Roadmap for Solving Sepsis Using Sepsis Alert, Sepsis Surveillance, & Sepsis Detection
By Tim Kuebelbeck, Chief Customer Officer at Ambient Clinical Analytics
As we move into 2021 our goal is simple; help doctors, nurses, hospitals & health systems solve sepsis using innovative technology and best practices while reducing alert fatigue and nurse and physician burnout. This whitepaper is a roadmap for helping you achieve those goals. 2020 has been a defining year in many ways for solving sepsis, sepsis surveillance, sepsis detection, and sepsis alerts. At Ambient Clinical Analytics we have learned that a smart communications approach using innovative technology helps save lives and reduce sepsis costs.
Over the years, we have been reminded that there are three keys to solving sepsis: early detection, early intervention, and driving both care and the delivery of the bundle components with technology and automation. Additionally, we have come to understand that providing a technology that allows for remote patient monitoring of a sepsis surveillance solution and if needed, tele-sepsis services, is critical. Focus on automating best practices using innovative technology to treat sepsis and ensure that protocols don’t slip through the cracks has become increasingly important. The COVID-19 pandemic has been devastating to our citizens, economy and incredibly challenging for our healthcare delivery system. This devastation is not limited to just providing care but has also stressed our physicians and nurses both emotionally and physically. Sepsis has been more prevalent during the pandemic, making sepsis surveillance, sepsis detection, and a sepsis alert more imperative than ever before.
The EHR Sepsis Approach
Many providers still believe that the sepsis detection algorithm alone is a silver bullet for solving sepsis. Clearly, based on how the EHR vendor solutions have approached sepsis, they too believe a single algorithm is the answer. Unfortunately, this is not the case and it continues to drive poor sepsis care in the U.S. while helping fuel a major sepsis crisis that hospitals and health systems find difficult to solve because of the large amounts of time, effort, and money previously spent with EHR vendors in failed attempts to fix sepsis. This flawed approach is leading to high mortality rates and poor outcomes. The common thinking is ‘if only our sepsis detector had higher specificity.’ What they are really saying is they alarm with way too many false positives. False positives are a huge issue with EHR provided sepsis detection and sepsis surveillance. False positives make the nurses and physicians lose faith in the sepsis alert which leads to disastrous results for septic patients.
Think of it this way, you can’t use a sepsis detection algorithm developed for the ICU in the Emergency Department (ED). If you did, the sensitivity would be too low, and you would not cast a wide enough net with your sepsis alert, resulting in missing many sepsis cases in your ED. On the other hand, if you tried using a sepsis surveillance algorithm designed for the ED in the ICU, your specificity would be too low and result in a very high false positive rate, eventually ending in doctors and nurses not trusting the sepsis alert. Which is why it is vital to have the ability to use multiple sepsis alert algorithms in your sepsis strategy. So why would you trust your EHR vendor to solve sepsis with a single algorithm?
The financial results of using EHR provided sepsis surveillance, sepsis detection, and sepsis alert solutions have been devastating to hospitals and health systems. In a study on hospital related costs of sepsis, the median of the mean hospital-wide cost of sepsis per patient was $32,421 (IQR $20,745–$40,835), and the median of the mean ICU cost of sepsis per patient was $27,461 (IQR $16,007–$31,251)². According to the Agency for Healthcare and Research Quality (AHRQ), the average payment for a stay across all payers is $9,700³. That is an average loss of $22,700 per sepsis patient treated. There are several sources and articles over the years that prove this. Specific to sepsis treatment, according to a recent article in HFMA, small hospitals experience net margin losses of ~$9.9M and larger hospitals experience a net margin loss of ~$33.9M on sepsis treatment⁴. All of this data adds up to further proof that EHR provided sepsis alert, sepsis detection, and sepsis surveillance solutions are failing our patients, our hospitals, and our health systems. The lack of impact EHR vendors are having on solving sepsis is costing lives, limbs, and long-term health issues in patients and contributing to the financial crisis our health systems face in today’s economic environment.
