Evaluating Sepsis Pathway Effectiveness in the Emergency Department

PROBLEM

A large hospital needed a way to evaluate the effectiveness of its clinical sepsis pathway to increase compliance to standards of care to impact mortality. The team needed to measure whether the pathway drove timely recognition and administration of antibiotics and fluids and link them to alert and order set performance, respectively. Typically a holistic pathway evaluation is time consuming and takes up scarce analytical resources.

APPROACH

Using Phrase, the quality improvement team quickly found that fluid administration for septic patients increased significantly. Although emergency department patient volumes varied widely during the Covid-19 pandemic, the team was able to easily confirm the pathway was working.

However, when doing further investigation in Phrase, the team identified variation in a newly launched emergency department which indicated that workflows needed to be changed and/or providers needed education. One Clinical Nurse Specialist who helps lead their sepsis program mentioned the importance of Phrase’s alert analytics to examine alerting behaviors of the individual provider to understand providers’ workflows and target education needs: “When patient volume for a new hospital quickly increased from zero to a thousand, we turned to Phrase to examine alerting behaviors from the data perspective to understand their workflow implications and resultant provider education needs.”

RESULT

The team believes the reporting in Phrase will amount to significant time savings across analytics activities like dashboard maintenance, creation of patient cohorts, and reduced time spent manipulating data as their project continues. Moreover, they see the benefit of scaling this to other teams and projects at their health system too as they expect this will save them approximately 65 hours of time and over $10,000 across clinical, analytics, and QI leadership on a per project basis for similar initiatives. Furthermore, Phrase helped the team identify an opportunity for a workflow optimization that will improve patient outcomes through increased compliance of the pathway.