Re: [Sepsis Groups] Core Measures for Sepsis

[Nielsenshultz, Yara]

Because it's not yet directly tied to reimbursement, we've started looking at 
sepsis mortality rates and plan to look at overall length of stay and ICU 
length of stay in relation to bundle compliance. We can then consider the 
financial impact of those factors. Reducing LOS (appropriately, of course) may 
also affect Medicare Spending per Beneficiary (MSPB), although I'm not sure how 
you would quantify the impact.

Here are some resources I've used:

* Proportion and Cost of Unplanned 30-Day Readmissions After Sepsis 
Compared with Other Medical Conditions (Feb 2017) - 
https://www.ncbi.nlm.nih.gov/pubmed/28114505

* Time to Treatment and Mortality during Mandated Emergency Care for 
Sepsis (May 2017) - http://www.nejm.org/doi/full/10.1056/NEJMoa1703058

* Creating the Best Medical Result at the Lowest Necessary Cost (Mar 
2016) - 
https://intermountainhealthcare.org/-/media/files/healthy-dialogues/james-slides-2016.pdf?la=en
 (Starts at p. 15)




YARA NIELSENSHULTZ, RN, BSN, MS

Clinical Quality Manager


[cid:image002.png@01D328A4.981A62D0]

100 Witmer Rd, Ste. 220  |  Horsham, PA 19044
W: 215.442.5122  |  F: 215.957.2875
www.evhc.net

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Mary Draper
Sent: Wednesday, August 09, 2017 6:20 PM
To: Tracie Hopkins ; 
sepsisgroups@lists.sepsisgroups.org
Subject: Re: [Sepsis Groups] Core Measures for Sepsis

I don't know of any source for reimbursement based on the sepsis core measures 
compliance. It isn't tied to value based purchasing yet.

Mary Draper RN BSN
Coordinator Quality Improvement
Peer Review Support CV/CT
Quality Management JMH
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
mary.dra...@johnmuirhealth.com
[cid:image003.png@01D328A4.981A62D0]
"O, let us always have a mountain within our soul,  with a peak so high that we 
never quite reach the top...
  For then we will always strive for greater things and will not be content  
with merely climbing hills." Ardath Rodale

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Tracie Hopkins
Sent: Tuesday, August 08, 2017 10:00 AM
To: 
sepsisgroups@lists.sepsisgroups.org
Subject: [Sepsis Groups] Core Measures for Sepsis


Hello,
Does anyone know where I can find the details for Core Measure for Sepsis? Not 
what they are-but the threshold for payment? Is it just SEP-1 or is each 
element measured for compliance & payment?  What percentage is required?   I 
thought it might be in the 5.3 version-but cannot find the specifics for 
reimbursement.  Any information you can share would be appreciated.  Our 
compliance rate is just over 50% & am planning on next steps to improve our 
numbers.  Knowing the financial impact will help gain support.  Thank you-
Tracie L Hopkins RN, BSN, CCRN
Sepsis Program Administrator
Covenant Healthcare
Saginaw, MI 48602
989-583-6604 Office
989-258-8587 Pager
[cid:image001.png@01D1B1D2.839602F0]

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Re: [Sepsis Groups] Septic shock question

[Nielsenshultz, Yara]

Agree. I assumed presence of infection.

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
Fax: (215) 957-2875
www.EmCare.com<http://www.emcare.com/>

From: Schrecengost, Lisa M. [mailto:schrecengo...@acmh.org]
Sent: Tuesday, March 28, 2017 11:33 AM
To: Nielsenshultz, Yara <yara.nielsenshu...@emcare.com>; Davis, Diana 
<dida...@cmhregional.com>; 'sepsisgroups@lists.sepsisgroups.org' 
<sepsisgroups@lists.sepsisgroups.org>
Subject: RE: Septic shock question

Is there a source of infection documented?   Or documentation of severe sepsis 
or septic shock?  If not, then I disagree.

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Nielsenshultz, Yara
Sent: Tuesday, March 21, 2017 5:50 PM
To: Davis, Diana; 'sepsisgroups@lists.sepsisgroups.org'
Subject: Re: [Sepsis Groups] Septic shock question

I would say yes. A lactate >/= 4 is automatically septic shock (as long as the 
patient also meets criteria for severe sepsis, which it looks like they do).

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
Fax: (215) 957-2875
www.EmCare.com<http://www.emcare.com/>

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Davis, Diana
Sent: Monday, March 20, 2017 1:59 PM
To: 'sepsisgroups@lists.sepsisgroups.org' 
<sepsisgroups@lists.sepsisgroups.org<mailto:sepsisgroups@lists.sepsisgroups.org>>
Subject: [Sepsis Groups] Septic shock question


Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315



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Re: [Sepsis Groups] Septic shock question

[Nielsenshultz, Yara]

I would say yes. A lactate >/= 4 is automatically septic shock (as long as the 
patient also meets criteria for severe sepsis, which it looks like they do).

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
Fax: (215) 957-2875
www.EmCare.com

From: Sepsisgroups [mailto:sepsisgroups-boun...@lists.sepsisgroups.org] On 
Behalf Of Davis, Diana
Sent: Monday, March 20, 2017 1:59 PM
To: 'sepsisgroups@lists.sepsisgroups.org' 
Subject: [Sepsis Groups] Septic shock question


Septic shock

To everyone:

Hoping to get some clarification re: potential septic shock pt.

1207- B/P-  84/57 P- 135.

Lactate at 1430- 4.8- lactate  at 1810- 4.3

WBC- 0.1 at 1621

Pt. weight- 73.28 Kg- pt received 1500cc NS - will fallout for this

No source identified

Will this patient meet septic shock due to lactate level?

We cannot come to conclusion 100%- so looking for help from everyone. I say 
yes.

Thank you.

Diana Davis, Quality Outcomes Coordinator

CMH Regional Health System

937-382-9315


Diana Davis, Quality Outcomes Coordinator
CMH Regional Health System
937-382-9315



Disclaimer

The information transmitted via this e-mail is intended only for the person or 
entity to which it is addressed and may contain confidential and/or proprietary 
information. Any use, review, retransmission, dissemination or other use of, or 
pursuing of any action in reliance upon this information by persons or entities 
other than the intended recipient is strictly prohibited. If you are the 
recipient of this e-mail transmission in error, please reply to the sender and 
delete the material from any computer. Thank you.
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