The Massachusetts Sepsis Consortium released their findings on Advancing Sepsis Care in Emergency Medicine in 2019. In that report, healthcare systems listed their challenges providing high quality sepsis care. 29.5 percent of respondents reported that the facility EHR system was a barrier to successful implementation of standardized screening and treatment protocols for a variety of reasons⁵. Sepsis detection is a tiny sliver of the entire sepsis care solution. CMS data have shown that since implementation, organizations that follow all the steps have significantly lower mortality rates for patients diagnosed with severe sepsis and septic shock⁶. Your sepsis surveillance solution must be able to handle a different sepsis alert and sepsis detection algorithms for different locations. Just as important, within a single hospital location, your sepsis surveillance solution must be able to handle different sepsis detection algorithms in different units.
Sepsis Detection
We have an end-to-end solution that is much more than just a sepsis patient tracker board, called Sepsis DART™. Sepsis DART™ was developed with Mayo Clinic, and it also includes an indicative sepsis alert that is configurable by each health system, and even configurable down to the unit level. Because different units have different sepsis detection requirements, we typically run a multitude of algorithms in each site we install at. We can start with the Mayo Clinic sepsis detection algorithm, but we also have other out of the box sepsis alert algorithms we have developed with other healthcare systems that we can utilize as starting points for you. Without the ability to run multiple sepsis alert algorithms, you will find yourself spending money, time, and effort on a sepsis alert solution without improving your sepsis bundle compliance or sepsis outcomes, leaving you in the same situation you were in the previous year.
Early Intervention (Sepsis Alert)
Above we have spent a lot of time talking about the first key component, which is early sepsis detection with a sepsis alert, but it is also important to understand that with sepsis surveillance you must drive early intervention which is the second key component to solving sepsis. With each hour that you don’t act, mortality for sepsis increases 7.6 percent. In fact, each hour of delay in antimicrobial administration over the ensuing 6 hours was associated with an average decrease in survival of 7.6%. Administration of an antimicrobial effective for isolated or suspected pathogens within the first hour of documented hypotension was associated with a survival rate of 79.9%⁷.
While deploying Sepsis DART™ in hospital systems across the U.S. this year, we saw three effective response models, depending on the quality systems, management processes, and investment levels at the hospital.
Delivering Care and Quality Beyond the Bundle Elements
This brings us to the third component which is delivering care and the sepsis bundle elements within the appropriate time windows. Beyond driving early intervention as described above, it is critical that your sepsis detection solution has sepsis patient tracker board functionality that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling bedside and remote monitoring of large numbers of patients simultaneously. We also learned that sepsis alert solutions must also employ smart notifications that directly notify the right care givers at the right time of a potential sepsis development in a patient and using smart escalation, continue to notify care givers via a smart sepsis alert until someone on the team takes the appropriate action. Unlike EHR’s, Sepsis DART™ does all of this and most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing both smart sepsis alert notification and reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
CMS and Other Sepsis Reporting
Abstracting sepsis cases for CMS reporting is manually intensive and time consuming. Most hospital systems invest a substantial amount of nursing resource doing nothing but case abstraction and reporting. Having a database with 90% of the data you need in one place, and all with data points time referenced against each other, and a set of canned reports specifically designed to allow you to view and pull that information for CMS reporting, is not only important but often reduces very significant portions for a nurse analyst’s job. Enough so, that most hospitals can cost justify a system with just the reduction in reporting time required for the analysts, never mind the lives saved, costs saved in LOS reductions and the quality-of-care improvements. In addition, the ability to generate ad hoc reports that can highlight things such as specific issues with bundle compliance, staff responsiveness, habitual alert silencing, and other associated process elements and patient health parameters can be a boon to driving overall quality improvement efforts across the care team.
