Hi,

I brought this to the attention of CMS back in the Fall.. perhaps if more 
people brought this forward CMS would change it.. The algorithm is calculated 
in complete contrast to the specifications.... CMS has yet to address this in 
the spec manual..

 Subject

Severe Sepsis - Septic Shock Algorithm



 Discussion Thread

 Response Via Email (Jennifer Witt)

10/17/2016 02:30 PM

For Version 5.1 if the patient did not have an initial lactate level collected 
then the case will fail the measure even if they had receive an IV antibiotic 
in the 24 hours prior to severe sepsis presentation and greater.  We will take 
this to the Measure Steward for consideration in a future version of the manual.

I hope this helps.


 Customer By Web Form (Cynthia Wells)

10/10/2016 12:20 AM

Hi, from the specifications patients with IV Broad Spectrum Abx use >24 hours 
are excluded from the measure set, however with updated Algorithm if the 
Patient Fails the Lactate Element the case automatically goes to a D and Abx 
element does not have to be answered. This is a change from Oct-Jun specs, yet 
still an exclusion. Are these patients supposed to be excluded from the measure 
or is there an error in the algorithm?



Cynthia Wells
Steward Health Care
Director of Clinical Performance Analytics
(508) 404-8647

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of [email protected]
Sent: Tuesday, March 07, 2017 2:44 PM
To: [email protected]; [email protected]
Subject: Re: [Sepsis Groups] Antibiotics >24 prior to presentation of Sepsis

We are seeing the same issue here.  It is causing huge issues for us as well.

         Ashlee Pinkston, RN-BSN, CCRN| Stroke/Sepsis Coordinator
                                                  Terre Haute Regional Hospital
                                                  3901 S. 7th Street
                                                  Terre Haute, In 47802
                                                  (812) 237-9398
                                                  
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From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Pender.Linda
Sent: Friday, March 03, 2017 12:12 PM
To: 
[email protected]<mailto:[email protected]>
Subject: [EXTERNAL] [Sepsis Groups] Antibiotics >24 prior to presentation of 
Sepsis

If a patient is on IV antibiotics for >24 hours prior severe sepsis 
presentation shouldn't they be excluded from the Sep-1 Core Measure? We use 
Comparion to abstract our data. The abstracting tool requires entry of the 
initial collection of the lactic acid before the antibiotics, if the patient 
did not have a lactic acid collected 6 hrs before of 3 hrs after the severe 
sepsis presentation, the pt fails the measure instead of being excluded.
Please let me know what you all think of this. It is truly affecting our 
numbers.

Linda G. Pender RRT-NPS
Sepsis Coordinator
Patient Care Services  Administration
phone: 478-633-6806  pager: 4444
KNOW Sepsis: Inside & Out
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