Honeyford, Kate, Timney, Alf, Lazzarino, Runa, Welch, John, Brent, Andrew Jonathan, Kinderlerer, Anne, Ghazal, Peter  ORCID: https://orcid.org/0000-0003-0035-2228, Gordon, Anthony C., Patil, Shashank, Cooke, Graham and Costelloe, Ceire E.
2025.
Digital innovation in healthcare: quantifying the impact of digital sepsis screening tools on patient outcomes-a multi-site natural experiment.
BMJ Health & Care Informatics
32
(1)
, e101141.
10.1136/bmjhci-2024-101141
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Abstract
Introduction The National Health Service (NHS) ‘move to digital’ incorporating electronic patient record systems (EPR) facilitates the translation of paper-based screening tools into digital systems, including digital sepsis alerts. We evaluated the impact of sepsis screening tools on in-patient 30-day mortality across four multi-hospital NHS Trusts, each using a different algorithm for early detection of sepsis. Methods Using quasi-experimental methods, we investigated the impact of the screening tools. Individual-level EPR data for 718 000 patients between 2010 and 2020 were extracted to assess the impact on a target cohort and control cohort using interrupted time series analysis, based on a binomial regression model. We included one Trust which uses a paper-based screening tool to compare the impact of digital and paper-based interventions, and one Trust which did not introduce a sepsis screening tool, but did introduce an EPR. Results All Trusts had lower odds of mortality, between 5% and 12%, after the introduction of the sepsis screening tool, before adjustment for pre-existing trends or patient casemix. After adjustment for existing trends, there was a significant reduction in mortality in two of the three Trusts which introduced sepsis screening tools. We also observed age-specific effects across Trusts. Conclusion Our findings confirm that patients with similar profiles have a lower mortality risk, consistent with our previous work. This study, conducted across multiple NHS Trusts, suggests that alerts could be tailored to specific patient groups based on age-related effects. Different Trusts may require unique indicators, thresholds, actions and treatments. Including additional EPR information could further enhance personalised care.
| Item Type: | Article |
|---|---|
| Date Type: | Published Online |
| Status: | Published |
| Schools: | Schools > Medicine |
| Publisher: | BMJ Publishing Group |
| ISSN: | 2632-1009 |
| Date of First Compliant Deposit: | 20 May 2025 |
| Date of Acceptance: | 20 March 2025 |
| Last Modified: | 21 May 2025 11:00 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/178389 |
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