It makes sense to me that the SSC database excludes hospice/palliative/comfort care patients since it is the ultimate goal to help otherwise healthy patients survive sepsis. However, if a large study is utilizing administrative coding, is there any way for patients on palliative/comfort care to be removed from the sample? If it is not possible, then measures hospitals are using that remove the hospice patients are not comparable to measures based on administrative coding data, one of the best ways to accurately determine the extent of the sepsis problem.
If anyone knows of a way to exclude palliative/comfort care patients using administrative data, please share. Thanks Katie ---------------------------------------------------------------------- Message: 1 Date: Fri, 24 Jan 2014 09:28:32 -0800 From: [email protected] To: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 93, Issue 6 Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" We also exclude those patients as their wishes/personal plan of care preclude us from fully implementing the EGDT bundle. Thanks Tracy @ KP Sent from my iPhone > On Jan 24, 2014, at 6:59 AM, > [email protected] wrote: > > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Sepsisgroups Digest, Vol 92, Issue 2 (Schorr, Christa) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Thu, 23 Jan 2014 11:18:02 -0500 > From: "Schorr, Christa" <[email protected]> > To: "Maddox, Lee" <[email protected]>, 'Gail Taylor' > <[email protected]>, "[email protected]" > <[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 92, Issue 2 > Message-ID: > <7f685eba782e5d4c9629d70d77c15980153545b...@mail-ccr02.chsmail.root.cooperhealth.edu> > > Content-Type: text/plain; charset="us-ascii" > > The SSC database was developed to capture specific process indictors > that were thought to improve the management and outcomes in the severe sepsis patient. If a patient is ultimately limiting the ability of the clinician to implement the process measures (comfort care, refusing vasopresors, antibiotics, fluids etc), the patient should not be entered into the database. > > The SSC has educated participants not to include patients in the > database if they are made comfort care within the first 24 hours and/or have limitations of support that would impact the ability of the clinical team to adequately treat the severe sepsis patient. The examples include withholding vasopressors, refusing surgery for source control, refusing central line access etc. > > However, if the patient has been identified and managed for severe > sepsis and subsequently at hour 26 or hour 60 is made made comfort care, then the patient should be included in the database. > > I hope this is helpful. > Christa > > From: [email protected] [mailto:[email protected]] On Behalf Of Maddox, Lee > Sent: Wednesday, January 22, 2014 9:18 AM > To: 'Gail Taylor'; [email protected] > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 92, Issue 2 > > > This may relate to how one defines hospice as our community > technically does not have an inpatient hospice (everyone comes to the hospital to die)- obviously a hospice admission to a hospice bed is not an acute care admission. The larger issue seems to be what do you do when someone is admitted as acute care and then very shortly after one of the following happens - for the sake of argument we will say in the first 24 hours: > > 1. The patient is made comfort care - which is technically not > hospice by Medicare definitions but in effect means pulling off all non palliative treatment. > 2. The family limits care - no new pressers, no more abx, no more invasive line placement etc > > Both obviously impact our ability to effectively implement the bundle. Mortality related to the above is not necessarily a given. If counted then you find yourself chasing deaths you can't do much about no matter how successful you are with performing all bundle elements. > > So what do you do with these people > > Thanks, > > Lee > Lee A. Maddox, M.D. > Medical Director of Pulmonary Services, Wellspan Division Chief > Pulmonary and Critical Care Medicine, Wellspan Site Director, Wellspan > Lung, Sleep, and Critical Care Phone 717-851-2939 Pager 717-751-9517 > Fax - 717-851-6446 > > -----Original Message----- > From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Gail Taylor > Sent: Friday, January 17, 2014 1:29 PM > To: [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 92, Issue 2 > > We exclude hospice patients from our mortality data as well. > > Gail Taylor, RN, MPH, CCRN > Corporate Administrator > Patient Care Integration > Methodist Le Bonheur Healthcare > 1211 Union Avenue Suite 638 > Memphis, TN 38104 > Office: 901-516-0701 or > 901-516-0749 > Cell: 901-258-3349 > Fax: 901-516-0794 > [email protected]<mailto:[email protected]> > > > Methodist Le Bonheur Healthcare is proud to once again be named among > the Top 100 Integrated Healthcare Networks in the country. > > "Be treated well." > > > > Privileged and Confidentiality Disclaimer This correspondence and any > attachments, is intended for the purposes of quality of care review and improvement. The source process and correspondence are confidential and protected pursuant to any and all