Dec 27

Sepsis Bundle Compliance

12/27/18 | Delivering Results

Sepsis Bundle Compliance

Sepsis is the leading cause of hospital mortality. Sepsis diagnoses are present in 40% of MU Health Care’s mortalities. Compliance with the 3- and 6-Hour Sepsis Bundles (a set of early interventions to be performed within 3 and 6 hours of identification, aimed at reducing sepsis mortality) are critical. Dashboards have been developed for retrospective analysis, however real-time information is necessary for timely, appropriate care.

The Tiger Institute Development at the Edge (TIDE) team has developed a first-of-its-kind, Sepsis Bundle Compliance Tool which gives providers real-time insight into the multi-factor, narrow bundle compliance time line and enables them to ensure appropriate care is delivered in a timely manner. The tool indicates whether each element was met, is at-risk of being out of compliance, or was not met. Providers can also review relevant clinical information including lab results, medication administration times, and fluids administered directly within the tool.

We believe real-time information to support standardization of care will support bundle compliance and result in a corresponding reduction in Sepsis mortality.

SMART Results Graphing

Only about half of the 78 million US adults diagnosed with hypertension have their blood pressure (BP) controlled. Recent research has identified the important role of home BP measurements, considered equal, or even superior, to clinic BP measurements in their predictive value.

However, home BP data in its numerical form—often provided by patients as written notes or submitted through telehealth applications—may not be used to its fullest potential. Visualization of home blood pressure data values may prove to be the solution; however, current  EHR systems do not have adequate capabilities for informative visualizations of home-entered values.

Beginning in February 2017, our TIDE team designed and developed a graphical display of BP measurements and provided for patients to easily record home BPs through their MU patient portal account. The team used Fast Healthcare Interoperability Resources (FHIR) standards to develop this view for both patients and physicians.

The physician view accommodates numerous patient-entered home BPs and includes intuitive display of target range and a smoothing line indicating rolling average. This view, which makes judgment about BP control more accurate, is now available (since February 2018) with the patient portal and within workflows for ambulatory primary care physicians in the Cerner Millennium EHR.

 

 

The team also developed a medication time line to correspond with times of home and/or clinical BP measurements. This can help a clinician more easily determine the effects of medication on a patient’s blood pressure so he or she can make a more informed adjustment to drugs and/or dosage. Research evaluation is underway.