Rhonda, At our institution we have our Quality data abstractors that are amazing and are the ones that will be performing the CMS abstraction. They are familiar with abstracting for other CMS core measures and understand the process with CMS and the resources available for us. My understanding is that they will be doing random sampling.
We have a separate process to abstract and record and monitor our process measures around sepsis in our ICU that our ICU Data coordinator abstracts. She captures all patients that come to our ICU with sepsis to track our compliance and outcomes. This data is entered into the Surviving Sepsis Campaign Access database and is great for running reports to track our progress toward our goals for compliance. Much of the data abstraction will be duplication and we suspect there will be some opportunities to share and glean from each other's efforts but the purpose for our abstraction is different so will remain separate. Michelle Foss RN Critical Care Data Coordinator 913.632.2429 office Shawnee Mission Medical Center -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, September 15, 2015 2:16 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 171, 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. Sepsis Core Measures Follow-up (Allen, Gilman B) 2. sepsis coordinator roles (Gluckner, Rhonda) ---------------------------------------------------------------------- Message: 1 Date: Tue, 15 Sep 2015 16:25:20 +0000 From: "Allen, Gilman B" <[email protected]> To: "'[email protected]'" <[email protected]> Cc: "'[email protected]'" <[email protected]> Subject: [Sepsis Groups] Sepsis Core Measures Follow-up Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" Sean, I attended your webinar on Sepsis Core measures last week and was left with a number of concerning questions: 1. If we are using the logic that "there is no evidence to show it doesn't hurt" to justify follow-up physical exam measures for evaluation of response to resuscitation, then why does the same logic not apply to the use of Normsol and other chloride-balanced crystalloids? I would argue that there is a growing body of evidence that normal saline may indeed "hurt" (JAMA. 2012;308(15):1566-1572.; Br J Surg 102 (1):24-36. Crit Care Med 2014; 42:1585-1591. 2. In defending the use of many of these unproven metrics of volume responsiveness and distal perfusion, you described many of these measures as a "proxy" measure of "attentive evaluation" and intensive care. I full agree, and practice this way. I believe these measures help represent a collective epi-phenomenon of intensive and regimented care. Using the same reasoning, why then is there no provision in any of this for providers to document their own rationale for diverging from some of these restrictive mandates when judged to be clinically justified. Is this not also a worthy "proxy" of intensive and attentive care? 3. When does the clock really start ticking? Our hospitals still don't have a solid and reliable answer to this question. Is it when the physician documents their suspicion of sepsis, 3 hours after a fever and hypotension? When blood cultures are first ordered one hour after the fever? Or when an MD orders Tylenol, a CBC, lactate, and blood cultures on someone he/she suspects may be either bleeding, in pain, or possibly infected post-Op? When do these types of patients really "declare" themselves septic. The efforts to try to "capture" every element of Goal-directed care in an "all-or-none" pass/fail algorithm dooms itself from the beginning. Why didn't CMS just start off with the 3 hour bundle, monitor how others do with the 6 hour bundle, and try to figure out where (and why) their algorithm is succeeding, or failing, to capture (and enforce) best practice? I've augured to my group that there is absolutely no excuse for not getting blood cultures, a lactate, and fluids on board within one hour of a high suspicion of sepsis. This is a low bar we should all be meeting, but probably aren't. Why not simply start there, and work our way forward? Gilman B. Allen, MD Associate Professor Department of Medicine Director of Adult Critical Care Services University of Vermont / Fletcher Allen Healthcare HSRF 220, 149 Beaumont Ave Burlington, VT 05405-0075 (802)656-9004 Fax: (802) 656-8926 [email protected]<mailto:[email protected]> [UVMMedicalCenter_Color] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150915/58acb7dd/attachment.html> -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.jpg Type: image/jpeg Size: 4785 bytes Desc: image002.jpg URL: <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20150915/58acb7dd/attachment-0001.jpg> ------------------------------ Message: 2 Date: Mon, 14 Sep 2015 14:00:44 +0000 From: "Gluckner, Rhonda" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] sepsis coordinator roles Message-ID: <blupr08mb1810e936294ac6d926da34129b...@blupr08mb1810.namprd08.prod.outlook.com> Content-Type: text/plain; charset="us-ascii" I am interested in knowing how other facilities with sepsis coordinators are planning on abstracting the data for the CMS metric in October. Is it falling under the realm of the sepsis coordinator, or does it belong to the quality department/data abstractors? Rhonda Gluckner, BSN, RN Sepsis Coordinator Mercy Health-Youngstown Office: 330.480.2935 Pager: 330.229.2035 Fax: 330.480.3177 [email protected]<mailto:[email protected]> CONFIDENTIALITY NOTICE: This 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/attachments/20150914/93008edd/attachment-0001.htm> ------------------------------ Subject: Digest Footer _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org ------------------------------ End of Sepsisgroups Digest, Vol 171, Issue 1 ******************************************** _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
