e-Bridge Sepsis Module

Sepsis workflow

Improving Sepsis Case Data Collection with Mobile Telemedicine 

THE CHALLENGE

Sepsis is the 11th leading cause of death in the United States, resulting in the hospitalization of 750,000 patients a year and 40,685 deaths. Therefore, every second count. According to the Journal of Emergency Medical Services, “In order to improve outcomes of patients presenting with sepsis, greater emphasis needs to be placed on early recognition and treatment of sepsis in the prehospital setting”. Therefore, the more prepared the ED is for the patient’s arrival, the quicker they can start administering resuscitation, antibiotics, and source control, and the better the outcome.

Through the use of a specialized digital mobile telemedicine app, EMS and sepsis teams are uniquely positioned to improve the saving of lives through timely intervention with engaging hospital and sepsis team staff via app features to initiate broader acute workflow improvements. Multi-faceted alerts including data collection and vitals shared real-time with ETA tracking to providers, speeds treatment and engagement to improve outcomes while adding short and long-term educational value. A vital part of sepsis cases is making sure treatment is handled in a timely manner. Having a configurable mobile telemedicine solution allows for ED and sepsis teams to effectively communicate in order to properly treat the patient.

THE SOLUTION

The sepsis case workflow process below utilizes GD’s e-Bridge Workflow Mobile Telemedicine app. The solution provides an easy to use, state or region-wide mechanism to alert, notify and track all sepsis cases in real time from prehospital first medical contact through hospital emergency department, handoff to sepsis teams. This will help the sepsis team be better prepared for the inbound patient while lessening the handoff time and increasing data accuracy.

Note that all e-Bridge Workflow templates are highly configurable, allowing flexibility to operate protocols your way, ensuring maximum effectiveness and compliance to your teams and sepsis accreditations.

  • 911 communications center receives a call for a possible sepsis and dispatches EMS
  • EMS receives the CAD location information and responds
  • Dispatch and arrival times documented in CAD
  • Upon arrival, EMS’ patient assessment identifies possible sepsis case
  • Once sepsis assessment is conducted EMS selects the destination/ hospital
  • EMS clicks the “Sepsis” button of the e-Bridge app on their mobile device and treats the patient. The location is tagged and the running clock begins.*
  • The highly configurable workflow template prompts for initial patient demographic*, driver’s license, ID scan/picture, and medical incident and treatment information.
  • Notifications for events are time stamped, logged and shared in real- time with preselected team members via e-Bridge (ED computer, mobile devices, etc.)
  • Existing or newly assigned specialists can be notified and added to the team- either pre-configured or at any point by ED after arrival
  • Live (synchronous) or asynchronous video consult with a physician, specialist, etc is available. Secure multimedia such as pictures, video, audio, text, team chat and vital sign and ECG sharing is available
  • If transporting, live ETA is sent to receiving hospital and specialists once in route

  • If AMA refusal, video consult with physician or specialist may avert refusal, otherwise video documentation of refusal is recorded to mitigate risk
  • Hospital ED physician/ nurse to notify and add hospital patient registration to the case, allowing them to pre-register the patient before arrival
  • ED team member assigns bed and EMS is notified pre-arrival, via the app
  • Hospital ED can see tracking map with priority and live ETA. Once the ambulance is within “geofence” of the hospital an “arrival” alert is announced and displayed and team members are alerted on the e-Bridge app
  • ED team assesses the need for a lab scan
  • EMS arrives and moves the patient to the pre-assigned bed and hands off the patient to ED staff that is already prepared and ready with a pre-registered ID wristband
  • ED staff take over patient care and the pre-hospital phase has ended
  • If transfer to the ICU is necessary it can now be initiated using the e-Bridge app
  • EMS clears us from the call and goes back in service but is available for questions, team chat, notifications, and outcome results, via the e-Bridge app
  • Downstream outcome feedback/ status is entered by hospital staff, EMS is notified via e-Bridge

EXPECTED RESULTS:

  • Process Improvement for sepsis patient intervention and flow
  • Automated Case Management
  • Timestamped and recorded metrics
  • Proactively prepare labs
  • Reduce false lab activations
  • Online Medical Control
  • Feedback and benchmarking
  • Smoother patient handoff
  • Communication with EMS on outcome data
  • Continued education and training for sepsis teams and EMS officials based on trend report and time studies
  • EMS transfer and follow up performed easier
  • Consistency in working protocols

METRICS TO TRACK

  • Infection Score
  • Patient temperature
  • Heart rate
  • Respiratory rate
  • SBP/MAP levels
  • Lactate Levels
  • Central Venous Pressure
  • Central Venous Oxygen Saturation
  • Vasopressor Agents

It all starts by taking the first step!