{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:20:40Z","timestamp":1781572840618,"version":"3.54.5"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2017,8,28]],"date-time":"2017-08-28T00:00:00Z","timestamp":1503878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The purpose of this study was to determine whether an electronic health record\u2013based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Primary outcomes were length of stay (LOS) and in-hospital mortality; other outcomes included time to first lactate and blood cultures prior to antibiotics. We also assessed sensitivity, positive predictive value (PPV), and clinician response to the alerts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Mean LOS for patients with sepsis decreased from 10.1 to 8.6 days (P\u2009&amp;lt;\u2009.001) following alert introduction. In adjusted time series analysis, the intervention was associated with a decreased LOS of 16% (95% CI, 5%-25%; P\u2009=\u2009.007, with significance of \u03b1\u2009=\u20090.006) and no change thereafter (0%; 95% CI, \u22122%, 2%). The sepsis alert system had no effect on mortality or other clinical or process measures. The intervention had a sensitivity of 80.4% and a PPV of 14.6%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Alerting based on simple laboratory and vital sign criteria was insufficient to improve sepsis outcomes. Alert fatigue due to the low PPV is likely the primary contributor to these results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A more sophisticated algorithm for sepsis identification is needed to improve outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocx072","type":"journal-article","created":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T03:12:30Z","timestamp":1501643550000},"page":"523-529","source":"Crossref","is-referenced-by-count":48,"title":["Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay"],"prefix":"10.1093","volume":"25","author":[{"given":"Jonathan S","family":"Austrian","sequence":"first","affiliation":[{"name":"Department of Medicine, New York University Langone Medical Center, New York, NY, USA"},{"name":"Medical Center Information Technology, New York University Langone Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine T","family":"Jamin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, New York University Langone Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn R","family":"Doty","sequence":"additional","affiliation":[{"name":"Medical Center Information Technology, New York University Langone Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Blecker","sequence":"additional","affiliation":[{"name":"Department of Medicine, New York University Langone Medical Center, New York, NY, USA"},{"name":"Department of Population Health, New York University School of Medicine, New York, NY, 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