applicable federal and/or state laws; including the 2005 Federal Patient Safety & Quality Improvement Act, and Medical Quality Improvement Act of 1986, 43 U.S.C. 1101, et seq., the Tennessee Patient Safety and Quality Improvement Act of 2011, T.C.A. 68-11-272 and/or any other law, statute, or doctrine applicable to protect the confidentiality and/or privileged nature of the process. Inclusion of disclaimer is not intended to restrict or otherwise limit the applicability of the privileges referenced above to documents or processes where the privilege would otherwise be applicable. If received in error please notify the sender and delete the content. Any hard copy should be discarded in an appropriate shredder. > > > > > > -----Original Message----- > From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of [email protected]<mailto:[email protected]> > Sent: Friday, January 17, 2014 12:20 PM > To: [email protected]<mailto:[email protected]> > Subject: Sepsisgroups Digest, Vol 92, Issue 2 > > Send Sepsisgroups mailing list submissions to > [email protected]<mailto:[email protected]> > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected]<mailto:[email protected]> > > You can reach the person managing the list at > [email protected]<mailto:[email protected]> > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: [Hospice patients in mortality data] (Brochis, Dale.) > 2. Re: Sepsisgroups Digest, Vol 91, Issue 1 > (Carlson, Barbara A. (Lincoln, NE)) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Wed, 15 Jan 2014 13:28:48 -0500 > From: "Brochis, Dale." > <[email protected]<mailto:[email protected]>> > To: "Cormack, Patricia \(WS\)" <[email protected]<mailto:[email protected]>>, "Wendy A. > Nieman" <[email protected]<mailto:[email protected]>>, "Robyn Haddock Crosswhite" > <[email protected]<mailto:[email protected]>>, <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] [Hospice patients in mortality data] > Message-ID: > <[email protected]<mailto:[email protected]>> > Content-Type: text/plain; charset="iso-8859-1" > > There is ambiguity and confusion in the answers provided regarding capture of mortality data, and unless clarified will never help identify a best practice, or importantly, how to clearly measure it. > > A hospice admission is not an inpatient acute care admission. > If mortality data is based upon inpatient acute care admissions, and > if all-cause mortality is not of value, then very clear definitions of the sepsis patients for whom mortality IS to be captures must be developed, disseminated and utilized. > > Reporting of any mortality number should clearly describe the > population captured and all exclusions. > > I agree that there is value in exploring who has expired - DNR status, Hospice status, and why they expired. However, independent decisions by individual organizations results in comparing different apples. I count all my apples, and compare my organization against others that exclude only their Macintosh, and another that excludes MacIntosh and Granny Smith. > > It's not that this differentiation is wrong, it is that it is > different - and undermines statistical value. > > ? > Dale Brochis Gainsharing Project Coordinator Case Management > Department Robert Wood Johnson University Hospital?at Rahway > 865 Stone Street > Rahway, NJ 07065 > > 732-499-6217 Office / 732-428-2108 Cell > [email protected]<mailto:[email protected]> > > > > -----Original Message----- > From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Cormack, Patricia (WS) > Sent: Monday, January 13, 2014 8:48 AM > To: Wendy A. Nieman; Robyn Haddock Crosswhite; [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > We do not include hospice patients in our mortality. Expected mortality. > Patty Cormack > > -----Original Message----- > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of > Wendy A. Nieman > Sent: Friday, January 10, 2014 7:47 AM > To: Robyn Haddock Crosswhite; [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > Hello everyone > If the patient dies while an inpatient they would be included in our mortality rate, regardless of Hospice status. > Wendy Nieman RN > ICU and Medical Quality Coordinator > St. Joeseph Mercy Hospital > Ann Arbor Michigan 48104 > > > ________________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] on behalf of Robyn > Haddock Crosswhite [[email protected]] > Sent: Wednesday, January 08, 2014 12:03 PM > To: [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > Our hospital includes hospice discharges regarding sepsis patients in our mortality rates, I just wanted to know if other hospitals are doing this as well? Thanks > > -----Original Message----- > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of [email protected]<mailto:[email protected]> > Sent: Monday, January 06, 2014 2:07 PM > To: [email protected]<mailto:[email protected]> > Subject: Sepsisgroups Digest, Vol 91, Issue 1 > > Send Sepsisgroups mailing list submissions to > [email protected]<mailto:[email protected]> > > To subscribe or unsubscribe via the World Wide Web, visit > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > or, via email, send a message with subject or body 'help' to > [email protected]<mailto:[email