Enhancing sepsis care through improved first-dose antibiotic turnaround time for hospital-based rehabilitation patients

Background: Timely administration of the first-dose intravenous antibiotic is a key quality measure in hospital accreditation and sepsis care. This study aimed to identify barriers to first-dose intravenous antibiotic administration in an inpatient rehabilitation unit at a leading academic medical center and implement targeted interventions to improve the 60-minute turnaround rate. Methods: In 2024, quality outcomes specialists used the Kaizen Rapid Cycle methodology to conduct a weekly review of all STAT intravenous antibiotic orders on the rehabilitation unit. Orders exceeding the 60-minute turnaround time were analyzed through root cause analysis (RCA) to identify delays. Findings from the RCA guided the development of interventions to improve compliance.  Results: At the start of 2024, the 60-minute antibiotic turnaround rate was 33.3%. After implementing key interventions, the turnaround rate increased to 68.4% by the end of March and remained stable throughout 2024. These interventions included stocking frequently used antibiotics in Pyxis, enhancing communication and notification for STAT antibiotic orders, maintaining ongoing surveillance, and providing individualized feedback to the frontline nurses.  Conclusions: Identifying and addressing barriers to timely antibiotic administration led to significant improvements in turnaround time. Enhancing communication, optimizing medication availability, and sustaining performance monitoring proved effective in improving compliance with sepsis care standards.