Delays in antimicrobial administration are associated with poorer outcomes in sepsis. Previous order set work defaulting STAT priority yielded modest gains, but there were missed opportunities when clinicians ordered antimicrobials outside the order set. Introduction of an electronic medical record alert, based on ordering patterns plus historical MAR administrations, was deployed in a Pediatric ICU. This intervention led to significant and sustained improvement in STAT ordering and more rapid antimicrobial administration.

Describe the new knowledge and additional skills the participant will gain after attending your presentation.: The attendee will appreciate the value of applying QI methodologies to a clinical informatics implementation. The CDS was refined iteratively, modeling test characteristics during a background deployment phase that allowed for key adjustments without burdening busy clinicians with excessive false positives or concern of false negatives. The tools and methods used in this development scale easily if stakeholders can be engaged and there is a commitment to data-driven improvement.


Eric Shelov (Presenter)
The Children's Hospital of Philadelphia

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