Completely agree Dr. Vora. Thanks,
MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience Sutter Health -2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| Office 916.286.6717 | [email protected] "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of Vora, Setu Sent: Tuesday, June 21, 2016 8:11 PM To: [email protected] Subject: [External] [Sepsis Groups] Appreciate your thoughts on sepsis definition guidance to clinicians and staff SITUATION Clinicians, quality, CDI, and coding teams need guidance about Sepsis definitions. BACKGROUND Many hospitals have recognized sepsis as the major driver of mortality, cost, and readmissions among hospitalized patients and have launched Sepsis collaboratives. CMS/Medicare launched SEP-1 sepsis related core measures October 1, 2015 Even before the CMS Sepsis mandate came out, hospitals invested heavily in sepsis education, technology, and process improvement infrastructure to improve sepsis care delivery and outcomes. Sepsis-3 - the new definitions of Sepsis and Septic Shock were released February 2016 with the goal of updating the definitions and providing consistency of terminology to clinical practitioners, researchers, administrators, and funders. ASSESSMENT At this time, there is a conflict between CMS definitions and the new Sepsis-3 definitions. According to Sepsis-3: Adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more. However, the Sepsis-3 Task Force also notes that: * Neither qSOFA nor SOFA is intended to be a stand-alone definition of sepsis. * The task force wishes to stress that SIRS criteria may still remain useful for the identification of infection. * The task force recommendations should not, however, constrain the monitoring of lactate as a guide to therapeutic response or as an indicator of illness severity. * The task force strongly encourages prospective validation of qSOFA in multiple US and non-US health care settings to confirm its robustness and potential for incorporation into future iterations of the definitions. RECOMMENDATION Our electronic alerts, public quality reporting, risk adjustment and payments are still based on the CMS method and ICD-10 definitions of Severe Sepsis and Septic Shock. We recommend following the current CMS definitions of Severe Sepsis and Septic Shock till further notice and guidance from CMS and ICD-10. What is your guidance to your staff at your hospitals? Thanks. Setu Vora, MD Medical Director, Critical Care Services Physician Director, Performance Improvement Backus Hospital- Leapfrog A Hartford Healthcare-East Region ________________________________________ From: Sepsisgroups [[email protected]] on behalf of [email protected] [[email protected]] Sent: Tuesday, June 21, 2016 10:56 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 210, Issue 1 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2flists.sepsisgroups.org%2flistinfo.cgi%2fsepsisgroups-sepsisgroups.org&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=8xbvBfP8UKM%2bLAoITp6WVD2GXW3GVD3cjwTGvUdUQsU%3d 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: July 1 2016 new CMS regulations (Dena Videtic) 2. Re: Response to Augmentin (Lanna Dimond) ---------------------------------------------------------------------- Message: 1 Date: Thu, 16 Jun 2016 15:50:02 +0000 From: Dena Videtic <[email protected]> To: "Dierks, Patricia" <[email protected]>, "'[email protected]'" <[email protected]> Subject: Re: [Sepsis Groups] July 1 2016 new CMS regulations Message-ID: <a0854b2bb1a04c4fb7bf7eb7bfc6400f0135f0a...@ddmsxmbx4.ad.bhssf.org> Content-Type: text/plain; charset="utf-8" Hi Patricia, There is a webinar being held on June 22nd by NAHQ called ?The New Face of Sepsis: Are you ready for July 1?? You can register for it here: https://na01.safelinks.protection.outlook.com/?url=https%3a%2f%2fnahqevents.webex.com%2fmw3100%2fmywebex%2fdefault.do%3fsiteurl%3dnahqevents%26service%3d6&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=o53qXT9dH8Xj7HxwOOi0L9HB6XsLQqZNmeqOg2jCDuo%3d CMS is also hosting a webinar on June 29th: ?SEP-1 Early Management Bundle, Severe Sepsis/Septic Shock:v5.1 Measure Updates? You may register for the webinar at the following link: https://na01.safelinks.protection.outlook.com/?url=https%3a%2f%2fcc.readytalk.com%2fr%2fl3ukm85hgj4v%26eom&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=ebQpSyq8VZd%2boncuCKZcnLl%2fR25s1zTZQ4GHKrkuan0%3d Dena Videtic RN Quality Indicators Doctors Hospital Coral Gables, FL 786-308-3315 From: Sepsisgroups [mailto:[email protected]] On Behalf Of Dierks, Patricia Sent: Wednesday, June 15, 2016 11:30 AM To: '[email protected]' Subject: [Sepsis Groups] July 1 2016 new CMS regulations All, Any information regarding July 1 changes coming from CMS? Patricia Dierks, MS, RN, CCRN Advanced Practice