Digital sepsis monitoring system improving care

A study has revealed that a digital sepsis alert system and multidisciplinary care plan has helped create lower odds of death, shorter hospital stays and increased odds of receiving timely antibiotics.

Carried out at Imperial College London, the study is believed to be the first evaluation of a digital sepsis alert system in a British hospital trust and the largest undertaken anywhere to date.

If diagnosed early, sepsis can be treated effectively with antibiotics but the difficulty lies in spotting sepsis before it develops, as symptoms are similar to other illnesses such as flu. The Imperial College London-based system, first introduced in 2016, monitors a range of changes in patients such as temperature, heart rate and glucose levels and alerts doctors and nurses if they fall outside safe parameters so they can investigate further.

Clinicians are then notified of patients who have triggered the alert either through a pop-up warning on their electronic health records and/or on a dashboard, which highlights any patient with an active alert when they open a patient’s record.

In addition to the alert, the trust designed a multidisciplinary care plan which is launched in the electronic patient record system when a clinician confirms a diagnosis of sepsis. This prompts the clinical team to determine the best options from a range of treatments, such as fluids, oxygen, diagnostic tests and early antibiotics, and ensure they are given to patients within one hour – in line with national targets.

Dr Kate Honeyford, lead author of the research, said: “Sepsis can be deadly if it’s not diagnosed and treated quickly. However, symptoms can be hard to spot and are similar to other conditions such as flu or a chest infection, which can result in delayed diagnosis and treatments. The sepsis alert system was put in place at Imperial College Healthcare NHS Trust to see if it can help monitor and flag patients who may have sepsis to clinicians for further investigations and treatments. Often digital systems are implemented but research on their performance is not done. Our study shows for the first time that robust analysis of a digital alert system was associated with improvements in outcomes for patients and the system presents an opportunity to improve care for patients who may have sepsis.”

The study was based around more than 21,000 hospital stays of patients who had triggered the alert system between October 2016 and May 2018, predominantly within emergency departments as well as acute and haematology wards at St Mary’s Hospital, Charing Cross Hospital and Hammersmith Hospital.