ArticleBMJ open quality2018
Implementation of a whole of hospital sepsis clinical pathway in a cancer hospital: impact on sepsis management, outcomes and costs.
Article in BMJ open quality, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Data-Driven Guideline Adherence in Data Representation and Compliance Measurement: Scoping Review.Journal of medical Internet research · 2026Review
- Impact of the implementation of an obstetric sepsis protocol on maternal and neonatal outcomes.Pregnancy (Hoboken, N.J.) · 2025Article
- Roles and responsibilities of registered nurses in the early recognition and management of sepsis in acute hospital settings: a scoping review.BMJ open quality · 2025Article
- Article
- Preneutropenic Fever in Patients With Hematological Malignancies: A Novel Target for Antimicrobial Stewardship.Open forum infectious diseases · 2024Article
- Emergency Department Use and Hospital Mortality Among Heart Transplant Recipients in the United States.Journal of the American Heart Association · 2024Article
- A nursing-led sepsis response team guiding resuscitation with point-of-care ultrasound: A review and model for improving bundle compliance while individualizing sepsis care.SAGE open medicine · 2024Review
- Care pathways of sepsis survivors: sequelae, mortality and use of healthcare services in France, 2015-2018.Critical care (London, England) · 2023Article
- Article
- Recognition and Management of Hospital-Acquired Sepsis Among Older General Medical Inpatients: A Multi-Site Retrospective Study.International journal of general medicine · 2023Article
- A state-wide implementation of a whole of hospital sepsis pathway with a mortality based cost-effectiveness analysis from a healthcare sector perspective.PLOS global public health · 2023Article
- Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review.Resuscitation plus · 2022Article
- One-year hospital readmission for recurrent sepsis: associated risk factors and impact on 1-year mortality-a French nationwide study.Critical care (London, England) · 2022Article
- Implementing a Personalized Antimicrobial Stewardship Program for Women with Gynecological Cancers and Healthcare-Associated Infections.Journal of personalized medicine · 2022Article
- Antimicrobial stewardship in Australia: the role of qualitative research in programme development.JAC-antimicrobial resistance · 2021Review
- Letter in reply to Carboni F et al.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Event Surrogate from Clinical Pathway Completion to Daily Meal for Availability Extension Using Standard Electronic Medical Records: a Retrospective Cohort Study.Journal of medical systems · 2021Article
- Excess cost of care associated with sepsis in cancer patients: Results from a population-based case-control matched cohort.PloS one · 2021Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Infection and sepsis are common problems in cancer management affecting up to 45% of patients and are associated with significant morbidity, mortality and healthcare utilisation.
objectiveTo develop and implement a whole of hospital clinical pathway for the management of sepsis (SP) in a specialised cancer hospital and to measure the impact on patient outcomes and healthcare utilisation.
methodsA multidisciplinary sepsis working party was established. Process mapping of practices for recognition and management of sepsis was undertaken across all clinical areas. A clinical pathway document that supported nurse-initiated sepsis care, prompt antibiotic and fluid resuscitation was implemented. Process and outcome measures for patients with sepsis were collected preimplementation (April-December 2012), postimplementation cohorts (April-December 2013), and from January to December 2014.
results323 patients were evaluated (111 preimplementation, 212 postimplementation). More patients with sepsis had lactate measured (75.0% vs 17.2%) and appropriate first dose antibiotic (90.1% vs 76.1%) (all p<0.05). Time to antibiotics was halved (55 vs 110 min, p<0.05). Patients with sepsis had lower rates of intensive care unit admission (17.1% vs 35.5%), postsepsis length of stay (7.5 vs 9.9 days), and sepsis-related mortality (5.0% vs 16.2%) (all p<0.05). Mean total hospital admission costs were lower in the SP cohort, with a significant difference in admission costs between historical and SP non-surgical groups of $A8363 (95% CI 81.02 to 16645.32, p=0.048) per patient on the pathway. A second cohort of 449 patients with sepsis from January to December 2014 demonstrated sustained improvement.
conclusionsThe SP was associated with significant improvement in patient outcomes and reduced costs. The SP has been sustained since 2013, and has been successfully implemented in another hospital with further implementations underway in Victoria.
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