Tele-Sepsis or Sepsis as a Service
This brings us to the newest innovation and maybe one of the most important for solving sepsis in every facility across the United States. Sepsis surveillance vendors need to provide Sepsis as a Service or Tele-Sepsis. With many hospital and health system organizations unable to fund the investment to create a centralized Clinical Control Tower environment or the inability to staff sepsis surveillance teams 24/7, it is important to pick a sepsis detection solution (like Sepsis DART™) that allows for Sepsis as a Service or Tele-Sepsis. Companies like Ambient can provide outsourced sepsis monitoring through their Clinical Control Tower technology. A services model for a tele-sepsis or sepsis as a service program should include the following:
Summary It is evident that despite improvements in modern statistical techniques and machine learning approaches, sepsis alert performance has not improved much in the past decade. The biggest questions are: What is the best path to solve sepsis moving forward? Is your current sepsis surveillance provider or EHR capable of delivering a comprehensive solution from sepsis detection to sepsis alert, followed by driving the clinic process that includes options for a tele-sepsis services model? Over the years and especially in 2020, we have learned that in recognizing and treating sepsis there are three elements critical to sepsis surveillance, improved clinical outcomes, and reduced mortality for effected patients. To summarize:
Center for Medicare and Medicaid Services (CMS) Sep-1 Reporting
The Center for Medicare and Medicaid Services (CMS), which collects data in order to push for treatment improvement and ensure transparency, has made the 2017 hospital sepsis (SEP-1) compliance rankings public as of July 25, 2018. Today, information regarding sepsis treatment compliance will be available to the public on the CMS Hospital Compare website. CMS’s focus on reporting is to drive improvement in sepsis recovery through measurement of, and to provide transparency to, hospitals’ compliance with sepsis treatment protocols. Since several reports have now been released about high numbers of preventable sepsis deaths, CMS (and other global healthcare quality bodies) have developed and reinforced new strategies for sepsis diagnosis and treatment, as well as improved visibility to sepsis treatment results. Though sepsis treatment compliance has steadily improved over the past few years, more needs to be done to further decrease sepsis mortality.
Thus, there is now an increased need for innovative information technology solutions for better practitioner support, more accurate reporting, and most importantly improved patient care.
About Sepsis
According to the World Health Organization, sepsis is a condition that affects over 30 million people globally every year and is responsible for some 6 million deaths. The Centers for Disease Control and Prevention report that 1.5 million Americans contract the disease every year and about a third of these patients die.
Hospitals have access to the correct materials to treat sepsis, and with early detection and treatment delivered in the first critical 6 hours after diagnosis, these are, for the most part, preventable deaths. But the disease is also notoriously difficult to diagnose. The chronic under-diagnosing, delayed treatment and subsequent deaths are the motivation behind worldwide campaigns to improve sepsis recovery strategies.
Sepsis results in extended and extreme care, including long stays in the ICU, where patients need a high level of monitoring and attention. These requirements make it a particularly expensive condition to treat, costing the US $24 billion annually.
Impact on Hospitals
It can be tricky to manage sepsis effectively, and even a slight miscommunication between healthcare professionals (due to moving a patient or shift change) can cause major inefficiencies and even death. A January 2018 report from the Society of Critical Care Medicine based on 478 patients showed that most SEP-1 failures stemmed from a failure to measure lactate levels or a lack of fluids. Using solutions like Sepsis DART™ help healthcare providers eliminate those failures.
For the past few years, health agencies around the world have been pushing for stricter monitoring and enforcement strategies, which include automated computerized alerting tools like Ambient’s Sepsis DART™. However, problems continue with diagnosis, treatment, and reporting because of different definitions of sepsis, information overload and, in some instances, “alert fatigue.”
Sepsis DART™
Sepsis DART™ (Detection And Response Tool) is designed to analyze patient data and identify potential sepsis conditions early, offering medical staff the right information for detection, and using smart sepsis alerts, support tracking of the treatment process. It moves with the patient through different hospital services and environments, integrates with any EMR system, and is customizable for various institutional purposes.
The Sepsis DART™ alert system monitors and communicates regarding all aspects of sepsis treatment bundles to the right practitioners at the right time, maintaining information on septic patients even between care locations and shifting staff. This reduces errors and omissions, as the entire care team understands on a real-time basis what treatment elements have and have not been delivered, and how much time is left to successfully complete treatment. And because Sepsis DART keeps all of the pertinent data for each case in a single repository, all centrally available and correlated to the “time zero” of the sepsis event, the effort required to abstract and report on sepsis cases is substantially reduced and that alone, not including improvements in outcomes and CMS compliance, often cost justifies any system costs.
