Using lean methodology to optimize time to antibiotic administration in patients with sepsis

Horng, Michelle; Brunsman, Allison; Smoot, Thomas; Starosta, Kaitlin; Smith, Zachary

doi:10.2146/ajhp161017

Cited by 11 publications

(19 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The full list of studies included [19,38,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] and their main characteristics are shown in Table 2 Additional le 2.…”

Section: Resultsmentioning

confidence: 99%

“…[45] Results were matched and disagree were solved by meeting consensus. Fifteen studies were classi ed as "good", [19,47,[49][50]52-55, 57-61, 63-64] 5 as "fair" [38,46,51,62,65] and 2 as "poor". [48,56] Statistical heterogeneity was evaluated with I 2 statistics and Heterogeneity chi-square test.…”

Section: Methodsmentioning

confidence: 99%

“…measured the HAI as primary outcome measure and 8 studies[50-53, 57-59, 64] the healthcare worker compliance. Five studies[38,47,52,60,62] included relevant data on unexpected mortality and 2 studies[48,59] on healthcare workers satisfaction".…”

mentioning

confidence: 99%

See 2 more Smart Citations

Can lean reduce infections? A systematic review and meta-analysis of prospective studies

Patrone

Cristina²,

Spagnolo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Lean is largely applied to the health sector and on the healthcare-associated infections (HAI). The latter are a plague for our society. However, a few results on the improvement of the outcome have been reported in literature. The purpose of this study is to analyze if the lean application can reduce the healthcare-associated infections rate.Methods: A comprehensive search was performed on PubMed/Medline, Scopus, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: "lean" and "infection" from August to December 2019. Inclusion criteria were: 1) research articles with quantitative data and relevant information on lean methodology and its impact on healthcare infections; 2) prospective studies. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines has been used.Results: 22 studies were included in the present meta-analysis. Lean application demonstrated a significant protective role on healthcare-associated infections rate (RR 0.50 [0.38-0.66]) with significant impact on central line-associated bloodstream infections (CLABSIs) (RR 0.47 [0.28-0.82]). There was a significant correlation between lean application and healthcare worker satisfaction and compliance, but no significant decrease of mortality has been reported.Conclusions: Lean has a positive impact on the decreasing of HAIs and on the improvement of compliance and satisfaction of the staff.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Can lean reduce infections? A systematic review and meta-analysis of prospective studies

Patrone

Cristina²,

Spagnolo

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…This, coupled with the potential for breakdowns in communication, accountability, medication reconciliation, and education, can lead to adverse drug events in the outpatient setting. 6 The research team sought to develop a pharmacist-driven process to address these issues and bridge the gap between the inpatient and outpatient settings while increasing successful patient contact points during the TOC process from the hospital to home.…”

Section: Discussionmentioning

confidence: 99%

“…Integrating pharmacists to perform medication review and education at many points during hospitalization can yield beneficial outcomes. 2-4,6,7 A reduction in medication discrepancies and postdischarge adverse events has been demonstrated when pharmacists are involved in discharge counseling and telephone follow-up postdischarge. 2-4,8 During telephone follow-up in the present study, 13% of medications had some form of discrepancy requiring intervention, and the average number of medication discrepancies addressed per patient was 2.2.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Discharge Education Program to Improve Transitions of Care for Patients at High Risk of Medication Errors

et al. 2019

View full text Add to dashboard Cite

Background: Transitions of care (TOC) points are those where patient outcomes can be affected, especially patients at high risk for medication errors. Pharmacist-led postdischarge telephone counseling positively affects patient outcomes, though challenges exist relating to successful patient contact. Objective: The objective of this study was to develop and evaluate a discharge education service bridging the inpatient and outpatient setting to increase successful patient contact points during the TOC process from hospital to home. Methods: This prospective, single-centered observational study examined the impact of a discharge medication education program on successful telephone follow-up contact. The primary outcome was the percentage of high-risk patients educated at hospital discharge who were successfully reached via follow-up telephone contact within 2 business days of discharge. Secondary end points included hospital readmission rates and patient survey responses. Results: A total of 50 patients were included in the initial evaluation of this service; 78% of patients were successfully contacted within 2 business days after discharge, an increase from a 20% success rate prior to service implementation. At follow-up telephone calls, patients reported taking an average of 16 medications. The 30-day readmission rate was 10% for patients receiving this service, compared with 19% prior to implementation. When asked if they understood the medication component of their care and if they found the TOC service to be satisfactory, 100% and 96% of patients strongly agreed or agreed with these statements, respectively, and none disagreed. Conclusion and Relevance: This service demonstrates how pharmacists can interact with a high-risk population and increase contact points to optimize care at crucial health care transition points.

show abstract

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Atkins

Bastin

Morgan

et al. 2022

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Introduction Sepsis is a life‐threatening medical emergency and a leading cause of morbidity and mortality worldwide. Reductions in time to antibiotics in patients presenting with sepsis or septic shock are associated with reduced mortality, and Surviving Sepsis Campaign guidelines recommend antibiotics within 1 h of recognition. Pharmacists are well‐equipped to help navigate the therapeutic and operational challenges associated with achieving this goal. Objectives To assess the association of pharmacist involvement in sepsis response with time to antibiotics in hospitalized patients with sepsis and septic shock. Methods A systematic review of the following databases was conducted: PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Studies must have included a designated role of an individual pharmacist in the management of sepsis or septic shock and not be considered an operational change. The primary outcome of interest was time to antibiotic administration, with secondary outcomes including intensive care unit (ICU) and hospital length of stay as well as in‐hospital mortality. Results We identified 10 studies including 1772 patients with sepsis or septic shock that evaluated a sepsis response in which a pharmacist was included. Studies included patients in the ICU, emergency department, and hospital ward setting. Seven studies demonstrated a significant reduction in time to antibiotics, with two other studies supporting this conclusion in extrapolation or sensitivity analysis. There was not a consistent reduction in ICU or hospital length of stay nor in‐hospital mortality between those interventions involving a pharmacist compared with their defined control groups. Conclusion Pharmacist involvement in sepsis response, often as part of a multiprofessional team‐based approach to sepsis care, is associated with a reduced time to antibiotic administration for hospitalized patients with sepsis or septic shock.

show abstract

Using lean methodology to optimize time to antibiotic administration in patients with sepsis

Abstract: Lean methodology was successfully used to reduce time to antibiotic administration, which led to improved compliance with the newly implemented sepsis CMS core measure.

Cited by 11 publications

References 16 publications

Can lean reduce infections? A systematic review and meta-analysis of prospective studies

Can lean reduce infections? A systematic review and meta-analysis of prospective studies

Implementation of a Discharge Education Program to Improve Transitions of Care for Patients at High Risk of Medication Errors

Pharmacist involvement in sepsis response and time to antibiotics: A systematic review

Contact Info

Product

Resources

About