785. Identifying Opportunities to Improve Adherence to Sepsis Care Guidelines Compliance

Abstract

BackgroundSepsis—a life-threatening organ dysfunction caused by a dysregulated host response to infection—is a major public health burden and is considered a leading cause of preventable death. Although sepsis care guidelines have been established by the Surviving Sepsis Campaign, improved compliance monitoring and analytics are required for sustainable improvement in clinical processes and patient outcomes. Using the Optum Pan-Therapeutic (PanTher) electronic medical record database, we developed granular process measures and a data analytics toolkit to measure compliance with sepsis care guidelines and provide insight into areas for improvement.MethodsWe identified 15,421 episodes of adult patients in January-June, 2017 with sufficient evidence of suspected sepsis. Episodes qualified if they: (1) met at least two of the quick Sequential Organ Failure Assessment (qSOFA) clinical criteria, (2) had a blood culture order initiated, and (3) had a serum lactate order. For these 15,421 episodes, we obtained the timestamps of antibiotics order and administration, blood culture order and collection, and when at least two of the qSOFA criteria were first met. Based on Surviving Sepsis Campaign care protocols for suspected Sepsis, we measured compliance for the timeliness of antibiotics administration and blood culture collection using a threshold of 3 hours after when the qSOFA criteria were first met.ResultsCompliance of the antibiotics administration and blood culture collection measures were found in 7,647/10,343 (74%) episodes and 1,219/1,530 (80%) episodes, respectively. The median times from when the qSOFA criteria were first met to antibiotics administration and blood culture collection were 77 minutes and 5 minutes, respectively.ConclusionWe have developed new process measures and a data analytics toolkit to monitor compliance rates and identify episodes where sepsis protocols are not followed according to sepsis care guidelines. These noncompliant episodes are opportunities for care providers to identify root causes of noncompliance and proactively work toward improved adherence to sepsis care guidelines. Disclosures All authors: No reported disclosures.