MedicalResearch.com Interview with:
Faheem Guirgis MD
Assistant Professor of Emergency Medicine
Department of Emergency Medicine
Division of Research
UF Health Jacksonville
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sepsis is quite prevalent among hospitals and the incidence is increasing. It is a life-threatening disease that can lead to poor outcomes if patients are not recognized and treated promptly. We recognized that our institution needed a strategic approach to the problem of sepsis, therefore the Sepsis Committee was created with the goal of creating a comprehensive sepsis program.
We developed a system for sepsis recognition and rapid care delivery that would work in any area of the hospital. We found that we reduced overall mortality from sepsis, the number of patients requiring mechanical ventilation, intensive care unit length and overall hospital length of stay, and the charges to the patient by approximately $7000 per patient.
MedicalResearch.com: What should readers take away from your report?
Response: With the implementation of electronic health record systems at hospital, automated sepsis recognition is possible and effective. Our study used an adjusted Modified Early Warning Score which can be calculated in the background of our EHR. Once automated recognition is instituted, a care delivery bundle should be designed that can work in any area of the hospital. Each area of the hospital should have specified roles for care delivery and should be adequately trained, with emphasis on early antibiotics, intravenous fluids, lactate measurement, and obtaining blood cultures to meet quality metrics. We used a rapid response team for sepsis care delivery on the wards. This novel approach has lead to reductions in mortality from other conditions and now we have shown that it works for sepsis as well.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should be data-driven and oriented to the particular hospital. Sepsis committees should meet to regularly review their data and try to determine if there are additional areas for improvement. Improving outcomes from sepsis requires a multi-disciplinary team, creativity, and persistence in looking for areas of potential improvement. It also requires sepsis committee members to know their patient population and be familiar with their data. Structured chart reviews of particular high-risk cases should also be undertaken.
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J Crit Care. 2017 Apr 8. pii: S0883-9441(16)31007-3. doi: 10.1016/j.jcrc.2017.04.005.
Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives.
Guirgis FW1, Jones L2, Esma R3, Weiss A4, McCurdy K5, Ferreira J6, Cannon C7, McLauchlin L8, Smotherman C9, Kraemer DF10, Gerdik C11, Webb K12, Ra J13, Moore FA14, Gray-Eurom K15.
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