Inclusion Criteria:  age ≥18 years placement on the electronic medical record (EMR) EPIC™ based sepsis managements standard operating procedures (SOPs) meets criteria for sepsis/septic shock by Sepsis-3 consensus criteria.  Exclusion Criteria:  have had a prior episode of sepsis during this hospitalization. have disease states that predispose to significant immune system dysfunction  have comorbidity burden or goals of care that preclude recovery after sepsis. These criteria include:  irreversible shock (death <12 hours) uncontrollable surgical source of sepsis patients deemed to be futile care or have advanced directives limiting resuscitative efforts alternative diagnoses causing shock state (e.g., hemorrhage, myocardial infarction or pulmonary embolus) severe congestive heart failure (NY Heart Association Class IV) known HIV infection with CD4+ count <200 cells/mm3 chronic liver disease with MELD score ≥15 severe traumatic brain injury (evidence of neurologic injury on CT scan and GCS<8) known pregnancy enrollment >96 hours after suspected sepsis onset pre-hospitalization bedridden performance status (WHO/Zubrod score ≥4) pre-existing state of CCI (ICU length of stay ≥14 days with SOFA>5) interfacility transfer patients with >96 hours critical illness prior to transfer subsequent clinical adjudication diagnosis not consistent with sepsis/septic shock by Sepsis-3 criteria.