For more detailed information on how you can solve sepsis in your organization with Ambient Clinical Analytics please contact tim.kuebelbeck@ambientclinical.com
About Ambient Clinical Analytics - As an industry leader, Ambient is supporting leading healthcare systems and has done so since its founding in 2013. Our solutions are designed by clinicians to be easy-to-use by every caregiver in your organization and are configured to be up and running rapidly. We are trusted by a community of high-performing healthcare providers across the United States. Our solutions are powerful real-time point-of-care and remote healthcare platforms designed to deliver life-saving solutions using data visualization, communication, and analytics based clinical decision support.
Ambient’s AWARE™ family of solutions are exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platforms. Ambient’s Sepsis DART™ product has been accepted into the Patient Safety Movement’s Actionable Patient Safety Solutions (APSS) #9 for Sepsis. Ambient has achieved ISO 13485:2016 certification, an internationally recognized quality standard specific to the medical device industry. The ISO 13485 standard sets out the requirements for a quality management system specific to the medical device industry. Ambient is also deploying the AWARE™ family of solutions, to help manage COVID-19. Ambient’s Virtual ICU platforms are ideal for dealing with current and possible future outbreaks. For more information, visit https://ambientclinical.com.
As we move into 2021 our goal is simple; help doctors, nurses, hospitals & health systems solve sepsis using innovative technology and best practices while reducing alert fatigue and nurse and physician burnout. This whitepaper is a roadmap for helping you achieve those goals. 2020 has been a defining year in many ways for solving sepsis, sepsis surveillance, sepsis detection, and sepsis alerts. At Ambient Clinical Analytics we have learned that a smart communications approach using innovative technology helps save lives and reduce sepsis costs.
Over the years, we have been reminded that there are three keys to solving sepsis: early detection, early intervention, and driving both care and the delivery of the bundle components with technology and automation. Additionally, we have come to understand that providing a technology that allows for remote patient monitoring of a sepsis surveillance solution and if needed, tele-sepsis services, is critical. Focus on automating best practices using innovative technology to treat sepsis and ensure that protocols don’t slip through the cracks has become increasingly important. The COVID-19 pandemic has been devastating to our citizens, economy and incredibly challenging for our healthcare delivery system. This devastation is not limited to just providing care but has also stressed our physicians and nurses both emotionally and physically. Sepsis has been more prevalent during the pandemic, making sepsis surveillance, sepsis detection, and a sepsis alert more imperative than ever before.
The EHR Sepsis Approach
Many providers still believe that the sepsis detection algorithm alone is a silver bullet for solving sepsis. Clearly, based on how the EHR vendor solutions have approached sepsis, they too believe a single algorithm is the answer. Unfortunately, this is not the case and it continues to drive poor sepsis care in the U.S. while helping fuel a major sepsis crisis that hospitals and health systems find difficult to solve because of the large amounts of time, effort, and money previously spent with EHR vendors in failed attempts to fix sepsis. This flawed approach is leading to high mortality rates and poor outcomes. The common thinking is ‘if only our sepsis detector had higher specificity.’ What they are really saying is they alarm with way too many false positives. False positives are a huge issue with EHR provided sepsis detection and sepsis surveillance. False positives make the nurses and physicians lose faith in the sepsis alert which leads to disastrous results for septic patients.
Think of it this way, you can’t use a sepsis detection algorithm developed for the ICU in the Emergency Department (ED). If you did, the sensitivity would be too low, and you would not cast a wide enough net with your sepsis alert, resulting in missing many sepsis cases in your ED. On the other hand, if you tried using a sepsis surveillance algorithm designed for the ED in the ICU, your specificity would be too low and result in a very high false positive rate, eventually ending in doctors and nurses not trusting the sepsis alert. Which is why it is vital to have the ability to use multiple sepsis alert algorithms in your sepsis strategy. So why would you trust your EHR vendor to solve sepsis with a single algorithm?
The financial results of using EHR provided sepsis surveillance, sepsis detection, and sepsis alert solutions have been devastating to hospitals and health systems. In a study on hospital related costs of sepsis, the median of the mean hospital-wide cost of sepsis per patient was $32,421 (IQR $20,745–$40,835), and the median of the mean ICU cost of sepsis per patient was $27,461 (IQR $16,007–$31,251)². According to the Agency for Healthcare and Research Quality (AHRQ), the average payment for a stay across all payers is $9,700³. That is an average loss of $22,700 per sepsis patient treated. There are several sources and articles over the years that prove this. Specific to sepsis treatment, according to a recent article in HFMA, small hospitals experience net margin losses of ~$9.9M and larger hospitals experience a net margin loss of ~$33.9M on sepsis treatment⁴. All of this data adds up to further proof that EHR provided sepsis alert, sepsis detection, and sepsis surveillance solutions are failing our patients, our hospitals, and our health systems. The lack of impact EHR vendors are having on solving sepsis is costing lives, limbs, and long-term health issues in patients and contributing to the financial crisis our health systems face in today’s economic environment.
