time taken from sepsis recognition (triage or CERS call) to the administration of the first dose of intravenous antibiotics
- Time taken from sepsis recognition to intravenous resuscitation
- Serum lactate level at time of sepsis recognition
- Observations at time of sepsis recognition.
Some additional measures that can be used at facility or LHD level to ascertain the effectiveness of the program include:
- Hospital length of stay for patients with sepsis
- Number of patients transferred to ICU with sepsis
- Case review of missed sepsis recognition
- ICU length of stay for patients with sepsis
- Morbidity and mortality rates for patients with sepsis
- Root Cause Analysis data
- Clinical Review / Rapid Response.