{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:31:26Z","timestamp":1785256286612,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS029656"],"award-info":[{"award-number":["R01HS029656"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sepsis ranks among the \u201cBig Three\" conditions most prone to harmful diagnostic errors. Despite its high prevalence and severity, health systems lack effective and contextually tailored strategies to optimize diagnostic accuracy for sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study is to understand factors related to high sepsis diagnostic accuracy using principles and tools of safety and implementation science.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multi\u2010site study involving 20 hospitals across four states in the United States. The primary objectives are to (1) describe hospital\u2010level variability and understand barriers and facilitators to sepsis diagnostic accuracy and (2) apply cross\u2010case and coincidence analysis to determine minimally sufficient and necessary conditions for optimal sepsis diagnosis that minimizes under\u2010 and overtreatment. To identify barriers and facilitators of acute sepsis diagnosis, we will conduct electronic surveys and in\u2010depth interviews with key informants from each hospital. We will use data from electronic health records (EHR) and data warehouses to operationalize sepsis diagnostic accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We have enrolled 20 hospitals and begum data collection. The findings of this study will be used to develop a context\u2010specific toolkit that guides the selection of feasible and important strategies to promote optimal sepsis diagnosis in diverse hospitals settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study uses tools and principles from safety and implementation science to generate first\u2010of\u2010its\u2010kind evidence to improve diagnostic excellence in sepsis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.70052","type":"journal-article","created":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T10:19:41Z","timestamp":1744539581000},"page":"800-807","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic safety and quality optimization in sepsis study protocol"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-8756","authenticated-orcid":false,"given":"Sachita","family":"Shrestha","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2624-4209","authenticated-orcid":false,"given":"Marc","family":"Kowalkowski","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Birken","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Palakshappa","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"King","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadwick","family":"Miller","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Pogue","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Michigan Ann Arbor Michigan USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_2_7_3_1","unstructured":"McDermottKW RoemerM.Most Frequent Principal Diagnoses for Inpatient Stays in U.S. Hospitals 2018. 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