The Massachusetts Sepsis Consortium released their findings on Advancing Sepsis Care in Emergency Medicine in 2019. In that report, healthcare systems listed their challenges providing high quality sepsis care. 29.5 percent of respondents reported that the facility EHR system was a barrier to successful implementation of standardized screening and treatment protocols for a variety of reasons⁵. Sepsis detection is a tiny sliver of the entire sepsis care solution. CMS data have shown that since implementation, organizations that follow all the steps have significantly lower mortality rates for patients diagnosed with severe sepsis and septic shock⁶. Your sepsis surveillance solution must be able to handle a different sepsis alert and sepsis detection algorithms for different locations. Just as important, within a single hospital location, your sepsis surveillance solution must be able to handle different sepsis detection algorithms in different units.
Sepsis Detection
We have an end-to-end solution that is much more than just a sepsis patient tracker board, called Sepsis DART™. Sepsis DART™ was developed with Mayo Clinic, and it also includes an indicative sepsis alert that is configurable by each health system, and even configurable down to the unit level. Because different units have different sepsis detection requirements, we typically run a multitude of algorithms in each site we install at. We can start with the Mayo Clinic sepsis detection algorithm, but we also have other out of the box sepsis alert algorithms we have developed with other healthcare systems that we can utilize as starting points for you. Without the ability to run multiple sepsis alert algorithms, you will find yourself spending money, time, and effort on a sepsis alert solution without improving your sepsis bundle compliance or sepsis outcomes, leaving you in the same situation you were in the previous year.
Early Intervention (Sepsis Alert)
Above we have spent a lot of time talking about the first key component, which is early sepsis detection with a sepsis alert, but it is also important to understand that with sepsis surveillance you must drive early intervention which is the second key component to solving sepsis. With each hour that you don’t act, mortality for sepsis increases 7.6 percent. In fact, each hour of delay in antimicrobial administration over the ensuing 6 hours was associated with an average decrease in survival of 7.6%. Administration of an antimicrobial effective for isolated or suspected pathogens within the first hour of documented hypotension was associated with a survival rate of 79.9%⁷.
While deploying Sepsis DART™ in hospital systems across the U.S. this year, we saw three effective response models, depending on the quality systems, management processes, and investment levels at the hospital.
- Upon sepsis alert remind all responsible team members
- Upon sepsis alert remind all responsible team members PLUS sepsis response teams
- Clinical control tower or clinical command center model
Delivering Care and Quality Beyond the Bundle Elements
This brings us to the third component which is delivering care and the sepsis bundle elements within the appropriate time windows. Beyond driving early intervention as described above, it is critical that your sepsis detection solution has sepsis patient tracker board functionality that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling bedside and remote monitoring of large numbers of patients simultaneously. We also learned that sepsis alert solutions must also employ smart notifications that directly notify the right care givers at the right time of a potential sepsis development in a patient and using smart escalation, continue to notify care givers via a smart sepsis alert until someone on the team takes the appropriate action. Unlike EHR’s, Sepsis DART™ does all of this and most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing both smart sepsis alert notification and reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
CMS and Other Sepsis Reporting
Abstracting sepsis cases for CMS reporting is manually intensive and time consuming. Most hospital systems invest a substantial amount of nursing resource doing nothing but case abstraction and reporting. Having a database with 90% of the data you need in one place, and all with data points time referenced against each other, and a set of canned reports specifically designed to allow you to view and pull that information for CMS reporting, is not only important but often reduces very significant portions for a nurse analyst’s job. Enough so, that most hospitals can cost justify a system with just the reduction in reporting time required for the analysts, never mind the lives saved, costs saved in LOS reductions and the quality-of-care improvements. In addition, the ability to generate ad hoc reports that can highlight things such as specific issues with bundle compliance, staff responsiveness, habitual alert silencing, and other associated process elements and patient health parameters can be a boon to driving overall quality improvement efforts across the care team.
