Not sure about the DNR cohort reference. These patients should receive full care unless refused.
-----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Brochis, Dale. Sent: Wednesday, May 28, 2014 5:54 AM To: Daniel Gerard; [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 110, Issue 3 This same perspective applies to calculation of mortality rates. We need a clear, non-modifiable way to capture mortality that is consistent across all organizations, while including ways to identify DNR, hospice modifiers. Dale Brochis BA 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] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Daniel Gerard Sent: Tuesday, May 27, 2014 1:32 PM To: [email protected] Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 110, Issue 3 Re: timing of Blood cultures. I agree with Terry. The same philosophy applies for all the measures we collect. The data is strongest by being consistent. Some sites "exclude" certain patients from data collection. The more site specific criteria that goes into the database that do not follow the "rules" the less valid the total numbers. It does help to find "failures" that is what drives system improvements Daniel Gerard RPh Critical Care Pharmacist McClaren-Northern Michigan Phone: 231-487-4770 FAX: 231-487-4817 [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Friday, May 23, 2014 4:19 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 110, Issue 3 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 109, Issue 1 (Terry Clemmer) ---------------------------------------------------------------------- Message: 1 Date: Thu, 22 May 2014 13:54:33 +0000 From: Terry Clemmer <[email protected]> To: "Dierks, Patricia" <[email protected]>, "'[email protected]'" <[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 109, Issue 1 Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" I personally feel strongly that once in place you should stick by the rules. If blood cultures should be done prior to antibiotics and they were not then the criteria was not met. There are many reasons they may not be met, some legitimate some not. Because there are always some legitimate reasons I am always skeptical of reports of 100% compliance. That usually means the system is being gamed by finding ways to excluding the "legitimate reasons" for not complying. The problem is that the interpretation of "legitimate reasons" do not have rules around them and they become substitute excuses with huge variation from data collector to data collector until the database becomes useless. Unless there are specific rules around a situation (like emergency surgery taking priority) that is standard and used by everyone doing the data collection, then a failure is a failure. Clearly the reason we play this excuse game is to look better or meet a goal. Remember in making the system better it is the failures that push us forward. Would it not be better to develop a system in which in the future patients going to surgery emergently would always get the cultures done rather than using this as a precedence to not do them in the future? Terry P. Clemmer, MD Director: Critical Care Medicine LDS Hospital Professor of Medicine University of Utah School of Medicine Salt Lake City, Utan 84143 Work Phone: 801-408-3661 Work Fax: 801-408-1668 -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Dierks, Patricia Sent: Wednesday, May 21, 2014 12:21 PM To: '[email protected]' Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 109, Issue 1 I would recommend sending blood cultures anyway. What if the offending organism happens to be resistant to usual antibiotics? Just to be safe... -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, May 12, 2014 2:11 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 109, Issue 1 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. Blood culture timing question (Reidford, Tammy) ---------------------------------------------------------------------- Message: 1 Date: Fri, 9 May 2014 19:32:39 +0000 From: "Reidford, Tammy" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Blood culture timing question Message-ID: <a16169235fc1ff4f80db47c5a050fc04035...@tx1p03dag0402.apptixhealth.net> Content-Type: text/plain; charset="us-ascii" I am asking input from others on behalf of one of our hospital sepsis champion on meeting the culture deadline for data extraction. A patient was sent to the ER from a physician's office with a prior outpatient CT showing colitis and was diagnosed with sepsis. Since the physicians already knew the source, the patient was sent emergently to OR for source control/colon resection without blood cultures. Does this affect how question 5 on whether a blood culture was sent? Thanks in advance for your input. Tammy Reidford, RN, CCDS Clinical Documentation Specialist Phone 812-485-6543 Pager 812- 428-1274 [email protected] CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately. Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege. -------------- next part -------------- An HTML attachment was scrubbed... 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