Real-time Inflammation Panel for inpatient care: a before-after evaluation of post-analytic timeliness and outcomes at a tertiary center

Background Post-analytic delays - between laboratory result availability and clinical action - remain a bottleneck in inpatient care. Prior alerting tools show variable benefit, often limited by workflow fit, routing, and duplicate notifications. We implemented a real-time, rule-based assistant to address these constraints. Objective To determine whether the “Inflammation Panel” shortens the interval from result-ready to treatment and improves outcomes. Materials and Methods Single-center, before-after evaluation at a tertiary hospital (Saint Petersburg, Russia). The assistant polls the lab store (around 2-s cadence), applies declarative rules (thresholds + trend + freshness + de-duplication) to CRP, WBC, troponin, and hemoglobin, and pushes role-routed alerts to team chats. Adults with eligible labs in contiguous pre- and post-deployment windows in 2025 were included (pre n = 2430, post n = 2560). Primary endpoint: time from result-ready to treatment start. Secondary endpoints: in-hospital mortality (sepsis, pneumonia), length of stay (LOS), and alert burden. Analyses used rank-based estimators for medians, adjusted logistic models, Kaplan-Meier displays, and interrupted time-series checks. System telemetry (poll cadence, dispatch latency, lab turnaround) was recorded. Results Among 4990 encounters, median result-to-treatment time decreased from 6.12 to 3.56 h. Sepsis mortality declined from 18.5% to 11.0% (OR 0.55, 95% CI 0.31–0.95); pneumonia mortality droped from 13.1% to 8.0% (OR 0.61, 95% CI 0.37–0.99). Mean legth of stay fell from 10.32 to 8.95 days (Δ -1.37). A Cox model indicated faster treatment post-deployment (HR 1.41, 95% CI 1.33–1.49). Alert burden averaged 0.23 alerts/patient-day with around 4% duplicate suppression. Against an operational composite, sensitivity was 0.88 and PPV 0.83. Telemetry showed around 2 s polling and around 2 s dispatch with lab processing median around 14 min. Conclusions A transparent, push-based assistant compressed the post-analytic interval and was associated with lower mortality and shorter LOS at modest alert burden. Declarative rules with trend context, freshness, and role-based routing, combined with continuous telemetry, offer a portable pattern for real-time clinical decision support.