Tele-Sepsis or Sepsis as a Service
This brings us to the newest innovation and maybe one of the most important for solving sepsis in every facility across the United States. Sepsis surveillance vendors need to provide Sepsis as a Service or Tele-Sepsis. With many hospital and health system organizations unable to fund the investment to create a centralized Clinical Control Tower environment or the inability to staff sepsis surveillance teams 24/7, it is important to pick a sepsis detection solution (like Sepsis DART™) that allows for Sepsis as a Service or Tele-Sepsis. Companies like Ambient can provide outsourced sepsis monitoring through their Clinical Control Tower technology. A services model for a tele-sepsis or sepsis as a service program should include the following:
- Monitoring the sepsis surveillance solution using a clinical command center technology such as Sepsis DART’s Clinical Control tower
- Working with the bed-side clinical teams in identifying and treating sepsis patients after a sepsis alert fires Provide training for sepsis response teams
- Managing the smart sepsis alert and escalation process to ensure treatment is in compliance with CMS bundle targets Lead sepsis related quality improvement projects for the hospital
- Develop process standards that meet best medical practices and regulatory requirements for supporting sepsis detection treatment and corresponding training modules
- Set-up a staffing program to include clinicians that have experience in treating sepsis patients
Summary It is evident that despite improvements in modern statistical techniques and machine learning approaches, sepsis alert performance has not improved much in the past decade. The biggest questions are: What is the best path to solve sepsis moving forward? Is your current sepsis surveillance provider or EHR capable of delivering a comprehensive solution from sepsis detection to sepsis alert, followed by driving the clinic process that includes options for a tele-sepsis services model? Over the years and especially in 2020, we have learned that in recognizing and treating sepsis there are three elements critical to sepsis surveillance, improved clinical outcomes, and reduced mortality for effected patients. To summarize:
- Early sepsis detection. Ideally this should be automated with sepsis surveillance happening in the background so the potential development of sepsis can be brought to the attention of a provider or nurse while they are providing care to their patients. Subtle changes may be taking place in the patient’s condition, and often the care team can become very focused on the current problem(s) they are dealing with and might miss the onset of sepsis.
- Early sepsis intervention. Detecting sepsis in a patient is great but does absolutely no good unless a provider steps in, reviews the patient’s case, and declares that the patient does indeed have sepsis, and then begin to institute treatment.
- Timely delivery of all required sepsis care elements. The treatment bundle for sepsis is well defined, and when delivered comprehensively within the defined time windows, provides remarkable improvements in not only the survivability of sepsis, but also in reductions of total care and length of hospitalization for patients who acquire sepsis. They (bundles) induced more consistent and timely application of evidence-based care and reduced practice variability.⁸
Center for Medicare and Medicaid Services (CMS) Sep-1 Reporting
The Center for Medicare and Medicaid Services (CMS), which collects data in order to push for treatment improvement and ensure transparency, has made the 2017 hospital sepsis (SEP-1) compliance rankings public as of July 25, 2018. Today, information regarding sepsis treatment compliance will be available to the public on the CMS Hospital Compare website. CMS’s focus on reporting is to drive improvement in sepsis recovery through measurement of, and to provide transparency to, hospitals’ compliance with sepsis treatment protocols. Since several reports have now been released about high numbers of preventable sepsis deaths, CMS (and other global healthcare quality bodies) have developed and reinforced new strategies for sepsis diagnosis and treatment, as well as improved visibility to sepsis treatment results. Though sepsis treatment compliance has steadily improved over the past few years, more needs to be done to further decrease sepsis mortality.
Thus, there is now an increased need for innovative information technology solutions for better practitioner support, more accurate reporting, and most importantly improved patient care.
About Sepsis
According to the World Health Organization, sepsis is a condition that affects over 30 million people globally every year and is responsible for some 6 million deaths. The Centers for Disease Control and Prevention report that 1.5 million Americans contract the disease every year and about a third of these patients die.
