Utilization of a multidisciplinary emergency department sepsis huddle to reduce time to antibiotics and improve SEP-1 compliance

Am J Emerg Med. 2020 Nov;38(11):2400-2404. doi: 10.1016/j.ajem.2020.09.014. Epub 2020 Sep 10.

Abstract

Sepsis is a significant public health crisis in the United States, contributing to 50% of inpatient hospital deaths. Given its dramatic health effects and implications in the setting of new CMS care guidelines, ED leaders have renewed focus on appropriate and timely sepsis care, including timely administration of antibiotics in patients at risk for sepsis. Modeling the success of multidisciplinary bedside huddles in improving compliance with appropriate care in other healthcare settings, a Sepsis Huddle was implemented in a large, academic ED, with the goal of driving compliance with standardized sepsis care as described in the CMS SEP-1 measure. A retrospective cohort analysis was performed, with the primary finding that utilization of the Sepsis Huddle resulted in antibiotics being administered on average 41 min sooner than when the Sepsis Huddle was not performed. Given that literature suggests that early administration of appropriate antibiotic therapy is a major driver of mortality reduction in patients with sepsis, this study represents a proof of concept that utilization of a Sepsis Huddle may serve to improve outcomes among ED patients at risk for sepsis.

Keywords: Communication; Protocolized care; SEP-1; Sepsis; Time to antibiotics.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Blood Culture
  • Centers for Medicare and Medicaid Services, U.S.
  • Checklist*
  • Early Medical Intervention
  • Emergency Service, Hospital
  • Female
  • Fluid Therapy
  • Guideline Adherence / statistics & numerical data
  • Humans
  • Lactic Acid / blood
  • Male
  • Patient Care Bundles
  • Patient Care Team / organization & administration*
  • Retrospective Studies
  • Sepsis / blood
  • Sepsis / diagnosis
  • Sepsis / drug therapy*
  • Time-to-Treatment / statistics & numerical data*
  • United States

Substances

  • Anti-Bacterial Agents
  • Lactic Acid