protected]> > > You can reach the person managing the list at > [email protected]<mailto:[email protected]> > > When replying, please edit your Subject line so it is more specific > than > "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Mortality (Angela Craig) > 2. Re: First Dose Antibiotics (Rick Rutherford) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 3 Jan 2014 13:31:38 -0600 > From: Angela Craig > <[email protected]<mailto:[email protected]>> > To: "'Michelle Corder'" <[email protected]<mailto:[email protected]>>, "Philip S. > Barie" > <[email protected]<mailto:[email protected]>>, Hesham Hassaballa > <[email protected]<mailto:[email protected]>>, > "<[email protected]<mailto:[email protected]>>" > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality > Message-ID: > > <343e31412fc9094487b54371286adda003d404b...@d109exchmb.crmchealth.hosp > it > al<mailto:343E31412FC9094487B54371286ADDA003D404B937@D109EXCHMB.crmchealth.hospit%0bal>> > > Content-Type: text/plain; charset="windows-1252" > > I think of it as "All Cause Mortality" so, no matter where they are > when they expire it counts > > Angela Craig APN,MS,CCNS > Clinical Nurse Specialist > Intensive Care Unit > Cookeville Regional Medical Center > 931-783-5035 > > ________________________________ > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of Michelle Corder > Sent: Thursday, January 02, 2014 9:36 AM > To: Philip S. Barie; Hesham Hassaballa; > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality > > I have a question for the establishing mortality rate: > Do you include a patient that is transfered out of the ICU but later expires on the floor in the mortality rate? > or > Do you only count the patients that expire while in the ICU? > > Michelle Corder > PIH Health > > ________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] On Behalf Of Philip S. > Barie [[email protected]] > Sent: Friday, December 27, 2013 10:39 AM > To: Hesham Hassaballa; <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality Yes, unless you can prove it to > be completely unrelated. Which, it seems as though you cannot. > ________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] on behalf of Hesham Hassaballa [[email protected]] > Sent: Tuesday, December 24, 2013 4:28 PM > To: <[email protected]<mailto:[email protected]>> > Subject: [Sepsis Groups] Mortality > I have a question: > > A patient was admitted with septic shock, and we successfully treated > him and he survived to ICU discharge. Approximately 17 days later, he codes and dies on the floor (unknown reason why) the day before he was slated to be discharged from the hospital. > > Does this really count against our sepsis mortality? > > Hesham A. Hassaballa, MD > Program Medical Director > Critical Care > Rush-Copley Medical Center > > Assistant Professor of Medicine > Rush University Medical Center > > Phone: (331) 454-6572 > > ### CONFIDENTIALITY NOTICE ### > This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]<mailto:[email protected]>. > > ### CONFIDENTIALITY NOTICE ### > > This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]<mailto:[email protected]>. > > NOTICE: This electronic mail (email) message, including any > attachments, is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. > If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED. > > If you have received this message by error, please notify the sender > by reply and immediately destroy this email and any attachments. > > Confidentiality Notice: This e-mail message, including any > attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /a > ttachments/20140103/76983d4f/attachment.html<http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/a%0bttachments/20140103/76983d4f/attachment.html>> > > ------------------------------ > > Message: 2 > Date: Sat, 4 Jan 2014 07:25:40 -0800 > From: Rick Rutherford <[email protected]<mailto:[email protected]>> > To: Sepsis List Serve <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] First Dose Antibiotics > Message-ID: <[email protected]<mailto:[email protected]>> > Content-Type: text/plain; charset="iso-8859-1" > > Hello All, > > We are seeing resistance to giving antibiotics early in patients who > meet criteria for severe sepsis but do not have a source. The argument often goes like this: "The patient is not critically ill and I do not have a source. Antibiotics will cloud an unclear picture further and have side effects such as liver and renal failure and breed resistance. > I am going to hold off on antibiotics unless a source becomes apparent." > Often, but not always, these patients will get their positive urine or blood culture 2-3 days later and we will have been out of compliance and put the patient at risk. Antibiotics noncompliance in nonshock septic patients is our most common miss in the bundles. > I would appreciate help in formulating counterarguments to these concerns. Especially useful would be articles demonstrating the safety of single doses of antibiotics and the consequences of incorrect antibiotics in sepsis and severe sepsis (Not Septic Shock which Dr. > Kumar and others have addressed nicely). > Thanks, > RIck RutherfordSepsis Task Force ChairVentura County