Hospitals have access to the correct materials to treat sepsis, and with early detection and treatment delivered in the first critical 6 hours after diagnosis, these are, for the most part, preventable deaths. But the disease is also notoriously difficult to diagnose. The chronic under-diagnosing, delayed treatment and subsequent deaths are the motivation behind worldwide campaigns to improve sepsis recovery strategies.
Sepsis results in extended and extreme care, including long stays in the ICU, where patients need a high level of monitoring and attention. These requirements make it a particularly expensive condition to treat, costing the US $24 billion annually.
Impact on Hospitals
It can be tricky to manage sepsis effectively, and even a slight miscommunication between healthcare professionals (due to moving a patient or shift change) can cause major inefficiencies and even death. A January 2018 report from the Society of Critical Care Medicine based on 478 patients showed that most SEP-1 failures stemmed from a failure to measure lactate levels or a lack of fluids. Using solutions like Sepsis DART™ help healthcare providers eliminate those failures.
For the past few years, health agencies around the world have been pushing for stricter monitoring and enforcement strategies, which include automated computerized alerting tools like Ambient’s Sepsis DART™. However, problems continue with diagnosis, treatment, and reporting because of different definitions of sepsis, information overload and, in some instances, “alert fatigue.”
Sepsis DART™
Sepsis DART™ (Detection And Response Tool) is designed to analyze patient data and identify potential sepsis conditions early, offering medical staff the right information for detection, and using smart sepsis alerts, support tracking of the treatment process. It moves with the patient through different hospital services and environments, integrates with any EMR system, and is customizable for various institutional purposes.
The Sepsis DART™ alert system monitors and communicates regarding all aspects of sepsis treatment bundles to the right practitioners at the right time, maintaining information on septic patients even between care locations and shifting staff. This reduces errors and omissions, as the entire care team understands on a real-time basis what treatment elements have and have not been delivered, and how much time is left to successfully complete treatment. And because Sepsis DART keeps all of the pertinent data for each case in a single repository, all centrally available and correlated to the “time zero” of the sepsis event, the effort required to abstract and report on sepsis cases is substantially reduced and that alone, not including improvements in outcomes and CMS compliance, often cost justifies any system costs.
For more detailed information on how you can solve sepsis in your organization with Ambient Clinical Analytics please contact tim.kuebelbeck@ambientclinical.com
About Ambient Clinical Analytics - As an industry leader, Ambient is supporting leading healthcare systems and has done so since its founding in 2013. Our solutions are designed by clinicians to be easy-to-use by every caregiver in your organization and are configured to be up and running rapidly. We are trusted by a community of high-performing healthcare providers across the United States. Our solutions are powerful real-time point-of-care and remote healthcare platforms designed to deliver life-saving solutions using data visualization, communication, and analytics based clinical decision support.
Ambient’s AWARE™ family of solutions are exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platforms. Ambient’s Sepsis DART™ product has been accepted into the Patient Safety Movement’s Actionable Patient Safety Solutions (APSS) #9 for Sepsis. Ambient has achieved ISO 13485:2016 certification, an internationally recognized quality standard specific to the medical device industry. The ISO 13485 standard sets out the requirements for a quality management system specific to the medical device industry. Ambient is also deploying the AWARE™ family of solutions, to help manage COVID-19. Ambient’s Virtual ICU platforms are ideal for dealing with current and possible future outbreaks. For more information, visit https://ambientclinical.com.
- Castellucci, M., Just 49% of hospitals follow CMS’ sepsis treatment protocols, Modern Healthcare, July 27, 2018
- Arefian H, et al Hospital-related cost of sepsis: A systematic review. J Infect. 2017 Feb;74(2):107-117. PMID: 27884733.
- AHRQ, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 2010
- Kulick, D., et al., Sepsis poses a cost-containment challenge in the face of the COVID-19 pandemic, HFMA, July 20, 2020
- Massachusetts Sepsis Consortium, Advancing Sepsis Care in Emergency Medicine, April 2019
- HHS.gov, Largest Study of Sepsis Cases among Medicare Beneficiaries Finds Significant Burden, HHS.gov, February 14, 2020
- Kumar A, et al Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006 Jun;34(6):1589-96. PMID: 16625125.
- Jozwiak M, Monnet X, Teboul JL., Implementing sepsis bundles, NCBI, September, 2016