PURPOSE: To evaluate the impact of clinical pharmacy consults on the clinical and economic outcomes associated with severe sepsis and septic shock.
METHODS: Charleston Area Medical Center (CAMC) encourages clinical pharmacy consults to promote adherence to the recommendations for early goal-directed therapy, which is achieved through direct interaction with the nurses and physicians at the patient's bedside. Since the implementation of clinical pharmacy consults at CAMC's General Hospital (February 2006), data has been retrospectively collected during February –July 2006 in order to assess the impact of clinical pharmacy consults on mortality associated with severe sepsis and septic shock. Additional data was collected from the same six-month period in 2005 in order to assess the influence of consults on hospital length of stay (LOS) and cost associated with hospitalization for the treatment of severe sepsis and septic shock.
RESULTS: A total of 115 patients were admitted to intensive care units at the General Hospital with ICD-9 procedure codes for severe sepsis and septic shock during the study period. Clinical pharmacy services were consulted in 58 (50.4%) of these patients. The implementation of clinical pharmacy sepsis consults resulted in a 21.8% improvement in outcome when comparing mortality rates of patients with consults versus those without (40.7% without consult vs. 18.9% with consult). In addition, hospital LOS for patients with sepsis decreased by 24% (3.9 patient days) over the studied period when compared to February –July of 2005, accounting for a projected one-year cost avoidance of $600,000.
CONCLUSION: Implementation of clinical pharmacy sepsis consults has resulted in the achievement of several significant endpoints including a reduction in sepsis-associated mortality, hospital LOS, and a decrease in costs associated with hospitalization for severe sepsis and septic shock.
CLINICAL IMPLICATIONS: A clinical pharmacy consult model for sepsis promotes multidisciplinary management of a complex clinical condition. This multidisciplinary model has resulted in improved outcomes, reduced hospital costs, and an overall improvement in the management of sepsis at an institutional level.
DISCLOSURE: Audis Bethea, No Financial Disclosure Information; No Product/Research Disclosure Information