Medical Center > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /a > ttachments/20140104/26cff8aa/attachment-0001.htm<http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/a%0bttachments/20140104/26cff8aa/attachment-0001.htm>> > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > > End of Sepsisgroups Digest, Vol 91, Issue 1 > ******************************************* > > > CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this email in error, please notify the sender immediately to arrange for return of these documents. > > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > > > This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of West Suburban Medical Center. > This footer also confirms that this email message has been scanned for the presence of computer viruses. > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > > ------------------------------ > > Message: 2 > Date: Wed, 15 Jan 2014 18:29:59 +0000 > From: "Carlson, Barbara A. (Lincoln, NE)" <[email protected]<mailto:[email protected]>> > To: "Cormack, Patricia (WS)" <[email protected]<mailto:[email protected]>>, "Wendy A. > Nieman" <[email protected]<mailto:[email protected]>>, Robyn Haddock Crosswhite > <[email protected]<mailto:[email protected]>>, "[email protected]<mailto:[email protected]>" > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > Message-ID: > <35dbb1774783904fb66a013e4e110d3f2ce73...@chiex011.chi.catholichealth.net<mailto:35dbb1774783904fb66a013e4e110d3f2ce73...@chiex011.chi.catholichealth.net>> > > Content-Type: text/plain; charset="us-ascii" > > Thoughts for the future... > > I would consider that currently patients are excluded from the > mortality measure if they are hospice day 0. > > >From CMS excluded population for mortality > "Admissions for patients enrolled in the Medicare Hospice Program any time in the 12 months prior to the index hospitalization including the first day of the index admission since it is likely these patients are continuing to seek comfort measures only." > > Also, if and when this measure is a CMS eMeasure, some abstraction in current core measures is excluded if the patient is hospice/comfort care day 0-1. > > Barbara Carlson RN > Performance Improvement > St Elizabeth Regional Medical Center > P 402-219-7332 > F 402-219-8992 > -----Original Message----- > From: [email protected]<mailto:[email protected]> [mailto:[email protected]] On Behalf Of Cormack, Patricia (WS) > Sent: Monday, January 13, 2014 7:48 AM > To: Wendy A. Nieman; Robyn Haddock Crosswhite; [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > We do not include hospice patients in our mortality. Expected mortality. > Patty Cormack > > -----Original Message----- > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of > Wendy A. Nieman > Sent: Friday, January 10, 2014 7:47 AM > To: Robyn Haddock Crosswhite; [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > Hello everyone > If the patient dies while an inpatient they would be included in our mortality rate, regardless of Hospice status. > Wendy Nieman RN > ICU and Medical Quality Coordinator > St. Joeseph Mercy Hospital > Ann Arbor Michigan 48104 > > > ________________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] on behalf of Robyn > Haddock Crosswhite [[email protected]] > Sent: Wednesday, January 08, 2014 12:03 PM > To: [email protected]<mailto:[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 91, Issue 1 > > Our hospital includes hospice discharges regarding sepsis patients in our mortality rates, I just wanted to know if other hospitals are doing this as well? Thanks > > -----Original Message----- > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of [email protected]<mailto:[email protected]> > Sent: Monday, January 06, 2014 2:07 PM > To: [email protected]<mailto:[email protected]> > Subject: Sepsisgroups Digest, Vol 91, Issue 1 > > Send Sepsisgroups mailing list submissions to > [email protected]<mailto:[email protected]> > > To subscribe or unsubscribe via the World Wide Web, visit > > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > or, via email, send a message with subject or body 'help' to > [email protected]<mailto:[email protected]> > > You can reach the person managing the list at > [email protected]<mailto:[email protected]> > > When replying, please edit your Subject line so it is more specific > than > "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Mortality (Angela Craig) > 2. Re: First Dose Antibiotics (Rick Rutherford) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 3 Jan 2014 13:31:38 -0600 > From: Angela Craig > <[email protected]<mailto:[email protected]>> > To: "'Michelle Corder'" <[email protected]<mailto:[email protected]>>, "Philip S. > Barie" > <[email protected]<mailto:[email protected]>>, Hesham Hassaballa > <[email protected]<mailto:[email protected]>>, > "<[email protected]<mailto:[email protected]>>" > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality > Message-ID: > > <343e31412fc9094487b54371286adda003d404b...