Identifying Severe Sepsis via Electronic Surveillance. (November 2015)

• Record Type: Journal Article
• Authors: Brandt, Bristol N.; Gartner, Amanda B.; Moncure, Michael; Cannon, Chad M.; Carlton, Elizabeth; Cleek, Carol; Wittkopp, Chris; Simpson, Steven Q.
• Is Part Of: American journal of medical quality. Volume 30:Number 6(2015:Nov./Dec.)
• Page Start: 559
• Page End: 565
• Publication Date: 2015-11
• Subjects: sepsis -- quality improvement -- electronic surveillance -- electronic medical record; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860614541291
• Languages: English
• ISSNs: 1062-8606

Abstract

An electronic sepsis surveillance system (ESSV) was developed to identify severe sepsis and determine its time of onset. ESSV sensitivity and specificity were evaluated during an 11-day prospective pilot and a 30-day retrospective trial. ESSV diagnostic alerts were compared with care team diagnoses and with administrative records, using expert adjudication as the standard for comparison. ESSV was 100% sensitive for detecting severe sepsis but only 62.0% specific. During the pilot, the software identified 477 patients, compared with 18 by adjudication. In the 30-day trial, adjudication identified 164 severe sepsis patients, whereas ESSV detected 996. ESSV was more sensitive but less specific than care team or administrative data. ESSV-identified time of severe sepsis onset was a median of 0.00 hours later than adjudication (interquartile range = 0.05). The system can be a useful tool when implemented appropriately but lacks specificity, largely because of its reliance on discreet data fields.