Preop Eval vs Sepsis Timer

Preop Eval organizes and presents much of the guidance that one needs in order to evaluate and prepare adult patients for non-cardiac surgery. It is based upon the guidelines on this topic from the American College of Cardiology, the European Society of Anaesthesiology, the American Society of Anesthesiologists, the Institute for Clinical Systems Improvement, the American College of Chest Physicians, and more (full references in the app). The app contains 1 algorithm and 3 resources: the cardiac evaluation algorithm, guidance on starting and stopping key medications in the perioperative period, guidance on timing of surgery after cardiac events, and guidance on preoperative testing. It also contains a review of preoperative evaluation mainly for students and residents. The app addresses such common questions as: - who needs bloodwork before surgery? - who needs an EKG or a CXR? - how do I handle patients on warfarin, clopidogrel, and DOAC's? - which patients need adjustment of perioperative insulin and diabetic meds, and how? - which active cardiac conditions preclude surgery? - how long after MI or stent should a patient wait before surgery? - are there adjustments to make on psych meds, rheumatologic meds, ACE's and ARB's? This app is written and intended for practicing physicians like internists, family physicians, and hospitalists; for resident physician trainees; and for medical students. In addition to being a reference, the algorithm is written to be a teaching tool by not just delivering an answer, but instead walking a physician through the evaluation process so that one learns that process along the way. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.

Sepsis is a serious condition caused by infections, and a leading cause of hospitalization and death across the world. In the US alone, sepsis causes over 250,000 deaths and 1.3 million hospitalizations every year. The annual cost of sepsis treatment to the US healthcare system is $23.7 billion dollars, making sepsis the most expensive condition treated in US hospitals. The key to surviving sepsis is rapid recognition and treatment with antibiotics, fluids and other drugs that stabilize blood pressure. Current guidelines recommend administering IV antibiotics within 1 hour of diagnosis, and giving IV fluids and performing other treatment steps within 3 and 6 hours depending on symptom severity. However, in busy hospital environments, delays can easily occur leading to avoidable complications and deaths. Sepsis Timer is a timed checklist and simple clinical decision support tool designed to help busy hospital clinicians perform key treatment steps within prescribed time intervals. Simply start a timer when a patient is diagnosed with sepsis and the app will list the necessary treatment steps and alert you when these steps are due. To turn off the alerts, simply check off the required steps. The treatment steps and timelines used in Sepsis Timer are based on Surviving Sepsis Campaign (SSC) guidelines that are also recommended by the Institute of Healthcare Improvement (IHI) and the US Centers for Medicare and Medicaid Services (CMS). Sepsis Timer features include: - Compliance with SSC sepsis bundles, and IHI and CMS SEP-1 Core Measure sepsis treatment guidelines - Simple and intuitive user interface - Configurable alert options include periodic and snooze alerts with customizable sounds - Response time tracking records time to completion of treatment steps and bundles - Simple statistical report shows average response times for completed timers over time - Thorough user manual and explanations for all treatment steps and app functions - Basic background information on sepsis diagnosis and treatment; for more in-depth information please use our Sepsis Clinical Guide app This app is intended for physicians, nurses and other healthcare professionals managing the care of critically ill patients in a hospital environment.