@d109exchmb.crmchealth.hosp > it > al<mailto:343E31412FC9094487B54371286ADDA003D404B937@D109EXCHMB.crmchealth.hospit%0bal>> > > Content-Type: text/plain; charset="windows-1252" > > I think of it as "All Cause Mortality" so, no matter where they are > when they expire it counts > > Angela Craig APN,MS,CCNS > Clinical Nurse Specialist > Intensive Care Unit > Cookeville Regional Medical Center > 931-783-5035 > > ________________________________ > From: [email protected]<mailto:[email protected]> > [mailto:[email protected]] On Behalf Of Michelle Corder > Sent: Thursday, January 02, 2014 9:36 AM > To: Philip S. Barie; Hesham Hassaballa; > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality > > I have a question for the establishing mortality rate: > Do you include a patient that is transfered out of the ICU but later expires on the floor in the mortality rate? > or > Do you only count the patients that expire while in the ICU? > > Michelle Corder > PIH Health > > ________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] On Behalf Of Philip S. > Barie [[email protected]] > Sent: Friday, December 27, 2013 10:39 AM > To: Hesham Hassaballa; <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Mortality Yes, unless you can prove it to > be completely unrelated. Which, it seems as though you cannot. > ________________________________ > From: [email protected]<mailto:[email protected]> > [[email protected]] on behalf of Hesham Hassaballa [[email protected]] > Sent: Tuesday, December 24, 2013 4:28 PM > To: <[email protected]<mailto:[email protected]>> > Subject: [Sepsis Groups] Mortality > I have a question: > > A patient was admitted with septic shock, and we successfully treated > him and he survived to ICU discharge. Approximately 17 days later, he codes and dies on the floor (unknown reason why) the day before he was slated to be discharged from the hospital. > > Does this really count against our sepsis mortality? > > Hesham A. Hassaballa, MD > Program Medical Director > Critical Care > Rush-Copley Medical Center > > Assistant Professor of Medicine > Rush University Medical Center > > Phone: (331) 454-6572 > > ### CONFIDENTIALITY NOTICE ### > This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]<mailto:[email protected]>. > > ### CONFIDENTIALITY NOTICE ### > > This message and any included attachments are from Cogent HMG and are intended only for the addressee. The contents in this message contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or contact the Cogent HMG Privacy Officer at [email protected]<mailto:[email protected]>. > > NOTICE: This electronic mail (email) message, including any > attachments, is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. > If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED. > > If you have received this message by error, please notify the sender > by reply and immediately destroy this email and any attachments. > > Confidentiality Notice: This e-mail message, including any > attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /a > ttachments/20140103/76983d4f/attachment.html<http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/a%0bttachments/20140103/76983d4f/attachment.html>> > > ------------------------------ > > Message: 2 > Date: Sat, 4 Jan 2014 07:25:40 -0800 > From: Rick Rutherford <[email protected]<mailto:[email protected]>> > To: Sepsis List Serve <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] First Dose Antibiotics > Message-ID: <[email protected]<mailto:[email protected]>> > Content-Type: text/plain; charset="iso-8859-1" > > Hello All, > > We are seeing resistance to giving antibiotics early in patients who > meet criteria for severe sepsis but do not have a source. The argument often goes like this: "The patient is not critically ill and I do not have a source. Antibiotics will cloud an unclear picture further and have side effects such as liver and renal failure and breed resistance. > I am going to hold off on antibiotics unless a source becomes apparent." > Often, but not always, these patients will get their positive urine or blood culture 2-3 days later and we will have been out of compliance and put the patient at risk. Antibiotics noncompliance in nonshock septic patients is our most common miss in the bundles. > I would appreciate help in formulating counterarguments to these concerns. Especially useful would be articles demonstrating the safety of single doses of antibiotics and the consequences of incorrect antibiotics in sepsis and severe sepsis (Not Septic Shock which Dr. > Kumar and others have addressed nicely). > Thanks, > RIck RutherfordSepsis Task Force ChairVentura County Medical Center > -------------- next part -------------- An HTML attachment was > scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org > /a > ttachments/20140104/26cff8aa/attachment-0001.htm<http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/a%0bttachments/20140104/26cff8aa/attachment-0001.htm>> > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected]<mailto:[email protected]> > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.o > rg > > > End of Sepsisgroups Digest, Vol 91, Issue 1 > ******************************************* > > > CONFIDENTIALITY NOTICE: The documents accompanying this email transmission contain confidential information belonging to the sender that is legally privileged. 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