TABLE 1.

Actionable Solutions to Support Operationalization of Pediatric Sepsis Criteria

Approach	Solution
Tailored approaches for different settings	Consider pretest probability of sepsis, available resources, and prevalence of other diseases with “sepsis-like” presentations
Sepsis bundle components individualized for specific settings	Impact of individual components on improving outcomes should be evaluated
Develop minimum variable datasets using routinely collected data	Minimum variable datasets and a common dictionary for data labeling can allow the merging of data for collaborative development and assessment of data-driven criteria and patient-relevant outcomes
Develop datasets from multiple settings around the world	The datasets should include information on patients through the continuum of care (primary care, emergency department, ward, and PICU). Ideally, the datasets should originate from diverse settings (geographical, sociodemographic, resource availability, etc.)
Determine locally relevant time zero	Depending on setting, the first presentations of sepsis may be to local health center, primary or secondary care
Determine locally relevant clinical decision support systems	Clinical decision support systems can be incorporated into electronic patient records in the high-income country and upper middle-income country settings, and mobile phone apps in low middle-income countries
Address antimicrobial stewardship	Structured clinical assessments and investigations can help determine treatment urgency of antimicrobials, to balance patient safety and antimicrobial stewardship
Develop locally relevant outcome measures	Outcome measures may include mortality, disability, critical care admission, or organ dysfunction depending on setting
Develop affordable and accurate diagnostics	Affordable host response and/or pathogen diagnostics can support risk stratification and stratification of likely response to novel therapies