Observational studyCritical care medicine2019
Patient Outcomes and Cost-Effectiveness of a Sepsis Care Quality Improvement Program in a Health System.
Observational study in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review.Annals of internal medicine · 2025Pooled it
- Implementation costs of hospital-based computerised decision support systems: a systematic review.Implementation science : IS · 2023Pooled it
- A Review of Mortality Risk Prediction Models in Smartphone Applications.Journal of medical systems · 2021Pooled it
- Association Between Community-Level Social Determinants of Health and Sepsis Incidence and Mortality: A Scoping Review.Critical care explorations · 2026Article
- From Resuscitation to Rehabilitation: The Post-Intensive Care Syndrome Continuum in Sepsis Care.Journal of clinical medicine · 2025Review
- A program to improve sepsis management in the Emergency Department: a multicenter prospective study in France.Internal and emergency medicine · 2025Article
- Trends of sepsis hospitalizations among female active component U.S. service members, 2011-2022.MSMR · 2025Article
- Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey.American journal of respiratory and critical care medicine · 2025Article
- Molecular Biomarkers and More Efficient Therapies for Sepsis.Biomedicines · 2025Article
- Context and determinants for implementing a sepsis survivor care transition intervention reported from five health systems and home health agencies.Frontiers in medicine · 2025Article
- Article
- Observational
- Information displays for automated surveillance algorithms of in-hospital patient deterioration: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Interleukin-36 is overexpressed in human sepsis and IL-36 receptor deletion aggravates lung injury and mortality through epithelial cells and fibroblasts in experimental murine sepsis.Critical care (London, England) · 2023Article
- Institutional Structures and Processes to Support Sepsis Care: A Multihospital Study.Critical care explorations · 2023Article
- Cost-effectiveness analysis of Smart Triage, a data-driven pediatric sepsis triage platform in Eastern Uganda.BMC health services research · 2023Article
- Sepsis Program Activities in Acute Care Hospitals - National Healthcare Safety Network, United States, 2022.MMWR. Morbidity and mortality weekly report · 2023Article
- Evaluating the costs and consequences of computerized clinical decision support systems in hospitals: a scoping review and recommendations for future practice.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Effect of a quality improvement program on compliance to the sepsis bundle in non-ICU patients: a multicenter prospective before and after cohort study.Frontiers in medicine · 2023Article
- Scoping review of costs of implementation strategies in community, public health and healthcare settings.BMJ open · 2022Article
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Authors and funding
10 authors.
Funding
Abstract
objectivesAssess patient outcomes in patients with suspected infection and the cost-effectiveness of implementing a quality improvement program. DESIGN, SETTING, AND
participantsWe conducted an observational single-center study of 13,877 adults with suspected infection between March 1, 2014, and July 31, 2017. The 18-month period before and after the effective date for mandated reporting of the sepsis bundle was examined. The Sequential Organ Failure Assessment score and culture and antibiotic orders were used to identify patients meeting Sepsis-3 criteria from the electronic health record.
interventionsThe following interventions were performed as follows: 1) multidisciplinary sepsis committee with sepsis coordinator and data abstractor; 2) education campaign; 3) electronic health record tools; and 4) a Modified Early Warning System. MAIN OUTCOMES AND MEASURES: Primary health outcomes were in-hospital death and length of stay. The incremental cost-effectiveness ratio was calculated and the empirical 95% CI for the incremental cost-effectiveness ratio was estimated from 5,000 bootstrap samples.
resultsIn multivariable analysis, the odds ratio for in-hospital death in the post- versus pre-implementation periods was 0.70 (95% CI, 0.57-0.86) in those with suspected infection, and the hazard ratio for time to discharge was 1.25 (95% CI, 1.20-1.29). Similarly, a decrease in the odds for in-hospital death and an increase in the speed to discharge was observed for the subset that met Sepsis-3 criteria. The program was cost saving in patients with suspected infection (-$272,645.7; 95% CI, -$757,970.3 to -$79,667.7). Cost savings were also observed in the Sepsis-3 group. CONCLUSIONS AND RELEVANCE: Our health system's program designed to adhere to the sepsis bundle metrics led to decreased mortality and length of stay in a cost-effective manner in a much larger catchment than just the cohort meeting the Centers for Medicare and Medicaid Services measures. Our single-center model of interventions may serve as a practice-based benchmark for hospitalized patients with suspected infection.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.