Evaluating a Sepsis Screening Tool in the Outpatient Setting

Sepsis, a condition requiring prompt intervention, is challenging to identify early in adult patients with cancer because of varied symptoms and disease status. To address this, a best practice advisory (BPA) using criteria for systemic inflammatory response syndrome was implemented at a large urban cancer center.

This quality improvement project aimed to evaluate the effectiveness of the BPA in identifying sepsis among adult patients with cancer in an outpatient setting. The team sought to determine whether the BPA could reliably prompt sepsis workups, thereby improving sepsis detection and management.

The quality improvement project implemented an outpatient sepsis BPA based on systemic inflammatory response syndrome criteria. The BPA triggered alerts for sepsis when two or more criteria were met.

The initial BPA alert resulted in 253 of 275 (92%) false-positive sepsis alerts. To improve accuracy, the heart rate threshold was adjusted from greater than 90 beats per minute to greater than 100 beats per minute. This adjustment reduced false positives by nearly 50%, improving specificity for identifying at-risk patients while maintaining effective detection of true sepsis cases.