We include in our sepsis mortality statistics those inpatients who are
discharged to Hospice. Included in our mortality rates are those that are made
comfort care more than six hours after admission, usually just prior to
discharge to hospice. If they are discharged to Hospice inpatient with the
diagnosis of sepsis/septicemia, etc., they have an admission order for comfort
care, and we exclude them from bundle and mortality data.
Basically, we use the same criteria for our mortality data that we use for the
calculating the bundle data. Exclude are those who -
are made comfort care within six hours of inpatient admission (proxy for
refused care)
those where the patient/family refused treatment
the clinical condition precluded the total completion of the measure
(e.g. mortality w/in six hours)
had a clinical contraindication for central line,
had a line attempted but could not be placed
transfers from other acute care facilities
An additional question to all along the same line - if patients who are made
comfort care w/in 24 hrs or later, are excluded from mortality statistics - do
we include or exclude them in bundle statistics? It seems if they are excluded
from the bundle compliance calculations, valuable data is lost about success or
lapses in bundle recognition and interventions, as well as the measure of the
interventions' effectiveness. If they are to be included in bundle data, then
shouldn't be included in the mortality data?
Mary
Mary K. Lewis, RN, CPHQ
Senior Data Analyst
Patient Safety & Quality
Alexian Brothers Health System
Arlington Heights, IL 60005
Office Phone (847) 385-7386
Email [email protected]<mailto:[email protected]>
Office Fax (847) 483-7057
-----Original Message-----
From:
[email protected]<mailto:[email protected]>
[mailto:[email protected]] On Behalf Of Jamie Roney
Sent: Thursday, April 03, 2014 12:08 PM
To: DanaMarie Smith;
[email protected]<mailto:[email protected]>
Subject: Re: [Sepsis Groups] Hospice Patients
Dana,
We do not count those in our mortality, but note them. We also exclude those
made a comfort care only within 24 hours of admission.
Jamie
Jamie Roney, MSN, RN-BC, BSHCM, CCRN
COVENANT HEALTH SEPSIS COORDINATOR
"Be a yardstick of quality. Some people aren't used to an environment where
excellence is expected." ~Steve Jobs
3615 19th Street, Lubbock, TX 79410
T: (806) 725-4689 C: (806) 773-1914
www.covenanthealth.org<http://www.covenanthealth.org>
......................................................................................
-----Original Message-----
From:
[email protected]<mailto:[email protected]>
[mailto:[email protected]] On Behalf Of DanaMarie
Smith
Sent: Thursday, April 03, 2014 8:51 AM
To:
[email protected]<mailto:[email protected]>
Subject: [Sepsis Groups] Hospice Patients
Hi Everyone,
I have a question and I want to know what everyone's practice is on the
subject. When I am doing chart abstract and reviews on our severe sepsis
patients I come across patients who get discharged to Hospice either home or to
inpatient Hospice in our hospital but they aren't admitted anymore and itsd a
completely different admission so they are technically discharged from acute
care. Then the patients who go to hospice expired. My question is that would
you count them on your mortality list or say they survived discharge from
acute care setting? Like I said even though there is an inpatient hospice they
are completely separated from the hospital admissin and don't even show up on
our regular mortality list. I hope I explained this well.
Thank You,
Dana
Dana Marie Moore RN
Clinical Data Analyst
Quality/Performance Improvement
Aria Health Hospital
Phone # 215- 612-4888
Fax # 215-612-4463
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