Imperial College London
Alternate

ProfessorAlisonHolmes

Faculty of Medicine, Department of Infectious Disease

Professor of Infectious Diseases
 
 
 
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Contact

 

+44 (0)20 3313 1283alison.holmes

 
 
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Location

 

8N16Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Honeyford:2020:jamia/ocz186,
author = {Honeyford, C and Cooke, G and Kinderlerer, A and Williamson, E and Gilchrist, M and Holmes, A and Glampson, B and Mulla, A and Costelloe, C},
doi = {jamia/ocz186},
journal = {Journal of the American Medical Informatics Association},
pages = {274--283},
title = {Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data},
url = {http://dx.doi.org/10.1093/jamia/ocz186},
volume = {27},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: To determine the impact of a digital sepsis alert on patient outcomes in a UK multi-site hospital network. Methods:A natural experiment utilising the phased introduction (without randomisation) of a digital sepsis alert into a multi-site hospital network. Sepsis alerts were either visible to clinicans (patients in the ‘intervention’ group) or running silently and not visible (the control group).  Inverse probability of treatment weighted multivariable logistic regression was used to estimate the effect of the intervention on individual patient outcomes.Outcomes:In-hospital 30-day mortality (all inpatients), prolonged hospital stay (≥7 days) and timely antibiotics (≤60minutes of the alert) for patients who alerted in the Emergency Department. Results: The introduction of the alert was associated with lower odds of death (OR:0.76; 95%CI:(0.70, 0.84) n=21183); lower odds of prolonged hospital stay ≥7 days (OR:0.93; 95%CI:(0.88, 0.99) n=9988);  and in patients who required antibiotics, an increased odds of receiving timely antibiotics (OR:1.71; 95%CI:(1.57, 1.87) n=4622).Discussion: Current evidence that digital sepsis alerts are effective is mixed. In this large UK study a digital sepsis alert has been shown to be associated with improved outcomes, including timely antibiotics. It is not known whether the presence of alerting is responsible for improved outcomes, or whether the alert acted as a useful driver for quality improvement initiatives.Conclusions: These findings strongly suggest that the the introduction of a network-wide digital sepsis alert is associated with improvements in patient outcomes, demonstrating that digital based interventions can be successfully introduced and readily evaluated.
AU  - Honeyford,C
AU  - Cooke,G
AU  - Kinderlerer,A
AU  - Williamson,E
AU  - Gilchrist,M
AU  - Holmes,A
AU  - Glampson,B
AU  - Mulla,A
AU  - Costelloe,C
DO  - jamia/ocz186
EP  - 283
PY  - 2020///
SN  - 1067-5027
SP  - 274
TI  - Evaluating a digital sepsis alert in a London multi-site hospital network: a natural experiment using electronic health record data
T2  - Journal of the American Medical Informatics Association
UR  - http://dx.doi.org/10.1093/jamia/ocz186
UR  - https://academic.oup.com/jamia/article/27/2/274/5607431
UR  - http://hdl.handle.net/10044/1/74143
VL  - 27
ER  -
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