Clinical Impact of a Sepsis Alert System Plus Electronic Sepsis Navigator Using the Epic Sepsis Prediction Model in the Emergency Department

-background: The Epic Sepsis Prediction Model (SPM) is a proprietary sepsis prediction algorithm that calculates a score correlating with the likelihood of an International Classification of Diseases, Ninth Revision code for sepsis. Objective: This study aimed to assess the clinical impact of an electronic sepsis alert and navigator using the Epic SPM on time to initial antimicrobial delivery. Methods: We performed a retrospective review of a nonrandomized intervention of an electronic sepsis alert system and naviga-tor using the Epic SPM. Data from the SPM site (site A) was compared with contemporaneous data from hospitals within the same health care system (sites B-D) and histor-ical data from site A. Nonintervention sites used a systemic inflammatory response syndrome (SIRS)-based alert with-out a sepsis navigator. Results: A total of 5368 admissions met inclusion criteria. Time to initial antimicrobial delivery from emergency department arrival was 3.33 h (interquar-tile range [IQR] 2.10-5.37 h) at site A, 3.22 h (IQR 1.97-5.60; p = 0.437, reference site A) at sites B-D, and 6.20 h (IQR 3.49-11.61 h; p < 0.001, reference site A) at site A histori-cal. After adjustment using matching weights, there was no difference in time from threshold SPM score to initial an-timicrobial between contemporaneous sites. Adjusted time to initial antimicrobial improved by 2.87 h ( p < 0.001) at site A compared with site A historical. Conclusions: Imple-mentation of an electronic sepsis alert system plus navigator using the Epic SPM showed no difference in time to initial antimicrobial delivery between the contemporaneous SPM alert plus sepsis navigator site and the SIRS-based electronic alert sites within the same health care system. (c) 2023 Else-vier Inc. All rights reserved.