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Sanjhai Ramdeen,1 Brandon Ferrell,1 Christopher Bonk,2 Laura Schubel,2 Robin Littlejohn,2 Muge Capan,3 Ryan Arnold,4 Kristen Miller1,2 1Georgetown University School of Medicine, Washington, DC, USA; 2National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, DC, USA; 3Decision Sciences & MIS Department, LeBow College of Business, Drexel University, Philadelphia, PA, USA; 4Department of Emergency Medicine, Drexel University School of Medicine, Philadelphia, PA, USACorrespondence: Kristen MillerNational Center for Human Factors in Healthcare, MedStar Health Research Institute, 3007 Tilden Street NW, Suite 6N, Washington, DC, 20008, USATel +1 2022433873Fax +1 8553449800Email Kristen.E.Miller@medstar.netObjective: The goal of the study was to assess the criteria availability of eight sepsis scoring methods within 6 hours of triage in the emergency department (ED).Design: Retrospective data analysis study.Setting: ED of MedStar Washington Hospital Center (MWHC), a 912-bed urban, tertiary hospital.Patients: Adult (age ≥ 18 years) patients presenting to the MWHC ED between June 1, 2017 and May 31, 2018 and admitted with a diagnosis of severe sepsis with or without shock.Main Outcomes Measured: Availability of sepsis scoring criteria of eight different sepsis scoring methods at three time points— 0 Hours (T0), 3 Hours (T1) and 6 Hours (T2) after arrival to the ED.Results: A total of 50 charts were reviewed, which included 23 (46%) males and 27 (54%) females. Forty-eight patients (96%) were Black or African American. Glasgow Coma Scale was available for all 50 patients at T0. Vital signs, except for temperature, were readily available (> 90%) at T0. The majority of laboratory values relevant for sepsis scoring criteria were available (> 90%) at T1, with exception to bilirubin (66%) and creatinine (80%). NEWS, PRESEP and qSOFA had greater than 90% criteria availability at triage. SOFA and SIRS consistently had the least percent of available criteria at all time points in the ED.Conclusion: The availability of patient data at different time points in a patient’s ED visit suggests that different scoring methods could be utilized to assess for sepsis as more patient information becomes available.Keywords: sepsis, scoring systems, available criteria, emergency department, patient safety, quality improvement |
