Epic alert exposes ‘silent killer’

Patients at risk of the ‘silent killer’ sepsis are being identified and treated quicker at Cambridge University Hospitals thanks to a new alert and action feature in its electronic patient record system.

A new alert and set of actions within the Trust’s electronic patient record system, Epic, part of the Trust’s eHospital digital transformation programme, identifies patients showing signs of sepsis - the life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.

National guidance recommends that patients with sepsis are given antibiotics within an hour of diagnosis to reduce the risk of serious complications or even death. Every year 250,000 people are affected by sepsis and it accounts for around 44,000 deaths, more than bowel, breast and prostate cancer combined.

However, sepsis can be difficult to spot and is often mistaken in the early stages for other more localised infections. This electronic alert brings to the clinicians’ attention that sepsis could be a possibility if a patient’s clinical observations meet the relevant criteria.

A series of electronic prompts built within the Epic system guides the actions and tests needed to help quickly diagnose sepsis. Clinicians select and order the most appropriate antibiotics to treat the source of the infection and the electronic system helps by recommending the correct dose and frequency.

Since its launch there has been a 70% increase in the proportion of patients diagnosed with sepsis receiving antibiotics within the recommended national timeframe when presenting at Accident and Emergency, and a 50% increase across adult inpatient areas at Addenbrooke’s and The Rosie hospitals.

Driven by the Trust’s Sepsis Action Group – consisting of clinicians from the emergency department, acute medicine, infectious diseases, rapid response and the eHospital digital team – they developed and built the electronic alert and action set  to further utilise the capabilities of the Trust’s Epic system, implemented across Addenbrooke’s and The Rosie hospitals in October 2014.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        

Dr Afzal Chaudhry, renal consultant and chief clinical information officer, said: “The vision of eHospital in 2010 was to use advanced technology to improve patient safety, provide high quality care and contribute to better outcomes. This is another excellent example of how we are achieving exactly that by developing the extensive capabilities of our advanced electronic patient record system.”

Dr Sian Coggle, consultant in acute medicine and infectious diseases and sepsis lead, added: “Improving prompt identification of sepsis patients and timely access to treatment is vital. The electronic alert and action set, devised with clinicians and built into the Epic system by our in-house eHospital digital team, better equips doctors and nurses to be more aware of the possibility of sepsis and act quickly with appropriate treatment.”

This work has been shortlisted in two categories at the national Patient Safety Awards: ‘best patient safety initiative in ED’ and ‘information technology’. Winners will be announced at a special ceremony in Manchester on 9 July 2018.


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