Metric Development for the Multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.

Area of Science:

• Pediatric critical care medicine
• Quality improvement science
• Health informatics

Background:

• A collaborative of 56 US hospitals, Improving Pediatric Sepsis Outcomes, was formed to enhance pediatric sepsis care.
• This initiative builds upon prior quality improvement (QI) efforts by standardizing electronic data capture and uniformity across participating sites.

Purpose of the Study:

• To develop and implement standardized variables and metrics for tracking quality improvement in pediatric sepsis patient outcomes.
• To establish a robust data analysis plan for monitoring progress over time.

Main Methods:

• An expert panel defined evidence-based metrics and corresponding variables across the care spectrum (ED, acute care, heme/onc, ICU).
• Statistical process control charts were used to map variables and visualize progress, informing Plan-Do-Study-Act cycles.
• Electronic health record (EHR) data abstraction feasibility was prioritized, defining time zero for sepsis recognition.

Main Results:

• Twenty-four metrics were developed for a uniformly defined sepsis cohort, with 44 final variables mapped to statistical process control charts.
• Forty of the 44 variables could be automatically abstracted from multiple EHRs, demonstrating high potential for automation.
• Despite challenges with abstracting certain variables (<80% of encounters), 90% of the projected data (200,007 sepsis episodes) has been submitted.

Conclusions:

• A comprehensive data dictionary was created for this large-scale pediatric sepsis QI collaborative, optimizing automated and sustainable reporting.
• The developed methodologies are applicable to other large-scale QI projects utilizing EHR data abstraction for sepsis research.