Effect of Emergency Department Care Reorganization on Door-to-antibiotic Times for Sepsis (LDS SWARM)

Completed

• Conditions: Septic Shock; Sepsis
• Interventions: Other: Immediate evaluation by multidisciplinary team

• Registration Number: NCT03226366
• Lead Sponsor: Intermountain Health Care, Inc.

Brief Summary

Sepsis is a common syndrome resulting from a dysregulated response to infection. The timing of antibiotic initiation is an important determinant of outcomes for patients presenting to the emergency department with sepsis. The potential effect of care reorganization on very early care for sepsis is unknown. This study will investigate whether multidisciplinary coordination of the initial patient evaluation in the emergency department influences door-to-antibiotic time for septic patients.

Detailed Description

This is a retrospective cohort study of emergency department sepsis care before versus after implementation of a "swarming" model for simultaneous patient evaluation by multidisciplinary care providers. The analysis will use data from similar hospitals that did not change sepsis care organization during the study period to control for changes in sepsis care not resulting from the "swarming" intervention.

Study Timeline

• Study Start: 2015-05-16
• Primary Completion: 2017-01-31
• Study First Submitted: 2017-07-19
• Study First Submitted QC: 2017-07-20
• Study First Posted: 2017-07-21
• Study Completion: 2020-04-11
• Status Verified: 2020-06
• Results First Submitted: 2020-06-01
• Results First Submitted QC: 2020-06-01
• Last Update Submitted: 2020-06-01
• Results First Posted: 2020-06-18
• Last Update Posted: 2020-06-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 3230

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Post-implementation (intervention site)	Immediate evaluation by multidisciplinary team	Adult patients age ≥18 years eligible to receive immediate evaluation by multidisciplinary team ("swarming") after presenting to the ED of the intervention hospital with sepsis or septic shock between May 16, 2016 and February 15, 2017

Primary Outcome Measures

Name	Time	Method
Time From ED Arrival to Administration of First Dose of Antibiotics	24 hours

Secondary Outcome Measures

Name	Time	Method
ED Length of Stay	Up to 1 week	Time (minutes) from ED arrival to ED departure
Door-to-physician Evaluation Time	Up to 24 hours	Time (minutes) from subject's arrival in the ED until initial evaluation by a physician.
Hospital Mortality	Up to 1 year

Trial Locations

Locations (4)

Intermountain Medical Center; 🇺🇸 Murray, Utah, United States

Riverton Hospital; 🇺🇸 Riverton, Utah, United States

LDS Hospital; 🇺🇸 Salt Lake City, Utah, United States

Alta View Hospital; 🇺🇸 Sandy, Utah, United States