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This research investigates the impact of an electronic medical record-based sepsis response protocol on the outcomes of hospitalized patients with hospital-onset sepsis.

May 31, 2026Open Access

Prioritizing the patient through a continuum of personalized care: insights from the 2026 Surviving Sepsis Campaign guidelines

Key Points

This research investigates the impact of an electronic medical record-based sepsis response protocol on the outcomes of hospitalized patients with hospital-onset sepsis.
Implemented an electronic medical record-based sepsis response protocol in August 2022.
Retrospectively analyzed patients screened for sepsis before and after SRP implementation for one year.
Conducted 1:1 propensity score matching for patient groups to assess outcomes.
SRP group patients had a lower 30-day mortality risk (hazard ratio 0.56; 95% CI, 0.36-0.86; P=0.017).
Blood culture testing rates improved in the SRP group (58.5%) compared to the preliminary group (45.5%) (P=0.019).
Survival benefits from SRP began to manifest after the first 4 months (P=0.036).

Abstract

Background:The effectiveness of electronic medical record-based alert systems, response protocols for sepsis diagnosis, and treatment in hospitalized patients remains unclear.This study aimed to determine whether the introduction of an electronic medical record-based sepsis response protocol (SRP) along with a 24/7 operating rapid response system affects the prognosis for patients with hospital-onset sepsis.Methods: In August 2022, an SRP based on the National Early Warning Score was implemented in the electronic medical record system at Asan Medical Center.We retrospectively analyzed patients screened by the detection system for 1 year after the SRP implementation.Patients of the first 6 months (preliminary group) and those of the second 6 months (SRP group) were matched 1:1 based on propensity scores.The primary outcome was 30-day mortality.Results: Of the 608 hospitalized patients screened by the system, 176 were assigned to each group after 1:1 propensity score matching.Patients in the SRP group were significantly more likely to receive blood cultures (58.5%) compared with the preliminary group (45.5%) (P=0.019).The SRP group showed a lower 30-day mortality risk (hazard ratio, 0.56; 95% CI, 0.36-0.86;P=0.017) compared to the preliminary group.A restricted cubic spline curve showed that SRP survival benefit began to manifest after the first 4 months (P=0.036).Conclusions: Alongside an existing rapid response system, the National Early Warning Score-based SRP in the electronic medical record reduced mortality for hospital-onset sepsis within 1 year.

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