• Jessica L Guidi, Katherine Clark, Mark T Upton, Hilary Faust, Craig A Umscheid, Meghan B Lane-Fall, Mark E Mikkelsen, William D Schweickert, Christine A Vanzandbergen, Joel Betesh, Gordon Tait, Asaf Hanish, Kirsten Smith, Denise Feeley, and Barry D Fuchs.
• Departments of 1 Medicine and.
• Ann Am Thorac Soc. 2015 Oct 1; 12 (10): 1514-9.

RationaleWe implemented an electronic early warning and response system (EWRS) to improve detection of and response to severe sepsis. Sustainability of such a system requires stakeholder acceptance. We hypothesized that clinicians receiving such alerts perceive them to be useful and effective.ObjectivesTo survey clinicians after EWRS notification about perceptions of the system.MethodsFor a 6-week study period 1 month after EWRS implementation in a large tertiary referral medical center, bedside clinicians, including providers (physicians, advanced practice providers) and registered nurses (RNs), were surveyed confidentially within 2 hours of an alert.Measurements And Main ResultsFor the 247 alerts that triggered, 127 providers (51%) and 105 RNs (43%) completed the survey. Clinicians perceived most patients as stable before and after the alert. Approximately half (39% providers, 48% RNs) felt the alert provided new information, and about half (44% providers, 56% RNs) reported changes in management as a result of the alert, including closer monitoring and additional interventions. Over half (54% providers, 65% RNs) felt the alert was appropriately timed. Approximately one-third found the alert helpful (33% providers, 40% RNs) and fewer felt it improved patient care (24% providers, 35% RNs).ConclusionsA minority of responders perceived the EWRS to be useful, likely related to the perception that most patients identified were stable. However, management was altered half the time after an alert. These results suggest further improvements to the system are needed to enhance clinician perception of the system's utility.

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