Partner, ICU/IMCU Department of Professional Practice Delnor Hospital 300 Randall Road Geneva, IL 60134 630-938-8169 office [email protected]<mailto:[email protected]> nm.org<https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2fwww.nm.org%2f&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=qEEXm9VXROskfc9q6w6cMzVGCWfogU8SwalWvEgfzgk%3d> cadencehealth.org<https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2fwww.cadencehealth.org%2f&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=0%2bXtyq6mrMegk%2b%2fLI%2bkLwenI0obEm33sDQz0AXgRHYQ%3d> [NM-Logo-stacked-2090.png]? This message and any included attachments are intended only for the addressee. The information contained in this message is confidential and may constitute proprietary or non-public information under international, federal, or state laws. 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. -------------- next part -------------- An HTML attachment was scrubbed... URL: <https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2flists.sepsisgroups.org%2fpipermail%2fsepsisgroups-sepsisgroups.org%2fattachments%2f20160616%2ff2b71a0a%2fattachment-0001.htm&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=f7QFjxPbZUaxTuUrjzaS5DbO%2fANX47lQ%2b8AEJ0O0BFc%3d> -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 3374 bytes Desc: image001.png URL: <https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2flists.sepsisgroups.org%2fpipermail%2fsepsisgroups-sepsisgroups.org%2fattachments%2f20160616%2ff2b71a0a%2fattachment-0001.png&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=x7sdsyOgk98BVz9OsU8ik4qGUEV2fotb2JuByzkPmCk%3d> ------------------------------ Message: 2 Date: Thu, 16 Jun 2016 11:54:10 -0600 From: Lanna Dimond <[email protected]> To: "[email protected]" <[email protected]> Cc: Sepsisgroups <[email protected]>, "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Response to Augmentin Message-ID: <of68c28796.f07ec9ed-on87257fd4.0061cc99-87257fd4.00625...@iasishealthcare.com> Content-Type: text/plain; charset="us-ascii" Augmentin and Amoxicillin/clavulante has been removed from the Antibiotic Monotherapy beginning with the new Appendix C July 2016. Also removed is Gatifloxacin, no longer on the market. Thank You, Lanna Lanna Dimond RN Jordan Valley Medical Center West Valley Campus Quality / Core Measure Data Analyst Office 801.964.3454 Fax 801.964.3545 [email protected] NOTICE: This email may contain PRIVILEGED and CONFIDENTIAL information and is intended only for the use of the specific individual(s) to which it is addressed. It may contain Protected Health Information that is privileged and confidential. Protected Health Information may be used or disclosed in accordance with law and you may be subject to penalties under law for improper use or further disclosure of the Protected Health Information in this email. If you are not an intended recipient of this email, you are hereby notified that any unauthorized use, dissemination or copying of this email or the information contained in it or attached to it is strictly prohibited. If you have received this email in error, please delete it and immediately notify the person named above by reply email. Thank you. From: phoebe atieno <[email protected]> To: "[email protected]" <[email protected]> Date: 06/14/2016 08:51 AM Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 208, Issue 13 Sent by: "Sepsisgroups" <[email protected]> If CMS only accepts IV antibiotics, why is Augumentin on the list for Monotherapy? Sent from Yahoo Mail on Android On Fri, Jun 10, 2016 at 5:39 PM, [email protected] <[email protected]> wrote: Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3a%2f%2flists.sepsisgroups.org%2flistinfo.cgi%2fsepsisgroups-sepsisgroups.org&data=01%7c01%7cbarnesm4%40sutterhealth.org%7c97c1a16ef1c043ab9f3708d39b6f01b6%7caef453eadaa243e0be62818066e9ff63%7c1&sdata=8xbvBfP8UKM%2bLAoITp6WVD2GXW3GVD3cjwTGvUdUQsU%3d 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. qSOFA (Thompson, Tyra) ---------------------------------------------------------------------- Message: 1 Date: Fri, 10 Jun 2016 17:58:20 +0000 From: "Thompson, Tyra" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] qSOFA Message-ID: <2B4696B884D50A45852EC0101D3C088BDAAA7D3A@hqex2> Content-Type: text/plain; charset="iso-8859-1" Greetings, Have any facilities incorporated the new Sepsis definition and guidelines into their practice and would you be willing to share? What were some of your "first steps" in preparing for your transition? Tyra Thompson, RN Quality Management Specialist Putnam Hospital Center 670 Stoneleigh Avenue l Carmel, NY 10512 l (845)279-5711 Extension 4027 [email protected] [cid:[email protected]] Health Quest has a secure e-mail policy. 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