As division chair I am commonly asked to justify program expansion with arguments such as RVU generation, improved quality, safety, outcomes etc. As a result, I am always on the lookout for articles to support any of these angles.It is now well accepted that infectious diseases specialists improve outcomes with respect to Staphylococcus aureus bacteremia. I read this article in Clinical Infectious Diseases about the positive impact on reduced mortality (from 39% to 29%) of a dedicated ID sepsis consult team for an emergency department. Not unexpectedly, 24/7 infectious diseases consultation resulted in greater compliance with the Surviving Sepsis Campaign bundle, including the prescription of appropriate and timely antibiotics.
So, a dedicated infectious diseases consult service for patients with sepsis/ septic shock in the emergency department can improve outcomes.
This sounds great, however, who really wants to staff sepsis consults in the emergency department 24/7?
This may not be feasible in the long-term and may not play out to scale in the real world.